Jia Bohan, Sun Junyi, Zhu Di, Wang Ling, Hu Xiaobo, Wang Haiyu, Qian Guowu, Zhang Donghua, Li Silin, Luo Hong, Zhang Shixi, Li Guotao, Li Guangming, Liang Hongxia, Yu Zujiang, Ren Zhigang
Department of Infectious Diseases, State Key Laboratory of Antiviral Drugs, Pingyuan Laboratory, The First Affiliated Hospital of Zhengzhou University, #1 Jianshe East Road, Zhengzhou, 450052, China.
Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
Sci Rep. 2025 Mar 31;15(1):11022. doi: 10.1038/s41598-025-85677-w.
Cancer significantly contributes to the unfavorable prognosis of coronavirus disease 2019 (COVID-19) patients. The efficacy and safety of azvudine and nirmatrelvir/ritonavir (Paxlovid) in cancer patients with COVID-19 remain uncertain. Therefore, we designed a comprehensive retrospective study encompassing clinical data of 32,864 hospitalized COVID-19 patients, 691 of whom were cancer patients treated with azvudine and 200 were cancer patients treated with Paxlovid. After 2:1 propensity score matching, 397 patients in the azvudine group and 199 patients in the Paxlovid group were enrolled. Cox regression analysis revealed the risk of all-cause death (HR: 1.84, 95% CI: 1.059-3.182, P = 0.030) and composite disease progression (HR: 1.70, 95% CI: 1.043-2.757, P = 0.033) were greater in the Paxlovid group than in the azvudine group. Two sensitivity analyses confirmed the robustness of our findings. The safety analysis of adverse events revealed no statistically significant differences between the two groups. In conclusion, we carried out the first analysis to compare the efficacy and safety of azvudine and Paxlovid in cancer patients with COVID-19 and demonstrated that azvudine significantly reduced the risk of all-cause death and composite disease progression among cancer patients with COVID-19 compared with Paxlovid.
癌症对2019冠状病毒病（COVID-19）患者的不良预后有显著影响。阿兹夫定和奈玛特韦/利托那韦（帕罗韦德）在COVID-19癌症患者中的疗效和安全性仍不确定。因此，我们设计了一项全面的回顾性研究，纳入了32864例住院COVID-19患者的临床数据，其中691例为接受阿兹夫定治疗的癌症患者，200例为接受帕罗韦德治疗的癌症患者。经过2:1倾向评分匹配后，阿兹夫定组纳入397例患者，帕罗韦德组纳入199例患者。Cox回归分析显示，帕罗韦德组全因死亡风险（HR：1.84，95%CI：1.059-3.182，P = 0.030）和综合疾病进展风险（HR：1.70，95%CI：1.043-2.757，P = 0.033）高于阿兹夫定组。两项敏感性分析证实了我们研究结果的稳健性。不良事件安全性分析显示两组之间无统计学显著差异。总之，我们首次分析比较了阿兹夫定和帕罗韦德在COVID-19癌症患者中的疗效和安全性，结果表明，与帕罗韦德相比，阿兹夫定显著降低了COVID-19癌症患者的全因死亡风险和综合疾病进展风险。
