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Retrovirus Life Cycles01:10

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Quantitative Structure-Activity Relationship, Activity Prediction, and Molecular Dynamics of Non-nucleotide Reverse Transcriptase Inhibitors
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Nirmatrelvir/ritonavir prescription and the risk of hospitalization and death in COVID-19 outpatients.

H R Vargas-Sánchez1, J C Tomás-López1, E Guzmán-Medina1

  • 1Coordinación de Unidades de Primer Nivel de Atención, Instituto Mexicano del Seguro Social, Mexico City, Mexico.

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Nirmatrelvir/ritonavir significantly reduced COVID-19 hospitalization and death risk in outpatients. This antiviral treatment demonstrated a 48% risk reduction for severe outcomes within 60 days.

Keywords:
Atención Primaria a la SaludCOVID-19Combinación de fármacosDeathDrug combinationHospitalizaciónHospitalizationMuertePrimary health careSARS-CoV-2

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Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Public Health

Background:

  • COVID-19 remains a significant global health concern, necessitating effective outpatient treatment strategies.
  • Nirmatrelvir/ritonavir is an oral antiviral medication approved for treating COVID-19 in high-risk individuals.
  • Evaluating real-world effectiveness of nirmatrelvir/ritonavir is crucial for optimizing patient care.

Purpose of the Study:

  • To assess the impact of nirmatrelvir/ritonavir prescription on hospitalization and mortality rates in ambulatory COVID-19 patients.
  • To compare outcomes between patients who received and did not receive nirmatrelvir/ritonavir.

Main Methods:

  • A comparative study analyzed data from 83,348 ambulatory patients with confirmed SARS-CoV-2 infection.
  • The study included patients aged 18 and above from September 2022 to September 2023.
  • A multivariate Poisson regression model compared 60-day hospitalization and all-cause death risks between treated and untreated groups.

Main Results:

  • Patients receiving nirmatrelvir/ritonavir had a combined 60-day incidence of hospitalization and death of 0.13%, compared to 0.26% in the untreated group.
  • Adjusted analysis revealed that nirmatrelvir/ritonavir prescription was associated with a 52% reduction in the risk of hospitalization and death (aRR 0.52; 95% CI: 0.36-0.75).
  • This risk reduction remained significant after adjusting for age, sex, and comorbidities like CKD, COPD, and cardiovascular disease.

Conclusions:

  • Prescription of nirmatrelvir/ritonavir is linked to a reduced risk of 60-day COVID-19 related hospitalization and death in outpatients.
  • The findings support the use of nirmatrelvir/ritonavir as an effective intervention for preventing severe outcomes in ambulatory COVID-19 patients.
  • Real-world data reinforces the clinical benefit of nirmatrelvir/ritonavir in managing COVID-19 in non-hospitalized individuals.