Hsu Wan-Hsuan, Shiau Bo-Wen, Tsai Ya-Wen, Wu Jheng-Yan, Liu Ting-Hui, Huang Po-Yu, Chuang Min-Hsiang, Lai Chih-Cheng
Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Center of Integrative Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Expert Rev Anti Infect Ther. 2024 Dec;22(12):1229-1237. doi: 10.1080/14787210.2024.2419579. Epub 2024 Oct 20.
To investigate the effectiveness of oral antiviral agents - nirmatrelvir - ritonavir or molnupiravir in non-hospitalized COVID-19 patients aged < 60 years.
This retrospective cohort study analyzed data of patients aged 18-60 years diagnosed with COVID-19 between 1 January 2022, and 30 June 2023. Propensity score matching was used to balance the demographic and clinical characteristics of patients receiving oral antivirals (nirmatrelvir - ritonavir or molnupiravir) and untreated controls. The primary outcome was a composite of all-cause emergency department visits, hospitalizations, or mortality within 30 days. The secondary outcomes included each individual component of the primary composite outcome.
Two matched cohorts (antiviral group and control group) comprising 52,585 patients with balanced baseline characteristics were created using propensity score-matching. During follow-up period, the antiviral group demonstrated a lower risk of the primary outcome than the control group (hazard ratio [HR] 0.772, 95% confidence interval [CI] 0.736-0.808, < 0.001). The antiviral group also exhibited a reduced risk of individual secondary outcomes, including emergency department visits (HR 0.780, 95% CI, 0.738-0.825), hospitalization (HR 0.755, 95% CI, 0.715-0.840), and mortality (HR 0.297, 95% CI, 0.147-0.600).
Oral antiviral agents were associated with lower risks of all-cause emergency department visits, hospitalizations, and mortality in non-hospitalized COVID-19 patients aged < 60 years.
探讨口服抗病毒药物——奈玛特韦-利托那韦或莫努匹拉韦对60岁以下非住院新冠病毒肺炎（COVID-19）患者的疗效。
这项回顾性队列研究分析了2022年1月1日至2023年6月30日期间确诊为COVID-19的18至60岁患者的数据。采用倾向评分匹配法平衡接受口服抗病毒药物（奈玛特韦-利托那韦或莫努匹拉韦）治疗的患者与未治疗对照组的人口统计学和临床特征。主要结局是30天内全因急诊就诊、住院或死亡的复合结局。次要结局包括主要复合结局的各个单独组成部分。
通过倾向评分匹配创建了两个匹配队列（抗病毒治疗组和对照组），共52,585例患者，其基线特征均衡。在随访期间，抗病毒治疗组的主要结局风险低于对照组（风险比[HR]0.772，95%置信区间[CI]0.736 - 0.808，P < 0.001）。抗病毒治疗组的各个次要结局风险也有所降低，包括急诊就诊（HR 0.780，95% CI 0.738 - 0.825）、住院（HR 0.755，95% CI 0.715 - 0.840）和死亡（HR 0.297，95% CI 0.147 - 0.600）。
口服抗病毒药物与60岁以下非住院COVID-19患者全因急诊就诊、住院和死亡风险较低相关。
