Department of Cardiology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China.
State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100037, China.
Adv Sci (Weinh). 2024 Jun;11(23):e2306050. doi: 10.1002/advs.202306050. Epub 2024 Mar 27.
COVID-19 can lead to adverse outcomes in patients with pre-existing diseases. Azvudine has been approved for treating COVID-19 in China, but the real-world data is limited. It is aimed to investigate the efficacy of Azvudine in patients with COVID-19 and pre-existing cardiovascular diseases. Patients with confirmed COVID-19 and pre-existing cardiovascular diseases are retrospectively enrolled. The primary outcome is all-cause death during hospitalization. Overall, 351 patients are included, with a median age of 74 years, and 44% are female. 212 (60.6%) patients are severe cases. Azvudine is used in 106 (30.2%) patients and not in 245 (69.8%). 72 patients died during hospitalization. After multivariate adjustment, patients who received Azvudine a lower risk of all-cause death (hazard ratio: 0.431; 95% confidence interval: 0.252-0.738; p = 0.002) than controls. Azvudine therapy is also associated with lower risks of shock and acute kidney injury. For sensitivity analysis in the propensity score-matched cohort (n = 90 for each group), there is also a significant difference in all-cause death between the two groups (hazard ratio: 0.189; 95% confidence interval: 0.071-0.498; p < 0.001). This study indicated that Azvudine therapy is associated with better outcomes in COVID-19 patients with pre-existing cardiovascular diseases.
新型冠状病毒肺炎（COVID-19）可导致合并基础心血管疾病患者发生不良结局。阿兹夫定已在中国获批用于治疗 COVID-19，但真实世界数据有限。本研究旨在评估阿兹夫定治疗合并基础心血管疾病的 COVID-19 患者的疗效。回顾性纳入确诊 COVID-19 且合并基础心血管疾病的患者，主要终点为住院期间全因死亡。共纳入 351 例患者，中位年龄 74 岁，44%为女性，212 例（60.6%）为重症患者。106 例（30.2%）患者使用阿兹夫定，245 例（69.8%）患者未使用阿兹夫定。72 例患者住院期间死亡。多因素调整后，使用阿兹夫定的患者全因死亡风险较低（风险比：0.431；95%置信区间：0.252-0.738；p=0.002）。阿兹夫定治疗与休克和急性肾损伤风险降低相关。在倾向性评分匹配队列的敏感性分析中（每组 n=90），两组间全因死亡也存在显著差异（风险比：0.189；95%置信区间：0.071-0.498；p<0.001）。本研究表明，阿兹夫定治疗可改善合并基础心血管疾病的 COVID-19 患者的结局。
