Department of Pharmacy, Affiliated Hospital of Guilin Medical University, Guilin, China.
School of Pharmacy, Guilin Medical University, Guilin, China.
Clinics (Sao Paulo). 2024 Jul 25;79:100406. doi: 10.1016/j.clinsp.2024.100406. eCollection 2024.
Patients with Hematological Malignancies (HM) are at a high risk of mortality from Coronavirus disease 2019 (COVID-19). The available antivirals were different between China and other countries. In China, azvudine was obtained for emergency use to treat adult COVID-19 patients with moderate symptoms in July 2022. While nirmatrelvir-ritonavir was well-known and used in many countries. The purpose of the present study was to assess whether there was any difference in the efficacy and safety of the two drugs.
This study was a prospective observational study of patients with HM who developed COVID-19. Patients were divided into three treatment groups: nirmatrelvir-ritonavir, azvudine, and observation. Treatment outcomes, first nucleic acid test negative time, hospitalization time, and the conversion rate of mild or moderate disease to severe disease were recorded.
First nucleic acid test negative time (23.5 days vs. 34 days, p = 0.015), hospitalization time (p = 0.015), and conversion rate (31.8 % vs. 8 %, p = 0.046) were statistically different between the nirmatrelvir-ritonavir and observation groups. First nucleic acid test negative time (20 days vs. 34 days, p = 0.009) and hospitalization time (p = 0.026) were statistically different between the azvudine and observation groups. ECOG score and liver disease were significantly associated with the conversion rate from mild or moderate disease to severe disease using multivariate analysis (p < 0.05).
The authors found no significant differences existed in outcome measures between patients with HM and COVID-19 who were treated with nirmatrelvir-ritonavir or azvudine.
血液恶性肿瘤（HM）患者因 2019 年冠状病毒病（COVID-19）而死亡的风险很高。可用于治疗 COVID-19 的抗病毒药物在中国和其他国家有所不同。在中国，阿兹夫定于 2022 年 7 月被批准紧急用于治疗中症 COVID-19 成年患者。而奈玛特韦/利托那韦在许多国家已广为人知并被广泛使用。本研究旨在评估这两种药物的疗效和安全性是否存在差异。
本研究是一项前瞻性观察性研究，纳入了 HM 合并 COVID-19 的患者。患者分为三组：奈玛特韦/利托那韦组、阿兹夫定组和观察组。记录治疗结局、首次核酸检测转阴时间、住院时间和轻症或中症向重症的转化率。
奈玛特韦/利托那韦组和观察组的首次核酸检测转阴时间（23.5 天比 34 天，p = 0.015）、住院时间（p = 0.015）和转化率（31.8%比 8%，p = 0.046）存在统计学差异。阿兹夫定组和观察组的首次核酸检测转阴时间（20 天比 34 天，p = 0.009）和住院时间（p = 0.026）存在统计学差异。多因素分析显示，ECOG 评分和肝病与轻症或中症向重症的转化率显著相关（p < 0.05）。
作者发现 HM 合并 COVID-19 患者接受奈玛特韦/利托那韦或阿兹夫定治疗的结局指标无显著差异。
