Oral antivirals for COVID-19 among patients with cancer

{ 'institution': [{'name': 'Research Square'}], 'indexed': {'date-parts': [[2024, 1, 25]], 'date-time': '2024-01-25T00:30:16Z', 'timestamp': 1706142616549}, 'posted': {'date-parts': [[2024, 1, 24]]}, 'group-title': 'In Review', 'reference-count': 32, 'publisher': 'Research Square Platform LLC', 'license': [ { 'start': { 'date-parts': [[2024, 1, 24]], 'date-time': '2024-01-24T00:00:00Z', 'timestamp': 1706054400000}, 'content-version': 'unspecified', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0/'}], 'content-domain': {'domain': [], 'crossmark-restriction': False}, 'accepted': {'date-parts': [[2024, 1, 18]]}, 'abstract': '<jats:title>Abstract</jats:title>\n' ' <jats:p>Purpose:\n' 'Immunocompromised individuals, such as those diagnosed with cancer, are at a significantly ' 'higher risk for severe illness and mortality when infected with SARS-CoV-2 (COVID-19) than ' 'the general population. Two oral antiviral treatments are approved for COVID-19: Paxlovid® ' '(nirmatrelvir/ritonavir) and Lagevrio® (molnupiravir). There is a paucity of data regarding ' 'the benefit from these antivirals among immunocompromised patients with cancer, and recent ' 'studies have questioned their efficacy among vaccinated patients, even those with risk ' 'factors for severe COVID-19.\n' 'Methods:\n' 'We evaluated the efficacy and safety of nirmatrelvir/ritonavir and molnupiravir in preventing ' 'severe illness and death using our database of 457 patients with cancer and COVID-19 from ' 'Brown University-affiliated hospitals. 67 patients received nirmatrelvir/ritonavir or ' 'molnupiravir and were compared to 56 concurrent controls who received no antiviral treatment ' 'despite being eligible to receive it.\n' 'Results:\n' 'Administration of nirmatrelvir/ritonavir or molnupiravir was associated with improved ' 'survival and lower 90-day all-cause and COVID-19-attributed mortality (p&lt;0.05) and with ' 'lower peak O2 requirements (ordinal odds ratio [OR] 1.52, 95% confidence interval [CI] ' '0.92-2.56).\n' 'Conclusion:\n' 'Acknowledging the small size of our sample as a limitation, we concluded that early antiviral ' 'treatment might be beneficial to immunocompromised individuals, particularly those with ' 'cancer, when infected with SARS-CoV-2. Larger-scale, well-stratified studies are needed in ' 'this patient population.</jats:p>', 'DOI': '10.21203/rs.3.rs-3876022/v1', 'type': 'posted-content', 'created': {'date-parts': [[2024, 1, 24]], 'date-time': '2024-01-24T18:57:57Z', 'timestamp': 1706122677000}, 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': 'Oral antivirals for COVID-19 among patients with cancer', 'prefix': '10.21203', 'author': [ { 'given': 'Dorra', 'family': 'Guermazi', 'sequence': 'first', 'affiliation': [{'name': 'Brown University'}]}, { 'given': 'Panos', 'family': 'Arvanitis', 'sequence': 'additional', 'affiliation': [{'name': 'The Warren Alpert Medical School of Brown University'}]}, { 'given': 'Kendra', 'family': 'Vieira', 'sequence': 'additional', 'affiliation': [{'name': 'The Warren Alpert Medical School of Brown University'}]}, { 'given': 'Jeremy L.', 'family': 'Warner', 'sequence': 'additional', 'affiliation': [{'name': 'Rhode Island Hospital'}]}, { 'given': 'Dimitrios', 'family': 'Farmakiotis', 'sequence': 'additional', 'affiliation': [{'name': 'The Warren Alpert Medical School of Brown University'}]}], 'member': '8761', 'reference': [ { 'key': 'ref1', 'doi-asserted-by': 'publisher', 'first-page': '1', 'DOI': '10.1007/s00432-022-04191-y', 'article-title': '"Effects of SARS-CoV-2 infections in patients with cancer on mortality, ' 'ICU admission and incidence: a systematic review with meta-analysis ' 'involving 709,908 participants and 31,732 cancer patients," (in eng)', 'author': 'Arayici ME', 'year': '2022', 'unstructured': 'M. 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