{"title":"雷米替韦和莫仑替韦对轻度至中度 COVID-19 肺移植受者的疗效相当:单中心经验。","authors":"Deepika Razia, Devika Sindu, Lauren Cherrier, Katherine Grief, Rajat Walia, Sofya Tokman","doi":"10.3389/frtra.2024.1408289","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Remdesivir (REM) and molnupiravir (MOL) are commonly used to treat lung transplant recipients (LTRs) with COVID-19; however, the clinical efficacy of these medications is yet to be compared. In this retrospective cohort study, we compared the clinical outcomes between LTRs with mild-to-moderate COVID-19 treated with REM and those treated with MOL.</p><p><strong>Methods and results: </strong>Between March 2020 and August 2022, 195 LTRs developed COVID-19 at our center. After excluding 82 who presented with severe disease requiring hospitalization, the remaining 113 were included in the analysis: 54 did not receive antiviral treatment, 30 were treated with REM, and 29 were treated with MOL. Adjusted multivariable logistic regression analysis showed similar rates of hospitalization (adjusted odds ratio (aOR) 1.169, [95% confidence interval (95% CI) 0.105-12.997, <i>p</i> = 0.899], ICU admission (aOR 0.822, 95% CI 0.042-16.220, <i>p</i> = 0.898), mechanical ventilation (aOR 0.903, 95% CI 0.015-55.124, <i>p</i> = 0.961), and COVID-19-related mortality (aOR 0.822, 95% CI 0.042-16.220, <i>p</i> = 0.898) between LTRs treated with REM and those treated with MOL for mild-to-moderate COVID-19, irrespective of SARS-CoV-2 strain.</p><p><strong>Conclusion: </strong>MOL may be a suitable alternative to REM to treat LTRs with mild-to-moderate COVID-19, and the choice of antiviral therapy can be driven by practical considerations such as route of administration and drug availability.</p>","PeriodicalId":519976,"journal":{"name":"Frontiers in transplantation","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11235218/pdf/","citationCount":"0","resultStr":"{\"title\":\"Remdesivir and molnupiravir had comparable efficacy in lung transplant recipients with mild-to-moderate COVID-19: a single center experience.\",\"authors\":\"Deepika Razia, Devika Sindu, Lauren Cherrier, Katherine Grief, Rajat Walia, Sofya Tokman\",\"doi\":\"10.3389/frtra.2024.1408289\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Remdesivir (REM) and molnupiravir (MOL) are commonly used to treat lung transplant recipients (LTRs) with COVID-19; however, the clinical efficacy of these medications is yet to be compared. In this retrospective cohort study, we compared the clinical outcomes between LTRs with mild-to-moderate COVID-19 treated with REM and those treated with MOL.</p><p><strong>Methods and results: </strong>Between March 2020 and August 2022, 195 LTRs developed COVID-19 at our center. After excluding 82 who presented with severe disease requiring hospitalization, the remaining 113 were included in the analysis: 54 did not receive antiviral treatment, 30 were treated with REM, and 29 were treated with MOL. Adjusted multivariable logistic regression analysis showed similar rates of hospitalization (adjusted odds ratio (aOR) 1.169, [95% confidence interval (95% CI) 0.105-12.997, <i>p</i> = 0.899], ICU admission (aOR 0.822, 95% CI 0.042-16.220, <i>p</i> = 0.898), mechanical ventilation (aOR 0.903, 95% CI 0.015-55.124, <i>p</i> = 0.961), and COVID-19-related mortality (aOR 0.822, 95% CI 0.042-16.220, <i>p</i> = 0.898) between LTRs treated with REM and those treated with MOL for mild-to-moderate COVID-19, irrespective of SARS-CoV-2 strain.</p><p><strong>Conclusion: </strong>MOL may be a suitable alternative to REM to treat LTRs with mild-to-moderate COVID-19, and the choice of antiviral therapy can be driven by practical considerations such as route of administration and drug availability.</p>\",\"PeriodicalId\":519976,\"journal\":{\"name\":\"Frontiers in transplantation\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-07-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11235218/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in transplantation\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3389/frtra.2024.1408289\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in transplantation","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3389/frtra.2024.1408289","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
简介:雷米替韦(REM)和莫鲁吡韦(MOL)是治疗COVID-19肺移植受者(LTR)的常用药物,但这两种药物的临床疗效尚未进行比较。在这项回顾性队列研究中,我们比较了轻度至中度COVID-19肺移植受者接受REM治疗与接受MOL治疗的临床疗效:2020年3月至2022年8月期间,本中心有195名LTR患者出现COVID-19。在排除了82名需要住院治疗的重症患者后,其余113人被纳入分析:54人未接受抗病毒治疗,30人接受了REM治疗,29人接受了MOL治疗。调整后的多变量逻辑回归分析显示,住院率(调整后的几率比(aOR)1.169,[95% 置信区间(95% CI)0.105-12.997,p = 0.899]、入住 ICU(aOR 0.822,95% CI 0.042-16.220,p = 0.898)、机械通气(aOR 0.903,95% CI 0.015-55.124,p = 0.961)和 COVID-19 相关死亡率(aOR 0.822,95% CI 0.042-16.220,p = 0.898):结论:在治疗轻度至中度 COVID-19 的 LTR 时,MOL 可能是 REM 的合适替代品。
Remdesivir and molnupiravir had comparable efficacy in lung transplant recipients with mild-to-moderate COVID-19: a single center experience.
Introduction: Remdesivir (REM) and molnupiravir (MOL) are commonly used to treat lung transplant recipients (LTRs) with COVID-19; however, the clinical efficacy of these medications is yet to be compared. In this retrospective cohort study, we compared the clinical outcomes between LTRs with mild-to-moderate COVID-19 treated with REM and those treated with MOL.
Methods and results: Between March 2020 and August 2022, 195 LTRs developed COVID-19 at our center. After excluding 82 who presented with severe disease requiring hospitalization, the remaining 113 were included in the analysis: 54 did not receive antiviral treatment, 30 were treated with REM, and 29 were treated with MOL. Adjusted multivariable logistic regression analysis showed similar rates of hospitalization (adjusted odds ratio (aOR) 1.169, [95% confidence interval (95% CI) 0.105-12.997, p = 0.899], ICU admission (aOR 0.822, 95% CI 0.042-16.220, p = 0.898), mechanical ventilation (aOR 0.903, 95% CI 0.015-55.124, p = 0.961), and COVID-19-related mortality (aOR 0.822, 95% CI 0.042-16.220, p = 0.898) between LTRs treated with REM and those treated with MOL for mild-to-moderate COVID-19, irrespective of SARS-CoV-2 strain.
Conclusion: MOL may be a suitable alternative to REM to treat LTRs with mild-to-moderate COVID-19, and the choice of antiviral therapy can be driven by practical considerations such as route of administration and drug availability.