Hsu Wan-Hsuan, Shiau Bo-Wen, Huang Po-Yu, Tsai Ya-Wen, Wu Jheng-Yan, Liu Ting-Hui, Chuang Min-Hsiang, Tey Shu-Farn, Hung Lun-Wu, Lai Chih-Cheng
Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Preventitve Medicine Division, Chi Mei Medical Center, Tainan, Taiwan.
Pneumonia (Nathan). 2025 May 25;17(1):12. doi: 10.1186/s41479-025-00168-w.
This real-world study aimed to assess the effectiveness of novel oral antiviral agents in managing COVID-19 among high-risk patients during the Omicron JN.1 subvariant wave.
Data from the TriNetX US network were analyzed using a multi-institutional propensity score matching (PSM) analysis. High-risk non-hospitalized adults with COVID-19 were included, and patients receiving oral antiviral agents (study group) were compared to those not receiving antiviral agents (control group). Primary outcomes included all-cause emergency department (ED) visits, hospitalizations, or death within 30 days.
Among 67,495 high-risk patients identified, 17,852 received oral antiviral agents (study group) and 49,643 did not (control group). After PSM, two matched cohorts of 17,847 patients each were established. The study group receiving antiviral agents exhibited a significantly lower risk of primary composite outcome during the 30-day follow-up period compared to the control group (HR, 0.77; 95% CI, 0.72-0.84). Regarding the secondary outcomes, the study group consistently exhibited a significantly lower risk of all-cause ED visits (4.2% vs. 5.4%; HR, 0.78; 95% CI, 0.71-0.86), hospitalization (2.8% vs. 3.3%; HR, 0.86; 95% CI, 0.77-0.97), and mortality (0.1% vs. 0.3%; HR, 0.17; 95% CI, 0.08-0.35) than the control group. Subgroup analyses showed consistent benefits across various demographic and clinical characteristics, except in individuals with booster vaccination.
Oral antiviral agents significantly reduced the risk of adverse outcomes among high-risk COVID-19 patients during the Omicron JN.1 subvariant wave. These findings support the potential benefits of oral antiviral therapy in treating COVID-19, particularly in high-risk populations.
这项真实世界研究旨在评估新型口服抗病毒药物在奥密克戎 JN.1 亚变体流行期间对高危患者管理新冠病毒病（COVID-19）的有效性。
使用多机构倾向评分匹配（PSM）分析对来自 TriNetX 美国网络的数据进行分析。纳入患有 COVID-19 的高危非住院成年人，并将接受口服抗病毒药物的患者（研究组）与未接受抗病毒药物的患者（对照组）进行比较。主要结局包括 30 天内全因急诊就诊、住院或死亡。
在确定的 67495 名高危患者中，17852 名接受了口服抗病毒药物（研究组），49643 名未接受（对照组）。经过 PSM 后，建立了两个各有 17847 名患者的匹配队列。与对照组相比，接受抗病毒药物的研究组在 30 天随访期内出现主要复合结局的风险显著降低（风险比[HR]，0.77；95%置信区间[CI]，0.72 - 0.84）。关于次要结局，研究组全因急诊就诊（4.2%对 5.4%；HR，0.78；95%CI，0.71 - 0.86）、住院（2.8%对 3.3%；HR，0.86；95%CI，0.77 - 0.97）和死亡（0.1%对 0.3%；HR，0.17；95%CI，0.08 - 0.35）的风险始终显著低于对照组。亚组分析显示，除了接种加强针的个体外，在各种人口统计学和临床特征中均有一致的益处。
在奥密克戎 JN.1 亚变体流行期间，口服抗病毒药物显著降低了高危 COVID-19 患者出现不良结局的风险。这些发现支持口服抗病毒治疗在治疗 COVID-19 中的潜在益处，特别是在高危人群中。
