Zhang Yi, Wang Xinrui, Huang Chong, Yang Hui, Jiang Chunguo, Yu Xiaojia, Hong Jun, Zhang Yi, Wang Yushu, Zhao Rui, An Zhuoling, Tong Zhaohui
Department of Pharmacy, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People's Republic of China.
School of Pharmaceutical Sciences, Capital Medical University, Beijing, People's Republic of China.
Infect Drug Resist. 2024 Apr 8;17:1367-1377. doi: 10.2147/IDR.S445826. eCollection 2024.
The efficacy of nirmatrelvir-ritonavir for hospitalized patients with COVID-19 has not been fully established.
We conducted a retrospective analysis of hospitalized COVID-19 patients with high risk for disease progression at Beijing Chaoyang Hospital from October 15, 2022, to March 31, 2023. Patients ≥18 years old who were hospitalized with COVID-19 within 5 days of symptom onset were included. Baseline data were obtained from the routine electronic health record database of the hospital information system. Outcomes were monitored at 28 days via electronic medical record reviews or telephone interviews.
We identified 1120 patients hospitalized with COVID-19 during the study period. After exclusions, 167 nirmatrelvir-ritonavir users and 132 controls were included. 28-day all-cause mortality rate was 12.0% (20/167) in the nirmatrelvir-ritonavir group, versus 22.7% (30/132) in the control group (unadjusted log-rank p = 0.010; HR = 0.49, 95% confidence interval [CI] = 0.28-0.86, IPTW-adjusted HR = 0.58, 95% CI = 0.40-0.86). The 28-day disease progression rates did not differ between the two groups (unadjusted HR = 0.59, 95% CI = 0.34-1.02, IPTW-adjusted HR = 0.73, 95% CI = 0.50-1.06). Nirmatrelvir-ritonavir significantly reduced all-cause mortality and disease progression within 28 days among patients aged ≥65 years without ≥2 vaccine doses.
We found significantly reduced all-cause mortality in the nirmatrelvir-ritonavir group, particularly in elderly patients who were incompletely vaccinated. Future randomized controlled studies are needed to validate our findings.
奈玛特韦-利托那韦对新冠病毒感染住院患者的疗效尚未完全明确。
我们对2022年10月15日至2023年3月31日在北京朝阳医院住院的、疾病进展风险高的新冠病毒感染患者进行了回顾性分析。纳入症状出现5天内住院的≥18岁新冠病毒感染患者。基线数据来自医院信息系统的常规电子健康记录数据库。通过电子病历审查或电话访谈在28天监测结局。
我们确定了研究期间1120例新冠病毒感染住院患者。排除后，纳入167例奈玛特韦-利托那韦使用者和132例对照。奈玛特韦-利托那韦组28天全因死亡率为12.0%（20/167），而对照组为22.7%（30/132）（未调整对数秩检验p = 0.010；风险比[HR]=0.49，95%置信区间[CI]=0.28 - 0.86，逆概率加权调整HR = 0.58，95% CI = 0.40 - 0.86）。两组28天疾病进展率无差异（未调整HR = 0.
