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Nirmatrelvir and ritonavir combination against COVID-19 caused by omicron BA.2.2 in the elderly: A single-center
Can Chen1, Ranyi Li1, Shuliang Xing2
1Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai, China.
Background:
Since coronavirus 2019 (COVID-19) swept the world, a variety of novel therapeutic and prevention strategies have been developed, among which nirmatrelvir-ritonavir is highly recommended. We intended to assess the effectiveness and safety of nirmatrelvir-ritonavir in the elderly mild-to-moderate COVID-19 population caused by the omicron BA.2.2 variant in real-world settings.
Methods:
An observational study was conducted retrospectively to review the outcomes of mild-to-moderate COVID-19 patients admitted between April 26 and June 30, 2022. Patients' baseline characteristics were collected and assessed. Participants in the intervention group were administered nirmatrelvir-ritonavir in addition to standard care, whereas those in the control group only received standard care. The primary outcome was the duration between the initial positive reverse-transcription polymerase chain reaction (RT-PCR) test and the subsequent conversion to a negative result.
Results:
The analysis included 324 patients who were administered nirmatrelvir-ritonavir and an equal number of control patients. The patient characteristics in both groups were evenly matched. The average duration from the initial positive RT-PCR to negative conversion was similar in both groups (16.2 ± 5.0 vs. 16.1 ± 6.3 days, p = .83). Control patients exhibited slower conversion in comparison to patients who received nirmatrelvir-ritonavir treatment within 10 days of symptom onset.
Conclusions:
These findings suggest that administering nirmatrelvir-ritonavir within 10 days of symptom onset could potentially reduce the time it takes for SARS-CoV-2-infected patients to negative RT-PCR results, thereby expanding the current usage guidelines for nirmatrelvir-ritonavir.
Insights
Nirmatrelvir-ritonavir did not significantly shorten viral clearance time in elderly COVID-19 patients. However, early treatment within 10 days of symptom onset may accelerate negative RT-PCR results.
Area of Science:
- Infectious Diseases
- Virology
- Geriatric Medicine
Background:
- The COVID-19 pandemic spurred development of new therapeutics, including nirmatrelvir-ritonavir.
- Real-world effectiveness of nirmatrelvir-ritonavir in elderly patients with the Omicron BA.2.2 variant requires assessment.
Purpose of the Study:
- To evaluate the effectiveness and safety of nirmatrelvir-ritonavir in elderly patients with mild-to-moderate COVID-19.
- To determine the impact of nirmatrelvir-ritonavir on viral clearance time in this population.
Main Methods:
- Retrospective observational study of mild-to-moderate COVID-19 patients (April-June 2022).
- Comparison of patients receiving nirmatrelvir-ritonavir plus standard care versus standard care alone.
- Primary outcome: time from positive RT-PCR to negative RT-PCR conversion.
Main Results:
- 324 patients in each group (nirmatrelvir-ritonavir vs. control), with matched characteristics.
- No significant difference in average time to negative RT-PCR between groups (16.2 ± 5.0 vs. 16.1 ± 6.3 days).
- Patients treated within 10 days of symptom onset showed faster conversion compared to controls.
Conclusions:
- Nirmatrelvir-ritonavir did not significantly shorten viral clearance time in the overall elderly study population.
- Early administration (within 10 days of symptom onset) may accelerate SARS-CoV-2 RT-PCR negativity.
- Findings suggest potential expansion of current nirmatrelvir-ritonavir usage guidelines.
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