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Effectiveness of nirmatrelvir-ritonavir for the treatment of patients with mild to moderate COVID-19 and at high risk of hospitalization: Systematic review and meta-analyses of observational studies.
Souza, Kathiaja Miranda; Carrasco, Gabriela; Rojas-Cortés, Robin; Michel Barbosa, Mariana; Bambirra, Eduardo Henrique Ferreira; Castro, José Luis; Alvares-Teodoro, Juliana.
Afiliação
  • Souza KM; Independent Consultant, Belo Horizonte, Brazil.
  • Carrasco G; Red Argentina Pública de Evaluación de Tecnologías Sanitarias (REDARETS), Neuquén, Argentina.
  • Rojas-Cortés R; Department of Health Systems and Services, Pan American Health Organization, Unit of Medicines and Health Technologies, Washington, DC, United States of America.
  • Michel Barbosa M; Postgraduate Program in Medicines and Pharmaceutical Services, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
  • Bambirra EHF; Postgraduate Program in Medicines and Pharmaceutical Services, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
  • Castro JL; Fundación Para la Innovación, la Formación, la Investigación y el Desarrollo Comunitário (FÜNDEC), San Isidro, S/C de Tenerife, España.
  • Alvares-Teodoro J; Postgraduate Program in Medicines and Pharmaceutical Services, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
PLoS One ; 18(10): e0284006, 2023.
Article em En | MEDLINE | ID: mdl-37824507
OBJECTIVE: To assess the effectiveness of nirmatrelvir-ritonavir in the treatment of outpatients with mild to moderate COVID-19 who are at higher risk of developing severe illness, through a systematic review with meta-analyses of observational studies. METHODS: A systematic search was performed, in accordance with the Cochrane search methods, to identify observational studies that met the inclusion criteria. The outcomes of mortality and hospitalization were analyzed. Search was conducted on PubMed, EMBASE, and The Cochrane Library. Two reviewers independently screened references, selected the studies, extracted the data, assessed the risk of bias using ROBINS-I tool and evaluated the quality of evidence using the GRADE tool. This study followed the PRISMA reporting guideline. RESULTS: A total of 16 observational studies were finally included. The results of the meta-analysis showed that in comparison to standard treatment without antivirals, nirmatrelvir-ritonavir reduced the risk of death by 59% (OR = 0.41; 95% CI: 0.35-0.52; moderate certainty of evidence). In addition, a 53% reduction in the risk of hospital admission was observed (OR = 0.47; 95% CI: 0.36-0.60, with very low certainty of evidence). For the composite outcome of hospitalization and/or mortality, there was a 56% risk reduction (OR = 0.44; 95% CI: 0.31-0.64, moderate certainty of evidence). CONCLUSION: The results suggest that nirmatrelvir-ritonavir could be effective in reducing mortality and hospitalization. The results were valid in vaccinated or unvaccinated high-risk individuals with COVID-19. Data from ongoing and future trials may further advance our understanding of the effectiveness and safety of nirmatrelvir-ritonavir and help improve treatment guidelines for COVID-19.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: COVID-19 Tipo de estudo: Systematic_reviews Limite: Humans Idioma: En Revista: PLoS One Assunto da revista: CIENCIA / MEDICINA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Brasil

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: COVID-19 Tipo de estudo: Systematic_reviews Limite: Humans Idioma: En Revista: PLoS One Assunto da revista: CIENCIA / MEDICINA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Brasil