Bhargava Ashish, Szpunar Susan, Sharma Mamta, Saravolatz Louis
Department of Medicine, Thomas Mackey Center for Infectious Disease Research, Henry Ford St. John Hospital, 19251 Mack Avenue, Suite 340, Grosse Pointe Woods, MI 48236, USA.
Viruses. 2025 May 29;17(6):782. doi: 10.3390/v17060782.
Nirmatrelvir plus ritonavir (NPR) has been approved for treating mild to moderate COVID-19 in high-risk adults but concerns about rebound effects have limited its use. This study aimed to identify individuals at risk of seeking medical care among high-risk non-hospitalized patients treated with NPR from 1 January 2022 to 31 December 2022, at our institution. Our outcome variable was the composite of subsequent evaluation in the Emergency Department or inpatient admission within four weeks of their NPR treatment. Of 369 patients who received NPR treatment, the mean (SD) age was 59.3 (±13.8) years; 64% (236) were female, and 77.7% (281) were white. The incidence of the composite event was 6.8% (25/369). In multivariable logistic regression, factors for seeking medical care following NPR treatment were female sex (OR 4.6; 95% CI 1.4-15.3; = 0.013), myocardial infarction (OR 4.1; 95% CI 1.4-11.8; = 0.011), chronic lung disease (CLD) except asthma and chronic obstructive pulmonary disease (COPD) (OR = 3.9, 95% CI 1.1-13.5; = 0.03), and diabetes mellitus with complications (OR 6.9; 95% CI 2.0-23.3; = 0.002) while alcohol users (OR 0.39; 95% CI 0.2-0.9; = 0.038) were less likely to seek medical care. Larger cohorts are necessary to further assess and confirm these risk factors.
奈玛特韦片/利托那韦片组合包装（NPR）已被批准用于治疗高危成人的轻至中度新冠肺炎，但对反弹效应的担忧限制了其使用。本研究旨在确定2022年1月1日至2022年12月31日在我们机构接受NPR治疗的高危非住院患者中可能寻求医疗护理的个体。我们的结局变量是在接受NPR治疗后四周内急诊复诊或住院的综合情况。在369例接受NPR治疗的患者中，平均（标准差）年龄为59.3（±13.8）岁；64%（236例）为女性，77.7%（281例）为白人。综合事件的发生率为6.8%（25/369）。在多变量逻辑回归分析中，NPR治疗后寻求医疗护理的因素包括女性（比值比4.6；95%置信区间1.4 - 15.3；P = 0.013）、心肌梗死（比值比4.1；95%置信区间1.4 - 11.8；P = 0.011）、除哮喘和慢性阻塞性肺疾病（COPD）外的慢性肺病（CLD）（比值比 = 3.9，95%置信区间1.1 - 13.5；P = 0.03）以及伴有并发症的糖尿病（比值比6.9；95%置信区间2.0 - 23.3；P = 0.002），而饮酒者寻求医疗护理的可能性较小（比值比0.39；95%置信区间0.2 - 0.9；P = 0.038）。需要更大的队列来进一步评估和确认这些风险因素。
