Department of Critical Care Medicine of the First Affiliated Hospital of Harbin Medical University, Hei Longjiang, China.
First Affiliated Hospital of Harbin Medical University, Hei Longjiang, China.
J Infect Public Health. 2024 Dec;17(12):102583. doi: 10.1016/j.jiph.2024.102583. Epub 2024 Oct 31.
COVID-19 pneumonia has spread across China and globally since late 2019, becoming a pandemic. Its extremely contagious nature as well as high morbidity and mortality rates have attracted widespread attention globally. For the treatment of SARS-CoV-2 pneumonia, two commonly used antiviral drugs in the clinic are nirmatrelvir/ritonavir(Paxlovid) and Azvudine, while the therapeutic efficacy of the two drugs and their impact on patient prognosis remain inconclusive. Therefore, the aim of this study is to investigate the effects of two antiviral drugs, Azvudine and Paxlovid, on the disease development and prognosis of patients with COVID-19.
This study collected and analyzed in Inner Mongolia hospital treated 267 cases of COVID - 19 patients. According to the use of antiviral medications, the participants in this experiment were split into the Azvudine and Paxlovid groups. The effectiveness of the medications was evaluated using the length of hospitalization, Nucleic acid into negative time for the first time, and laboratory indices such as total protein, lymphocytes, leukocytes, albumin, creatinine, and platelets.
Compared with the Azvudine group, patients in the Paxlovid group had a shorter recovery time, a higher degree of rise in lymphocytes, a faster recovery of the immune system, a lower rise in creatinine, and a lesser renal burden, but patients in the Paxlovid group had a greater decrease in total protein.
In assessing patient conditions for treatment selection, Paxlovid may be preferable for individuals with renal insufficiency or those exhibiting compromised immune responses. Conversely, for patients experiencing malnutrition or cirrhotic hypoproteinemia, Azvudine could be considered to mitigate the reduction in protein levels.
自 2019 年底以来，COVID-19 肺炎已在中国和全球范围内传播，成为一种大流行。其极高的传染性以及高发病率和死亡率引起了全球的广泛关注。对于 SARS-CoV-2 肺炎的治疗，临床上常用的两种抗病毒药物是奈玛特韦/利托那韦（Paxlovid）和阿兹夫定，而这两种药物的治疗效果及其对患者预后的影响仍存在争议。因此，本研究旨在探讨两种抗病毒药物，阿兹夫定和 Paxlovid，对 COVID-19 患者疾病发展和预后的影响。
本研究收集并分析了内蒙古医院治疗的 267 例 COVID-19 患者。根据抗病毒药物的使用情况，将参与者分为阿兹夫定组和 Paxlovid 组。通过住院时间、首次核酸转阴时间以及总蛋白、淋巴细胞、白细胞、白蛋白、肌酐和血小板等实验室指标评估药物的疗效。
与阿兹夫定组相比，Paxlovid 组患者的恢复时间更短，淋巴细胞升高程度更高，免疫系统恢复更快，肌酐升高程度更低，肾脏负担更小，但 Paxlovid 组患者总蛋白下降幅度更大。
在评估患者病情以选择治疗方案时，对于肾功能不全或免疫反应受损的患者，Paxlovid 可能更优；对于存在营养不良或肝硬化低蛋白血症的患者，可考虑使用阿兹夫定以减轻蛋白水平降低的情况。
