Effect of Paxlovid in COVID-19 treatment during the periods of SARS-CoV-2 Omicron BA.5 and BN.1 subvariant dominance in the Republic of Korea: a retrospective cohort study.

IF 2.1 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Osong Public Health and Research Perspectives Pub Date : 2024-04-01 Epub Date: 2024-03-28 DOI:10.24171/j.phrp.2023.0230
Dong-Hwi Kim, Min-Gyu Yoo, Na-Young Kim, So Young Choi, Minjeong Jang, Misuk An, Se-Jin Jeong, Jungyeon Kim
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Abstract

Background: This study was conducted to assess the efficacy of nirmatrelvir/ritonavir treatment in patients with coronavirus disease 2019 (COVID-19), particularly those aged 60 years and older. Using real-world data, the period during which the BN.1 Omicron variant was dominant was compared to the period dominated by the BA.5 variant.

Methods: In this retrospective cohort study, data were collected regarding 2,665,281 patients infected with severe acute respiratory syndrome coronavirus 2 between July 24, 2022, and March 31, 2023. Propensity score matching was utilized to match patients who received nirmatrelvir/ ritonavir in a 1:4 ratio between BN.1 and BA.5 variant groups. Multivariable logistic regression analysis was employed to assess the effects of nirmatrelvir/ritonavir within these groups.

Results: Compared to the prior period, the efficacy of nirmatrelvir/ritonavir did not significantly differ during the interval of Omicron BN.1 variant dominance in the Republic of Korea. Among patients treated with nirmatrelvir/ritonavir, a significantly lower risk of mortality was observed in the BN.1 group (odds ratio [OR], 0.698; 95% confidence interval [CI], 0.557-0.875) compared to the BA.5 group. However, this treatment did not significantly reduce the risk of severe or critical illness, including death, for those in the BN.1 group (OR, 0.856; 95% CI, 0.728-1.007).

Conclusion: Nirmatrelvir/ritonavir has maintained its effectiveness against COVID-19, even with the emergence of the BN.1 Omicron subvariant. Consequently, we strongly recommend the administration of nirmatrelvir/ritonavir to patients exhibiting COVID-19-related symptoms, irrespective of the dominant Omicron variant or their vaccination status, to mitigate disease severity and decrease the risk of mortality.

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大韩民国SARS-CoV-2 Omicron BA.5和BN.1亚变异体占优势期间COVID-19治疗中Paxlovid的效果:一项回顾性队列研究。
研究目的本研究旨在评估尼马瑞韦/利托那韦治疗2019年冠状病毒病(COVID-19)患者,尤其是60岁及以上患者的疗效。利用真实世界的数据,对BN.1 Omicron变体占主导地位的时期与BA.5变体占主导地位的时期进行了比较:在这项回顾性队列研究中,收集了 2022 年 7 月 24 日至 2023 年 3 月 31 日期间 2,665,281 名严重急性呼吸系统综合征冠状病毒 2 感染者的数据。研究采用倾向得分匹配法,将接受尼马瑞韦/利托那韦治疗的患者按 1:4 的比例匹配到 BN.1 和 BA.5 变异组。采用多变量逻辑回归分析评估了这些组别中尼马瑞韦/利托那韦的效果:结果:与之前相比,在Omicron BN.1变异体在大韩民国占主导地位期间,尼马瑞韦/利托那韦的疗效没有明显差异。与 BA.5 组相比,在接受尼尔马特韦/利托那韦治疗的患者中,BN.1 组的死亡风险显著降低(几率比 [OR],0.698;95% 置信区间 [CI],0.557-0.875)。然而,这种治疗方法并没有明显降低BN.1组患者罹患重症或危重症(包括死亡)的风险(OR,0.856;95% CI,0.728-1.007):结论:即使出现了 BN.1 Omicron 亚变异体,尼马瑞韦/利托那韦仍能保持对 COVID-19 的有效性。因此,我们强烈建议对出现 COVID-19 相关症状的患者使用尼马瑞韦/利托那韦,无论其主要的 Omicron 变体或疫苗接种情况如何,以减轻疾病的严重程度并降低死亡风险。
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来源期刊
Osong Public Health and Research Perspectives
Osong Public Health and Research Perspectives Medicine-Public Health, Environmental and Occupational Health
CiteScore
10.30
自引率
2.30%
发文量
44
审稿时长
16 weeks
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