帕克斯洛维德用于患有慢性脏病的住院COVID-19患者
Hong Cai1, Jiayi Yan2, Shang Liu2
1Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Ren Ji Hospital, Uremia Diagnosis and Treatment Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, China.
Antiviral research
|June 27, 2023
概括
早期启动Paxlovid显著降低了COVID-19慢性病 (CKD) 患者的死亡率. 这种抗病毒治疗在高风险的CKD患者诊断后五天内开始时最有效.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- COVID-19带来了显著的死亡风险,特别是在慢性病 (CKD) 患者中.
- 关于Paxlovid在COVID-19患有CKD的患者 (eGFR<90毫升/分钟) 的疗效的数据有限.
研究的目的:
- 评估Paxlovid治疗的早期与晚期启动对住院COVID-19患者患有CKD的临床结果的有效性.
- 确定COVID-19的CKD患者全因死亡的独立风险因素.
主要方法:
- 在2022年4月至6月的住院成人COVID-19患者的回顾性队列研究.
- 考克斯的比例危险回归模型与时间依赖的共变量评估了Paxlovid的启动时间和临床结果.
- 包括1279名患者,分析早期 (5天内) 与晚期 (≥5天) 的Paxlovid启动.
主要成果:
- 早期开始使用帕克斯洛维德与较晚开始或不接受治疗相比,所有原因死亡率较低 (P=0.046).
- 在查尔森并发症指数 (CCI) > 7 的CKD患者中,早期Paxlovid显著降低了全因死亡率 (P=0.041).
- 慢性病患者因任何原因死亡的独立风险因素包括较低的eGFR,较高的CCI,ICU入院,升高的hsCRP和慢性肝病.
结论:
- 早期的帕克斯洛维德治疗显著减少了所有原因的死亡,侵入性通风和重症监护室的入院,在COVID-19患者中严重的CKD.
- 在COVID-19大流行期间,及时服用Paxlovid对于改善脆弱CKD人群的结果至关重要.
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