COVID-19 hospitalization risk after outpatient nirmatrelvir/ritonavir use, January to August 2022, North Carolina.
J Antimicrob Chemother
; 79(4): 859-867, 2024 Apr 02.
Article
em En
| MEDLINE
| ID: mdl-38380946
ABSTRACT
BACKGROUND:
In the USA, nirmatrelvir/ritonavir is authorized for the treatment of mild-to-moderate COVID-19 in patients at least 12â years of age, at high risk for progression to severe COVID-19.OBJECTIVES:
To estimate the impact of outpatient nirmatrelvir/ritonavir on COVID-19 hospitalization risk in a US healthcare system.METHODS:
We conducted a cohort study using electronic health records among outpatients with a positive SARS-CoV-2 PCR test between January and August 2022. We evaluated the association of nirmatrelvir/ritonavir therapy with time to hospitalization by estimating adjusted HRs and assessed the impact of nirmatrelvir/ritonavir on predicted COVID-19 hospitalizations using machine-learning methods.RESULTS:
Among 44â671 patients, 4948 (11%) received nirmatrelvir/ritonavir, and 201 (0.4%) were hospitalized within 28â days of COVID-19 diagnosis. Nirmatrelvir/ritonavir recipients were more likely to be older, white, vaccinated, have comorbidities and reside in areas with higher average socioeconomic status. The 28â day cumulative incidence of hospitalization was 0.06% (95% CI 0.02%-0.17%) among nirmatrelvir/ritonavir recipients and 0.52% (95% CI 0.46%-0.60%) among non-recipients. For nirmatrelvir/ritonavir versus no therapy, the age-adjusted HR was 0.08 (95% CI 0.03-0.26); the fully adjusted HR was 0.16 (95% CI 0.05-0.50). In the machine-learning model, the primary features reducing predicted hospitalization risk were nirmatrelvir/ritonavir, younger age, vaccination, female gender and residence in a higher socioeconomic status area.CONCLUSIONS:
COVID-19 hospitalization risk was reduced by 84% among nirmatrelvir/ritonavir recipients in a large, diverse healthcare system during the Omicron wave. These results suggest that nirmatrelvir/ritonavir remained highly effective in a setting substantially different than the original clinical trials.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Pacientes Ambulatoriais
/
Prolina
/
COVID-19
/
Lactamas
/
Leucina
/
Nitrilas
Limite:
Female
/
Humans
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article