Comparison of azvudine, molnupiravir, and nirmatrelvir/ritonavir in adult patients with mild-to-moderate COVID-19: a retrospective cohort study

{ 'indexed': {'date-parts': [[2024, 2, 11]], 'date-time': '2024-02-11T12:15:44Z', 'timestamp': 1707653744037}, 'reference-count': 38, 'publisher': 'Springer Science and Business Media LLC', 'issue': '1', 'license': [ { 'start': { 'date-parts': [[2024, 2, 9]], 'date-time': '2024-02-09T00:00:00Z', 'timestamp': 1707436800000}, 'content-version': 'tdm', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0'}, { 'start': { 'date-parts': [[2024, 2, 9]], 'date-time': '2024-02-09T00:00:00Z', 'timestamp': 1707436800000}, 'content-version': 'vor', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0'}], 'funder': [ { 'name': 'Key Research & Developmenta Program of Hunan Province', 'award': ['2022SK2047', '2020SK3014']}, {'name': 'Natural Science Foundation of Changsha city', 'award': ['kq2208448']}], 'content-domain': {'domain': ['link.springer.com'], 'crossmark-restriction': False}, 'abstract': '<jats:title>Abstract</jats:title><jats:p>This study aimed to explore the effectiveness and ' 'safety of azvudine, nirmatrelvir/ritonavir, and molnupiravir in adult patients with ' 'mild-to-moderate COVID-19. This retrospective cohort study included patients with ' 'mild-to-moderate COVID-19 (asymptomatic, mild, and common types) at the First Hospital of ' 'Changsha (Hunan Province, China) between March and November 2022. Eligible patients were ' 'classified into the azvudine, nirmatrelvir/ritonavir, or molnupiravir groups according to the ' 'antiviral agents they received. The outcomes were the times to nucleic acid negative ' 'conversion (NANC). This study included 157 patients treated with azvudine (n\u2009=\u200966), ' 'molnupiravir (n\u2009=\u200966), or nirmatrelvir/ritonavir (n\u2009=\u200925). There were no ' 'statistically significant differences in the time from diagnosis to NANC among the azvudine, ' 'molnupiravir, and nirmatrelvir/ritonavir groups [median, 9 (95% CI 9–11) vs. 11 (95% CI ' '10–12) vs. 9 (95% CI 8–12) days, <jats:italic>P</jats:italic>\u2009=\u20090.15], time from ' 'administration to NANC [median, 9 (95% CI 8–10) vs. 10 (95% CI 9.48–11) vs. 8.708 (95% CI ' '7.51–11) days, <jats:italic>P</jats:italic>\u2009=\u20090.50], or hospital stay [median, 11 ' '(95% CI 11–13) vs. 13 (95% CI 12–14) vs. 12 (95% CI 10–14) days, ' '<jats:italic>P</jats:italic>\u2009=\u20090.14], even after adjustment for sex, age, COVID-19 ' 'type, comorbidities, Ct level, time from diagnosis to antiviral treatment, and number of ' 'symptoms. The cumulative NANC rates in the azvudine, molnupiravir, and nirmatrelvir/ritonavir ' 'groups were 15.2%/12.3%/16.0% at day 5 (<jats:italic>P</jats:italic>\u2009=\u20090.858), ' '34.8%/21.5%/32.0% at day 7 (<jats:italic>P</jats:italic>\u2009=\u20090.226), ' '66.7%/52.3%/60.0% at 10 days (<jats:italic>P</jats:italic>\u2009=\u20090.246), and ' '86.4%/86.2%/80.0% at day 14 (<jats:italic>P</jats:italic>\u2009=\u20090.721). No serious ' 'adverse events were reported. Azvudine may be comparable to nirmatrelvir/ritonavir and ' 'molnupiravir in adult patients with mild-to-moderate COVID-19 regarding time to NANC, ' 'hospital stay, and AEs.</jats:p>', 'DOI': '10.1038/s41598-024-53862-y', 'type': 'journal-article', 'created': {'date-parts': [[2024, 2, 9]], 'date-time': '2024-02-09T08:03:22Z', 'timestamp': 1707465802000}, 'update-policy': 'http://dx.doi.org/10.1007/springer_crossmark_policy', 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': 'Comparison of azvudine, molnupiravir, and nirmatrelvir/ritonavir in adult patients with ' 'mild-to-moderate COVID-19: a retrospective cohort study', 'prefix': '10.1038', 'volume': '14', 'author': [ {'given': 'Mei-Ping', 'family': 'Chen', 'sequence': 'first', 'affiliation': []}, {'given': 'Di-Xuan', 'family': 'Jiang', 'sequence': 'additional', 'affiliation': []}, {'given': 'Jia-Xi', 'family': 'Rang', 'sequence': 'additional', 'affiliation': []}, {'given': 'Hai-Bo', 'family': 'Zhuo', 'sequence': 'additional', 'affiliation': []}, {'given': 'Zhi-Guo', 'family': 'Zhou', 'sequence': 'additional', 'affiliation': []}], 'member': '297', 'published-online': {'date-parts': [[2024, 2, 9]]}, 'reference': [ { 'key': '53862_CR1', 'doi-asserted-by': 'publisher', 'first-page': '782', 'DOI': '10.1001/jama.2020.12839', 'volume': '324', 'author': 'WJ Wiersinga', 'year': '2020', 'unstructured': 'Wiersinga, W. 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