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The Impact of Nirmatrelvir-Ritonavir in Reducing Hospitalizations Among High-Risk Patients With SARS-CoV-2 During the Omicron Predominant Era - 24/05/23

Doi : 10.1016/j.amjmed.2023.02.022 
Mohanad M. Al-Obaidi, MD, MPH a, Ahmet B. Gungor, MS b, Sangeetha Murugapandian, MD c, Bijin Thajudeen, MD c, Iyad Mansour, MD c, Ryan C. Wong, MD c, Bekir Tanriover, MD, MPH, MBA c, Tirdad T. Zangeneh, DO, MA a,
a Division of Infectious Diseases, College of Medicine, University of Arizona, Tucson 
b Division of Nephrology, Banner University Medical Center, Tucson, Arizona 
c Division of Nephrology, College of Medicine, University of Arizona, Tucson 

Requests for reprints should be addressed to Tirdad T. Zangeneh, DO, MA, Division of Infectious Disease, College of Medicine, University of Arizona, 1501 N Campbell Avenue, PO Box 245022 Tucson, AZ, 85724.Division of Infectious Disease, College of MedicineUniversity of Arizona1501 N Campbell Avenue, PO Box 245022TucsonAZ85724

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Abstract

Background

The coronavirus disease 2019 (COVID-19) pandemic has caused significant morbidity and mortality in high-risk populations. Several therapeutics have been developed to reduce the risk of complications related to COVID-19, hospitalizations, and death. In several studies, nirmatrelvir-ritonavir (NR) was reported to reduce the risk of hospitalizations and death. We aimed to evaluate the efficacy of NR in preventing hospitalizations and death during the Omicron predominant period.

Methods

We retrospectively evaluated patients from June 1, 2022, through September 24, 2022. There were a total of 25,939 documented COVID-19 cases. Using propensity matching, we matched 5754 patients treated with NR with untreated patients.

Results

Postmatching, the median age of the NR-treated group was 58 years (interquartile range, 43-70 years) and 42% were vaccinated. Postmatching composite outcome of the 30-day hospitalization and mortality in the NR-treated group were 0.9% (95% confidence interval [CI]: 0.7%−1.2%) versus 2.1% (95% CI: 1.8%−2.5%) in the matched control group, with a difference of −1.2 (−1.7, −0.8), P value <.01. The difference rates (NR vs. control) in 30-day all-cause hospitalizations and mortality were −1.2% (95% CI: −1.6% to −0.7%, P value <.01) and −0.1% (95% CI: −0.2% to 0.0%, P value = 0.29), respectively. We found similar finding across different age groups (≥65 vs. <65) and the vaccinated group.

Conclusion

We report a significant benefit with the use of NR in reducing hospitalizations among various high-risk COVID-19 groups during the Omicron BA.5 predominant period.

El texto completo de este artículo está disponible en PDF.

Keywords : COVID-19, Omicron variant, Nirmatrelvir-ritonavir


Esquema


 Funding: None.
 Conflicts of Interest: ABG, SM, BT, IM, RCW, and BT report none. MMA-O reports an honorarium from Shionogi Inc. and La Jolla Pharmaceuticals for serving on their advisory board. TTZ reports a research grant with AiCuris.
 Authorship: All authors had access to the data and a role in writing this manuscript.


© 2023  Elsevier Inc. Reservados todos los derechos.
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Vol 136 - N° 6

P. 577-584 - juin 2023 Regresar al número
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