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

{ 'DOI': '10.1038/s41598-024-53862-y', 'ISSN': ['2045-2322'], 'URL': 'http://dx.doi.org/10.1038/s41598-024-53862-y', '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>', 'alternative-id': ['53862'], 'article-number': '3318', 'assertion': [ { 'group': {'label': 'Article History', 'name': 'ArticleHistory'}, 'label': 'Received', 'name': 'received', 'order': 1, 'value': '21 July 2023'}, { 'group': {'label': 'Article History', 'name': 'ArticleHistory'}, 'label': 'Accepted', 'name': 'accepted', 'order': 2, 'value': '6 February 2024'}, { 'group': {'label': 'Article History', 'name': 'ArticleHistory'}, 'label': 'First Online', 'name': 'first_online', 'order': 3, 'value': '9 February 2024'}, { 'group': {'label': 'Competing interests', 'name': 'EthicsHeading'}, 'name': 'Ethics', 'order': 1, 'value': 'The authors declare no competing interests.'}], 'author': [ {'affiliation': [], 'family': 'Chen', 'given': 'Mei-Ping', 'sequence': 'first'}, {'affiliation': [], 'family': 'Jiang', 'given': 'Di-Xuan', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Rang', 'given': 'Jia-Xi', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Zhuo', 'given': 'Hai-Bo', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Zhou', 'given': 'Zhi-Guo', 'sequence': 'additional'}], 'container-title': 'Scientific Reports', 'container-title-short': 'Sci Rep', 'content-domain': {'crossmark-restriction': False, 'domain': ['link.springer.com']}, 'created': {'date-parts': [[2024, 2, 9]], 'date-time': '2024-02-09T08:03:22Z', 'timestamp': 1707465802000}, 'deposited': { 'date-parts': [[2024, 2, 9]], 'date-time': '2024-02-09T08:06:08Z', 'timestamp': 1707465968000}, 'funder': [ { 'award': ['2022SK2047', '2020SK3014'], 'name': 'Key Research & Developmenta Program of Hunan Province'}, {'award': ['kq2208448'], 'name': 'Natural Science Foundation of Changsha city'}], 'indexed': {'date-parts': [[2024, 2, 11]], 'date-time': '2024-02-11T12:15:44Z', 'timestamp': 1707653744037}, 'is-referenced-by-count': 0, 'issue': '1', 'issued': {'date-parts': [[2024, 2, 9]]}, 'journal-issue': {'issue': '1', 'published-online': {'date-parts': [[2024, 12]]}}, 'language': 'en', 'license': [ { 'URL': 'https://creativecommons.org/licenses/by/4.0', 'content-version': 'tdm', 'delay-in-days': 0, 'start': { 'date-parts': [[2024, 2, 9]], 'date-time': '2024-02-09T00:00:00Z', 'timestamp': 1707436800000}}, { 'URL': 'https://creativecommons.org/licenses/by/4.0', 'content-version': 'vor', 'delay-in-days': 0, 'start': { 'date-parts': [[2024, 2, 9]], 'date-time': '2024-02-09T00:00:00Z', 'timestamp': 1707436800000}}], 'link': [ { 'URL': 'https://www.nature.com/articles/s41598-024-53862-y.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://www.nature.com/articles/s41598-024-53862-y', 'content-type': 'text/html', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://www.nature.com/articles/s41598-024-53862-y.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'member': '297', 'original-title': [], 'prefix': '10.1038', 'published': {'date-parts': [[2024, 2, 9]]}, 'published-online': {'date-parts': [[2024, 2, 9]]}, 'publisher': 'Springer Science and Business Media LLC', 'reference': [ { 'DOI': '10.1001/jama.2020.12839', 'author': 'WJ Wiersinga', 'doi-asserted-by': 'publisher', 'first-page': '782', 'journal-title': 'JAMA', 'key': '53862_CR1', 'unstructured': 'Wiersinga, W. 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