Real-world efficacy of oral azvudine in hospitalized patients with COVID-19: A multicenter retrospective cohort study
Rui Han, Youhong Guan, Pulin Li, Min Tang, Guanghe Fei, Daxiong Zeng, Ran Wang
Journal of Infection and Public Health, doi:10.1016/j.jiph.2025.102987
Background: Azvudine has become a widely used treatment for COVID-19 in China. Our study aimed to assess the real-world efficacy of azvudine in hospitalized COVID-19 patients during the omicron variant surge. Methods: This multicenter retrospective cohort study was conducted at three hospitals, starting from December 2022. We developed a propensity-score matching (PSM) model to compare patients receiving azvudine with a control group. The primary outcome measured was a composite outcome, while secondary outcomes included all-cause death, intensive care unit admission, and initiation of invasive mechanical ventilation. Results: We enrolled a total of 7216 hospitalized COVID-19 patients, monitoring them for 28 days. Following PSM, we included 901 patients in both the azvudine group and the control group. The incidence of the composite outcome was 20.2 % in the azvudine group and 25.5 % in the control group (p = 0.007). The allcause mortality rate was 10.0 % in the azvudine group and 13.7 % in the control group (p = 0.016). The intensive care unit admission was 15.5 % in the azvudine group and 19.6 % in the control group (p = 0.022). Conclusion: During the omicron epidemic in China, oral administration of azvudine was associated with a reduced risk of the composite outcome and all-cause mortality in COVID-19 patients.
Abbreviations severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); coronavirus disease 2019 (COVID-19); arterial partial pressure of oxygen (PaO 2 ); inspired oxygen concentration (FiO 2 ); intensive care unit (ICU); body mass index (BMI); interleukin 6 (IL-6); propensity score matching (PSM); standardized mean difference (SMD); hazard ratios (HR); confidence intervals (CI); Kaplan-Meier (KM); P-glycoprotein(P-gp).
Declaration The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
Authors' contributions Rui Han was involved in the conception and design. Rui Han and Youhong Guan analyzed and interpreted the results. Pulin Li and Min Tang were responsible for drafting the paper. Daxiong Zeng critically revised its intellectual content. Guanghe Fei and Ran Wang approved the final version to be published; and that all authors agree to be accountable for all aspects of the work. All authors have approved the final article.
Ethics approval and consent to participate This study obtained approval from the Ethics Committee of the First Affiliated Hospital of Anhui Medical University (Quick-PJ-2023-07-34), the Ethics Committee of Hefei Second People's Hospital..
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