Azvudine and nirmatrelvir-ritonavir in hospitalized patients with moderate-to-severe COVID-19 : Emulation of a randomized target trial
© 2023 The Authors. Journal of Medical Virology published by Wiley Periodicals LLC..
To examine the effectiveness of azvudine and nirmatrelvir-ritonavir in treating hospitalized patients with moderate-to-severe COVID-19. We emulated a target trial with a multicenter retrospective cohort of hospitalized adults with moderate-to-severe COVID-19 without contraindications for azvudine or nirmatrelvir-ritonavir between December 01, 2022 and January 19, 2023 (during the Omicron BA.5.2 variant wave). Exposures included treatment with azvudine or nirmatrelvir-ritonavir for 5 days versus no antiviral treatment during hospitalization. Primary composite outcome (all-cause death and initiation of invasive mechanical ventilation), and their separate events were evaluated. Of the 1154 patients, 27.2% were severe cases. In the intent-to-treat analyses, azvudine reduced all-cause death (Hazard ratio [HR]: 0.31; 95% CI: 0.12-0.78), and its composite with invasive mechanical ventilation (HR: 0.47; 95% CI: 0.24-0.92). Nirmatrelvir-ritonavir reduced invasive mechanical ventilation (HR: 0.42; 95% CI: 0.17-1.05), and its composite with all-cause death (HR: 0.38; 95% CI: 0.18-0.81). The study did not identify credible subgroup effects. The per-protocol analyses and all sensitivity analyses confirmed the robustness of the findings. Both azvudine and nirmatrelvir-ritonavir improved the prognosis of hospitalized adults with moderate-to-severe COVID-19.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:95 |
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| Enthalten in: |
Journal of medical virology - 95(2023), 12 vom: 19. Dez., Seite e29318 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Zhou, Yiling [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 20.12.2023 Date Revised 10.01.2024 published: Print Citation Status MEDLINE |
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| doi: |
10.1002/jmv.29318 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM366028049 |
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| 245 | 1 | 0 | |a Azvudine and nirmatrelvir-ritonavir in hospitalized patients with moderate-to-severe COVID-19 |b Emulation of a randomized target trial |
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| 520 | |a © 2023 The Authors. Journal of Medical Virology published by Wiley Periodicals LLC. | ||
| 520 | |a To examine the effectiveness of azvudine and nirmatrelvir-ritonavir in treating hospitalized patients with moderate-to-severe COVID-19. We emulated a target trial with a multicenter retrospective cohort of hospitalized adults with moderate-to-severe COVID-19 without contraindications for azvudine or nirmatrelvir-ritonavir between December 01, 2022 and January 19, 2023 (during the Omicron BA.5.2 variant wave). Exposures included treatment with azvudine or nirmatrelvir-ritonavir for 5 days versus no antiviral treatment during hospitalization. Primary composite outcome (all-cause death and initiation of invasive mechanical ventilation), and their separate events were evaluated. Of the 1154 patients, 27.2% were severe cases. In the intent-to-treat analyses, azvudine reduced all-cause death (Hazard ratio [HR]: 0.31; 95% CI: 0.12-0.78), and its composite with invasive mechanical ventilation (HR: 0.47; 95% CI: 0.24-0.92). Nirmatrelvir-ritonavir reduced invasive mechanical ventilation (HR: 0.42; 95% CI: 0.17-1.05), and its composite with all-cause death (HR: 0.38; 95% CI: 0.18-0.81). The study did not identify credible subgroup effects. The per-protocol analyses and all sensitivity analyses confirmed the robustness of the findings. Both azvudine and nirmatrelvir-ritonavir improved the prognosis of hospitalized adults with moderate-to-severe COVID-19 | ||
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| 700 | 1 | |a Jiang, Li |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Renqing |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Huohuo |e verfasserin |4 aut | |
| 700 | 1 | |a Shi, Qingyang |e verfasserin |4 aut | |
| 700 | 1 | |a Yang, Zhirong |e verfasserin |4 aut | |
| 700 | 1 | |a Mao, Yi |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Sha |e verfasserin |4 aut | |
| 700 | 1 | |a Yang, Zhibo |e verfasserin |4 aut | |
| 700 | 1 | |a Ding, Jialin |e verfasserin |4 aut | |
| 700 | 1 | |a Zhou, Yongzhao |e verfasserin |4 aut | |
| 700 | 1 | |a Ren, Bi |e verfasserin |4 aut | |
| 700 | 1 | |a He, Liping |e verfasserin |4 aut | |
| 700 | 1 | |a Zhao, Xing |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Weimin |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Sheyu |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Dan |e verfasserin |4 aut | |
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