Nirmatrelvir plus ritonavir reduces COVID-19 hospitalization and prevents long COVID in adult outpatients.
Ritonavir
/ therapeutic use
Humans
Female
Male
Middle Aged
COVID-19 Drug Treatment
Hospitalization
/ statistics & numerical data
Retrospective Studies
Adult
SARS-CoV-2
/ drug effects
COVID-19
/ epidemiology
Aged
Leucine
/ therapeutic use
Antiviral Agents
/ therapeutic use
Outpatients
Drug Therapy, Combination
Proline
/ analogs & derivatives
Lactams
Nitriles
COVID-19
Hospitalization
Long COVID
Nirmatrelvir–ritonavir
Omicron variant
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
29 10 2024
29 10 2024
Historique:
received:
25
01
2024
accepted:
14
10
2024
medline:
30
10
2024
pubmed:
30
10
2024
entrez:
30
10
2024
Statut:
epublish
Résumé
Nirmatrelvir plus ritonavir received Emergency Use Authorization for treating mild to moderate COVID-19 in high-risk patients. Its efficacy against the Omicron variant of SARS-CoV-2 remains uncertain. This retrospective cohort study assessed the effect of nirmatrelvir-ritonavir in preventing severe disease progression and long COVID symptoms after acute COVID-19 in non-hospitalized adults. SALAMA medical records from Dubai's COVID-19 healthcare centers between May 22, 2022, and April 30, 2023, were used to identify 7290 eligible patients, 9.6% of whom received nirmatrelvir-ritonavir. Treatment was associated with a notable reduction in COVID-19-related hospitalizations (adjusted hazard ratio [HR] of 0.39; 95% CI, 0.18-0.85) by day 28 of symptom onset. Moreover, nirmatrelvir-ritonavir was associated with fewer long COVID symptoms (adjusted HR of 0.42; 95% CI, 0.19-0.95). This suggests the significant effectiveness of nirmatrelvir-ritonavir against the Omicron variant, reducing both severe and long-term COVID-19 symptoms.
Identifiants
pubmed: 39472619
doi: 10.1038/s41598-024-76472-0
pii: 10.1038/s41598-024-76472-0
doi:
Substances chimiques
Ritonavir
O3J8G9O825
nirmatrelvir
7R9A5P7H32
Leucine
GMW67QNF9C
Antiviral Agents
0
Proline
9DLQ4CIU6V
Lactams
0
Nitriles
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
25901Informations de copyright
© 2024. The Author(s).
Références
http://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care/underlyingconditions.html , A.J., 2023.
Sanyaolu, A. et al. Comorbidity and its impact on patients with COVID-19. SN Compr. Clin. Med. 2, 1069–1076 (2020).
doi: 10.1007/s42399-020-00363-4
pubmed: 32838147
pmcid: 7314621
Subramanian, A. et al. Symptoms and risk factors for long COVID in non-hospitalized adults. Nat. Med. 28, 1706–1714 (2022).
doi: 10.1038/s41591-022-01909-w
pubmed: 35879616
pmcid: 9388369
US Food and Drug Administration. Emergency use authorization 105. (2021). https://www.fda.gov/media/155049/download . Accessed 12 December 2022.
https://www.covid19treatmentguidelines.nih.gov/tables/management-of-nonhospitalized-adults-summary/ . Accessed Janauary 6.
Jayk Bernal, A. et al. Molnupiravir for oral treatment of Covid-19 in nonhospitalized patients. N. Engl. J. Med. 386, 509–520 (2021).
doi: 10.1056/NEJMoa2116044
pubmed: 34914868
Owen, D. R. et al. An oral SARS-CoV-2 Mpro inhibitor clinical candidate for the treatment of COVID-19. Science. 374, 1586–1593 (2021).
doi: 10.1126/science.abl4784
pubmed: 34726479
Sevrioukova, I. F. & Poulos, T. L. Structure and mechanism of the complex between cytochrome P4503A4 and ritonavir. Proc. Natl. Acad. Sci. 107, 18422–18427 (2010).
doi: 10.1073/pnas.1010693107
pubmed: 20937904
pmcid: 2973003
Munblit, D. et al. Long COVID: aiming for a consensus. Lancet Respirat. Med. 10, 632–634 (2022).
doi: 10.1016/S2213-2600(22)00135-7
Groff, D. et al. Short-term and long-term rates of Postacute Sequelae of SARS-CoV-2 infection: a systematic review. JAMA Netw. Open. 4, e2128568–e2128568 (2021).
doi: 10.1001/jamanetworkopen.2021.28568
pubmed: 34643720
pmcid: 8515212
Whitaker, M. et al. Persistent COVID-19 symptoms in a community study of 606,434 people in England. Nat. Commun. 13, 1957 (2022).
doi: 10.1038/s41467-022-29521-z
pubmed: 35413949
pmcid: 9005552
Su, Y. et al. Multiple early factors anticipate post-acute COVID-19 sequelae. Cell. 185, 881–895e820 (2022).
doi: 10.1016/j.cell.2022.01.014
pubmed: 35216672
pmcid: 8786632
Al-Aly, Z., Bowe, B. & Xie, Y. Long COVID after breakthrough SARS-CoV-2 infection. Nat. Med. 28, 1461–1467 (2022).
doi: 10.1038/s41591-022-01840-0
pubmed: 35614233
pmcid: 9307472
Kim, H. et al. Can nirmatrelvir/ritonavir treatment shorten the duration of COVID-19 isolation? Front. Med. 9 (2022).
Ganatra, S. et al. Oral nirmatrelvir and ritonavir in nonhospitalized vaccinated patients with coronavirus disease 2019 (COVID-19). Clin. Infect. Dis. ciac673 (2022).
Najjar-Debbiny, R. et al. Effectiveness of paxlovid in reducing severe coronavirus disease 2019 and mortality in high-risk patients. Clin. Infect. Dis. ciac443 (2022).
Congdon, S. et al. Nirmatrelvir/ritonavir and risk of long COVID symptoms: A retrospective cohort study. Sci. Rep. 13, 19688 (2023).
doi: 10.1038/s41598-023-46912-4
pubmed: 37951998
pmcid: 10640584
Xie, Y., Choi, T. & Al-Aly, Z. Association of Treatment with Nirmatrelvir and the risk of Post–COVID-19 Condition. JAMA Int. Med. 183, 554–564 (2023).
doi: 10.1001/jamainternmed.2023.0743
pubmed: 36951829
pmcid: 10037200
Dubai Health Authority. https://www.dha.gov.ae/en/media/news/762 . Accessed 10/12/2023.
Dubai Health Authority. https://services.dha.gov.ae/sheryan/wps/portal/home/circular-details?circularRefNo=CIR-2021-00000039&isPublicCircular=1&fromHome=true . Accessed 1/02/2022.
Dubai Health Authority. https://www.dha.gov.ae/uploads/112021/ef299be5-9980-4389-9a31-80df9eb069fc.pdf , Accessed: 1/02/2022.
Sharif-Askari, S. Risk factors and early preventive measures for long COVID in non-hospitalized patients: Analysis of a large cohort in the United Arab Emirates. Public. Health. 230, 198–206 (2024).
doi: 10.1016/j.puhe.2024.02.031
Davis, H. E. et al. Characterizing long COVID in an international cohort: 7 months of symptoms and their impact. eClinicalMedicine 38 (2021).
Aggarwal, N. R. et al. Real-world use of nirmatrelvir–ritonavir in outpatients with COVID-19 during the era of omicron variants including BA.4 and BA.5 in Colorado, USA: A retrospective cohort study. Lancet. Infect. Dis. 23, 696–705 (2023).
Schwartz, K. L. et al. Population-based evaluation of the effectiveness of nirmatrelvir–ritonavir for reducing hospital admissions and mortality from COVID-19. Can. Med. Assoc. J. 195, E220 (2023).
doi: 10.1503/cmaj.221608
Imai, M. et al. Efficacy of antiviral agents against Omicron subvariants BQ.1.1 and XBB. N. Engl. J. Med. 388, 89–91 (2023).
doi: 10.1056/NEJMc2214302
pubmed: 36476720
Yang, C., Zhao, H., Espín, E. & Tebbutt, S. J. Association of SARS-CoV-2 infection and persistence with long COVID. Lancet Respirat. Med. 11, 504–506 (2023).
doi: 10.1016/S2213-2600(23)00142-X