Ensitrelvir in hospitalized patients with COVID-19 who were moderately to severely immunocompromised: a single-center

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Masaya Yamato1, Masahiro Kinoshita2, Yuki Yoshida3

  • 1Department of General Internal Medicine and Infectious Diseases, Rinku General Medical Center, Izumisano, Japan.

Therapeutic Advances in Infectious Disease
|August 6, 2026
PubMed

Insights

Ensitrelvir showed promising outcomes in hospitalized immunocompromised patients with COVID-19, demonstrating lower mortality compared to remdesivir in an exploratory study. Further research is needed due to the small sample size.

Area of Science:

  • Infectious Diseases
  • Virology
  • Immunology

Background:

  • Immunocompromised patients face a heightened risk of severe COVID-19.
  • Effective antiviral treatments are crucial for this vulnerable population.

Purpose of the Study:

  • To evaluate the clinical outcomes of ensitrelvir in hospitalized immunocompromised patients with COVID-19.
  • To compare ensitrelvir's efficacy against remdesivir as a reference treatment.

Main Methods:

  • A single-center retrospective cohort study was conducted.
  • Patients with moderate/severe immunodeficiency receiving ensitrelvir or remdesivir were analyzed.
  • Primary outcome was 28-day all-cause mortality; secondary outcomes included time to discharge and viral clearance.

Main Results:

  • The study included 56 patients (22 ensitrelvir, 34 remdesivir).
  • 28-day mortality was 4.5% for ensitrelvir and 8.8% for remdesivir.
  • Inverse probability of treatment weighting (IPTW) suggested lower adjusted mortality for ensitrelvir (4.2% vs. 10.7%).

Conclusions:

  • Ensitrelvir was associated with low mortality in this exploratory cohort.
  • Comparisons with remdesivir require caution due to study limitations, including small sample size and potential treatment selection biases.
  • Further investigation is warranted to confirm ensitrelvir's role in managing COVID-19 in immunocompromised individuals.
Abstract

Keywords:
COVID-19ensitrelvirhospital stayimmunodeficiencymortalityoral administrationremdesivirvirus clearance

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