尼尔马特雷尔维尔或莫尔努皮拉维尔的使用和Omicron感染的严重结果
Dan-Yu Lin1, Francois Abi Fadel2, Shuaiqi Huang3
1Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill.
JAMA network open
|September 21, 2023
概括
尼尔马特里尔维尔和莫尔努皮拉维尔显著减少了感染Omicron亚型的非住院COVID-19患者的住院和死亡. 这些口服抗病毒药物无论患者的人口统计或疫苗接种状况如何,都有效.
科学领域:
- 传染性疾病 传染性疾病
- 病毒学 病毒学
- 公共卫生 公共卫生
背景情况:
- 里托纳维尔增强的尼尔马特里尔维尔和莫尔努皮拉维尔是高风险的非住院COVID-19患者的授权治疗方法.
- 这些抗病毒药物对新出现的SARS-CoV-2 Omicron亚型 (例如,BQ.1.1,XBB.1.5) 的疗效在很大程度上仍未被描述.
研究的目的:
- 评估尼马特里尔维尔或莫尔努皮拉维尔使用与患有Omicron亚变体感染的患者住院和死亡风险之间的关联.
- 评估这些口服抗病毒药物在不同患者群体和不断变化的病毒菌株中的有效性.
主要方法:
- 一项队列研究包括了68,867名高风险的COVID-19患者,这些患者在2022年4月至2023年2月期间被诊断出患有COVID-19.
- 治疗组包括尼尔马特里尔维尔,莫尔努皮拉维尔或没有抗病毒疗法.
- 结果 (死亡,住院或死亡) 用调整的危险比率进行分析,控制多个共同变量.
主要成果:
- 尼马特雷尔维尔的使用与84%的死亡率 (aHR=0.16) 和37%的住院或死亡率 (aHR=0.63) 的减少有关.
- 莫尔努皮拉维尔的使用与77%的死亡率 (aHR=0.23) 和41%的住院或死亡率 (aHR=0.59) 的减少有关.
- 这些保护性关联在各种子组中是一致的,包括年龄,种族,疫苗接种状态和先前感染.
结论:
- 尼尔马特里尔维尔和莫尔努皮拉维尔都在减少患有Omicron驱动的COVID-19的非住院患者的死亡率和住院率方面表现出显著的有效性.
- 这些发现支持在高风险人群中继续使用这些口服抗病毒药物,而不管特定的Omicron亚型,疫苗接种史或并发症.
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