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Association of nirmatrelvir/ritonavir treatment on upper respiratory SARS-CoV-2 RT-PCR negative conversion rates among high-risk patients with COVID-19
Clinical Infectious Diseases ( IF 11.8 ) Pub Date : 2022-07-23 , DOI: 10.1093/cid/ciac600
Hongyan Li 1 , Menghan Gao 2 , Hailong You 3 , Peng Zhang 4 , Yuchen Pan 5 , Nan Li 6 , Ling Qin 7 , Heyuan Wang 8 , Dan Li 9 , Yang Li 9 , Hongmei Qiao 10 , Lina Gu 6 , Songbai Xu 11 , Weiying Guo 8 , Nanya Wang 12 , Chaoying Liu 9 , Pujun Gao 13 , Junqi Niu 14 , Jie Cao 15 , Yang Zheng 7
Affiliation  

Background Acceleration of negative respiratory conversion of SARS-CoV-2 in patients with coronavirus disease 2019 (COVID-19) might reduce viral transmission. Nirmatrelvir/ritonavir is a new antiviral agent recently approved for treatment of COVID-19 that has the potential to facilitate negative conversion. Methods A cohort of hospitalized adult patients with mild-to-moderate COVID-19 who had a high-risk for progression to severe disease were studied. These patients presented with COVID-19 symptoms between March 5 and April 5, 2022. The time from positive to negative upper respiratory RT-PCR conversion was assessed by Kaplan-Meier plots and Cox proportional hazards regression with the adjustment for patients baseline demographic and clinical characteristics. Results There were 258 patients treated with nirmatrelvir/ritonavir and 224 non-treated patients who had mild-to-moderate COVID-19. The median (interquartile range) time for patients who converted from positive to negative RT-PCR was 10 days (7-12 days) in patients treated ≤5 days after symptom onset and 17 days (12-21 days) in non-treated patients, respectively. The proportions of patients with a negative conversion at day 15 were 89.7% and 42.0% in treated patients and non-treated patients, corresponding to a hazard ratio of 4.33 (95% CI, 3.31-5.65). Adjustment for baseline differences between the groups had little effect on the association. Subgroup analysis on treated patients suggests that time to negative conversion did not vary with the patients’ baseline characteristics. Conclusion This cohort study of high-risk patients with mild-to-moderate COVID-19 found an association between nirmatrelvir/ritonavir treatment and accelerated negative RT-PCR respiratory SARS-CoV-2 conversion that might reduce the risk of viral shedding and disease transmission.

中文翻译:

尼马瑞韦/利托那韦治疗对 COVID-19 高危患者上呼吸道 SARS-CoV-2 RT-PCR 阴性转化率的影响

背景 2019 年冠状病毒病 (COVID-19) 患者 SARS-CoV-2 呼吸负转换的加速可能会减少病毒传播。Nirmatrelvir/ritonavir 是一种新的抗病毒药物,最近被批准用于治疗 COVID-19,有可能促进负转化。方法 研究了一组住院的轻度至中度 COVID-19 成年患者,这些患者有进展为严重疾病的高风险。这些患者在 2022 年 3 月 5 日至 4 月 5 日期间出现 COVID-19 症状。通过 Kaplan-Meier 图和 Cox 比例风险回归评估从阳性到阴性上呼吸道 RT-PCR 转换的时间,并根据患者的基线人口统计和临床情况进行调整特征。结果 有 258 名接受 nirmatrelvir/ritonavir 治疗的患者和 224 名未接受治疗的轻度至中度 COVID-19 患者。RT-PCR 从阳性转为阴性的患者的中位(四分位间距)时间在症状出现后 ≤ 5 天接受治疗的患者为 10 天(7-12 天),在未接受治疗的患者中为 17 天(12-21 天) , 分别。在第 15 天出现阴性转化的患者比例在接受治疗的患者和未接受治疗的患者中分别为 89.7% 和 42.0%,对应的风险比为 4.33(95% CI,3.31-5.65)。对组间基线差异的调整对关联几乎没有影响。对接受治疗的患者进行的亚组分析表明,转阴的时间不随患者的基线特征而变化。
更新日期:2022-07-23
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