Associations of nirmatrelvir-ritonavir treatment with death and clinical improvement in hospitalized patients with COVID-19 during the Omicron wave in Beijing, China : a multicentre, retrospective cohort study
BACKGROUND: The effectiveness of nirmatrelvir-ritonavir has mainly been shown in non-hospitalized patients with mild-to-moderate coronavirus disease 2019 (COVID-19). The real-world effectiveness of nirmatrelvir-ritonavir urgently needs to be determined using representative in-hospital patients with COVID-19 during the Omicron wave of the pandemic.
METHODS: We performed a multicentre, retrospective study in five Chinese PLA General Hospital medical centers in Beijing, China. Patients hospitalized with COVID-19 from 10 December 2022 to 20 February 2023 were eligible for inclusion. A 1:1 propensity score matching was performed between the nirmatrelvir-ritonavir group and the control group.
RESULTS: 1010 recipients of nirmatrelvir-ritonavir and 1010 matched controls were finally analyzed after matching. Compared with matched controls, the nirmatrelvir-ritonavir group had a lower incidence rate of all-cause death (4.6/1000 vs. 6.3/1000 person-days, p = 0.013) and a higher incidence rate of clinical improvement (47.6/1000 vs. 45.8/1000 person-days, p = 0.012). Nirmatrelvir-ritonavir was associated with a 22% lower all-cause mortality and a 14% higher incidence of clinical improvement. Initiation of nirmatrelvir-ritonavir within 5 days after symptom onset was associated with a 50% lower mortality and a 26% higher clinical improvement rate. By contrast, no significant associations were identified among patients receiving nirmatrelvir-ritonavir treatment more than 5 days after symptom onset. Nirmatrelvir-ritonavir was also associated with a 50% increase in survival days and a 12% decrease in days to clinical improvement.
CONCLUSION: Among hospitalized patients with COVID-19 during the Omicron wave in Beijing, China, the early initiation of nirmatrelvir-ritonavir was associated with clinical benefits of lowering mortality and improving clinical recovery.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:56 |
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| Enthalten in: |
Annals of medicine - 56(2024), 1 vom: 13. Feb., Seite 2313062 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Han, Xiaobo [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 16.02.2024 Date Revised 22.02.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1080/07853890.2024.2313062 |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM368447944 |
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| 100 | 1 | |a Han, Xiaobo |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Associations of nirmatrelvir-ritonavir treatment with death and clinical improvement in hospitalized patients with COVID-19 during the Omicron wave in Beijing, China |b a multicentre, retrospective cohort study |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Completed 16.02.2024 | ||
| 500 | |a Date Revised 22.02.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: The effectiveness of nirmatrelvir-ritonavir has mainly been shown in non-hospitalized patients with mild-to-moderate coronavirus disease 2019 (COVID-19). The real-world effectiveness of nirmatrelvir-ritonavir urgently needs to be determined using representative in-hospital patients with COVID-19 during the Omicron wave of the pandemic | ||
| 520 | |a METHODS: We performed a multicentre, retrospective study in five Chinese PLA General Hospital medical centers in Beijing, China. Patients hospitalized with COVID-19 from 10 December 2022 to 20 February 2023 were eligible for inclusion. A 1:1 propensity score matching was performed between the nirmatrelvir-ritonavir group and the control group | ||
| 520 | |a RESULTS: 1010 recipients of nirmatrelvir-ritonavir and 1010 matched controls were finally analyzed after matching. Compared with matched controls, the nirmatrelvir-ritonavir group had a lower incidence rate of all-cause death (4.6/1000 vs. 6.3/1000 person-days, p = 0.013) and a higher incidence rate of clinical improvement (47.6/1000 vs. 45.8/1000 person-days, p = 0.012). Nirmatrelvir-ritonavir was associated with a 22% lower all-cause mortality and a 14% higher incidence of clinical improvement. Initiation of nirmatrelvir-ritonavir within 5 days after symptom onset was associated with a 50% lower mortality and a 26% higher clinical improvement rate. By contrast, no significant associations were identified among patients receiving nirmatrelvir-ritonavir treatment more than 5 days after symptom onset. Nirmatrelvir-ritonavir was also associated with a 50% increase in survival days and a 12% decrease in days to clinical improvement | ||
| 520 | |a CONCLUSION: Among hospitalized patients with COVID-19 during the Omicron wave in Beijing, China, the early initiation of nirmatrelvir-ritonavir was associated with clinical benefits of lowering mortality and improving clinical recovery | ||
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Covid-19 | |
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| 700 | 1 | |a Li, Chenglong |e verfasserin |4 aut | |
| 700 | 1 | |a Yuan, Xin |e verfasserin |4 aut | |
| 700 | 1 | |a Cui, Junchang |e verfasserin |4 aut | |
| 700 | 1 | |a Han, Zhihai |e verfasserin |4 aut | |
| 700 | 1 | |a Meng, Jiguang |e verfasserin |4 aut | |
| 700 | 1 | |a Zhao, Weiguo |e verfasserin |4 aut | |
| 700 | 1 | |a Xie, Fei |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Kaifei |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Yuhong |e verfasserin |4 aut | |
| 700 | 1 | |a Muo, Guoxin |e verfasserin |4 aut | |
| 700 | 1 | |a Xi, Na |e verfasserin |4 aut | |
| 700 | 1 | |a Zheng, Mengli |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Rentao |e verfasserin |4 aut | |
| 700 | 1 | |a Xiao, Kun |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Wei |e verfasserin |4 aut | |
| 700 | 1 | |a Xiong, Junchen |e verfasserin |4 aut | |
| 700 | 1 | |a Zhao, Dahui |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Xinxin |e verfasserin |4 aut | |
| 700 | 1 | |a Han, Xinjie |e verfasserin |4 aut | |
| 700 | 1 | |a Cheng, Haibo |e verfasserin |4 aut | |
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| 700 | 1 | |a Shi, Yinghan |e verfasserin |4 aut | |
| 700 | 1 | |a Xie, Wuxiang |e verfasserin |4 aut | |
| 700 | 1 | |a Xie, Lixin |e verfasserin |4 aut | |
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