Post-acute hospitalization and mortality of nirmatrelvir plus ritonavir for COVID-19 survivors

Hsu, Wan‐Hsuan; Tsai, Ya‐Wen; Wu, Jheng‐Yan; Liu, Ting-Hui; Lai, Chih‐Cheng

doi:10.1016/j.jinf.2023.02.007

Cited by 17 publications

(40 citation statements)

References 5 publications

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“…We created the first cohort of nonhospitalized patients with SUDs who tested positive for SARS‐CoV‐2 infection or who were diagnosed with COVID‐19. The inclusion criteria were as follows: (a) having at least two medical encounters with HCOs from March 1, 2020, to January 1, 2023; (b) being 18 years of age or older; (c) having a positive test result for SARS‐CoV‐2 infection or being diagnosed with COVID‐19, as previously described 29,30 ; and (d) being diagnosed with SUDs. We did not include patients who needed to be hospitalized within 5 days of SARS‐CoV‐2 infection, those who were receiving other medications, such as tixagevimab, cilgavimab, bebtelovimab, bemdesivir, molnupiravir, or remdesivir, or those who had received a convalescent plasma transfusion.…”

Section: Methodsmentioning

confidence: 99%

Clinical effectiveness of nirmatrelvir plus ritonavir in patients with COVID‐19 and substance use disorders based on real‐world data

Liu

Huang

et al. 2023

Journal of Medical Virology

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This study assessed the clinical efficacy of nirmatrelvir plus ritonavir (NMV-r) in treating patients with coronavirus disease-2019 (COVID-19) and substance use disorders (SUDs). This study included two cohorts: the first examined patients with SUDs, with and without a prescription for NMV-r, while the second compared patients prescribed with NMV-r, with and without a diagnosis of SUDs. SUDs were defined using ICD-10 codes, related to SUDs, including alcohol, cannabis, cocaine, opioid, and tobacco use disorders (TUD). Patients with underlying SUDs and COVID-19 were identified using the TriNetX network. We used 1:1 propensity score matching to create balanced groups. The primary outcome of interest was the composite outcome of all-cause hospitalization or death within 30 days. Propensity score matching yielded two matched groups of 10 601 patients each. The results showed that the use of NMV-r was associated with a lower risk of hospitalization or death, 30 days after COVID-19 diagnosis (hazard ratio (HR), 0.640; 95% confidence interval (CI): 0.543-0.754), as well as a lower risk of all-cause hospitalization (HR, 0.699; 95% CI: 0.592-0.826) and all-cause death (HR, 0.084; 95% CI: 0.026-0.273).However, patients with SUDs had a higher risk of hospitalized or death within 30 days of COVID-19 diagnosis than those without SUDs, even with the use of NMV-r (HR, 1.783; 95% CI: 1.399-2.271). The study also found that patients with SUDs had a higher prevalence of comorbidities and adverse socioeconomic determinants of health than those without SUDs. Subgroup analysis showed that the benefits of NMV-r were consistent across most subgroups with different characteristics, including age (patients aged ≥60 years [HR, 0.507; 95% CI: 0.402-0.640]), sex

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Section: Methodsmentioning

confidence: 99%

Clinical effectiveness of nirmatrelvir plus ritonavir in patients with COVID‐19 and substance use disorders based on real‐world data

Liu

Huang

et al. 2023

Journal of Medical Virology

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“…Furthermore, many real‐world studies have demonstrated the clinical benefit of NMV‐r in the treatment of patients with COVID‐19 9–13 . In addition to the positive impacts of NMV‐r on the clinical outcomes of acute COVID‐19, several studies have investigated the association between the use of NMV‐r and long COVID 14–17 . Two retrospective cohort studies 14,15 were conducted using the healthcare databases of the US Department of Veterans Affairs, but their findings were inconsistent.…”

Section: Introductionmentioning

confidence: 99%

“…[9][10][11][12][13] In addition to the positive impacts of NMV-r on the clinical outcomes of acute COVID-19, several studies have investigated the association between the use of NMV-r and long COVID. [14][15][16][17] Two retrospective cohort studies 14,15 were conducted using the healthcare databases of the US Department of Veterans Affairs, but their findings were inconsistent. Xie et al 14 demonstrated that compared with a control group that did not receive NMV-r, a group treated with NMV-r had lower risks of post-acute sequelae of COVID-19, post-acute death, and post-acute hospitalization.…”

mentioning

confidence: 99%

Efficacy of nirmatrelvir and ritonavir for post‐acute COVID‐19 sequelae beyond 3 months of SARS‐CoV‐2 infection

Chuang

Liu

et al. 2023

Journal of Medical Virology

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The effect of nirmatrelvir plus ritonavir (NMV-r) on post-acute COVID-19 sequelae beyond 3 months of SARS-CoV-2 infection remains unknown. This retrospective cohort study utilized data from the TriNetX Research Network. We identified nonhospitalized adult patients with COVID-19 receiving a diagnosis between January 1 and July 31, 2022. Propensity score matching (PSM) was used to create two matched cohorts: NMV-r and non-NMV-r groups, respectively. We measured the primary outcomes using a composite of all-cause emergency room (ER) visits or hospitalization and a composite of post-COVID-19 symptoms according to the WHO Delphi consensus, which also stated that post COVID-19 condition occurs usually 3 months from the onset of COVID-19, during the follow-up period between 90 days after the index diagnosis of COVID-19 and the end of follow-up (180 days).Initially, we identified 12 247 patients that received NMV-r within 5 days of diagnosis and 465 135 that did not. After PSM, 12 245 patients remained in each group. During the follow-up period, patients treated with NMV-r had a lower risk of all-cause hospitalization and ER visits compared with untreated patients (659 vs.

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“…This finding was consistent with our previous study, in which patients receiving nirmatrelvir plus ritonavir could have a lower risk of all-cause hospitalization or mortality (HR, 0.543; 95% CI, 0.495-0.597) 30 to 180 days after a documented COVID-19 diagnosis. 4 Both findings indicated that the novel oral anti-viral agents, including molnupiravir and nirmatrelvir plus ritonavir, are able to provide further clinical benefits for COVID-19 survivors during the post-acute phase. These findings suggested the promising effects of antivirals in the prevention of post-acute COVID-19 complications.…”

mentioning

confidence: 99%

“…This study used the data from the TriNetX Research Network, which provides real-time information of over more than 250 million patients from 120 Healthcare Organizations (HCOs). As previously described, 4 , 5 we identified adult patients who tested positive for SARS-CoV-2 infection or were diagnosed with COVID-19 between March 1, 2020 and June 30, 2022 from the platform on February 16, 2023. To assess the post-acute outcomes, we excluded the patients who died within the first month of COVID-19.…”

mentioning

confidence: 99%

The effect of molnupiravir on post-acute outcome of COVID-19 survivors

Hsu¹,

Shiau²,

Tsai

et al. 2023

Journal of Infection

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Post-acute hospitalization and mortality of nirmatrelvir plus ritonavir for COVID-19 survivors

Cited by 17 publications

References 5 publications

Clinical effectiveness of nirmatrelvir plus ritonavir in patients with COVID‐19 and substance use disorders based on real‐world data

Clinical effectiveness of nirmatrelvir plus ritonavir in patients with COVID‐19 and substance use disorders based on real‐world data

Efficacy of nirmatrelvir and ritonavir for post‐acute COVID‐19 sequelae beyond 3 months of SARS‐CoV‐2 infection

The effect of molnupiravir on post-acute outcome of COVID-19 survivors

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