RESUMO
Among adults at risk for severe coronavirus disease 2019 (COVID-19), the lowest hospitalization rate was among those who received nirmatrelvir-ritonavir after 3 or more messenger RNA vaccine doses (adjusted hazard ratio, 0.22; 95% confidence interval, .19-.24). Eligible adults, including those previously vaccinated, should be considered for COVID-19 antiviral treatment.
Assuntos
Antivirais , Vacinas contra COVID-19 , COVID-19 , Hospitalização , Ritonavir , SARS-CoV-2 , Humanos , Ritonavir/uso terapêutico , Ritonavir/administração & dosagem , Hospitalização/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Feminino , COVID-19/prevenção & controle , COVID-19/epidemiologia , Adulto , SARS-CoV-2/imunologia , Antivirais/uso terapêutico , Antivirais/administração & dosagem , Vacinas contra COVID-19/administração & dosagem , Idoso , Vacinação/estatística & dados numéricos , Leucina/análogos & derivados , Leucina/uso terapêutico , Tratamento Farmacológico da COVID-19 , Lactamas , Nitrilas , ProlinaRESUMO
Nirmatrelvir-ritonavir (Paxlovid), an oral antiviral treatment, is authorized for adults with mild-to-moderate COVID-19 who are at increased risk for progression to severe illness. However, real-world evidence on the benefit of Paxlovid, according to vaccination status, age group, and underlying health conditions, is limited. To examine the benefit of Paxlovid in adults aged ≥18 years in the United States, a large electronic health record (EHR) data set (Cosmos) was analyzed to assess the association between receiving a prescription for Paxlovid and hospitalization with a COVID-19 diagnosis in the ensuing 30 days. A Cox proportional hazards model was used to estimate this association, adjusted for demographic characteristics, geographic location, vaccination, previous infection, and number of underlying health conditions. Among 699,848 adults aged ≥18 years eligible for Paxlovid during April-August 2022, 28.4% received a Paxlovid prescription within 5 days of COVID-19 diagnosis. Being prescribed Paxlovid was associated with a lower hospitalization rate among the overall study population (adjusted hazard ratio [aHR] = 0.49), among those who had received ≥3 mRNA COVID-19 vaccines (aHR = 0.50), and across age groups (18-49 years: aHR = 0.59; 50-64 years: aHR = 0.40; and ≥65 years: aHR = 0.53). Paxlovid should be prescribed to eligible adults to reduce the risk of COVID-19-associated hospitalization.