Association of nirmatrelvir/ritonavir treatment on upper respiratory SARS-CoV-2 RT-PCR negative conversion rates among high-risk patients with COVID-19
PhD Hongyan Li, PhD Menghan Gao, MD Hailong You, MD Peng Zhang, MM Yuchen Pan, MD Nan Li, MD Ling Qin, MD Heyuan Wang, MD Dan Li, MD Yang Li, MD Hongmei Qiao, MD Lina Gu, MD Songbai Xu, MD Weiying Guo, MD Nanya Wang, MD Chaoying Liu, MD Pujun Gao, MD Junqi Niu, MD Jie Cao, MD Yang Zheng, Prof H Li
doi:10.1093/cid/ciac600/6649232
Background: Acceleration of negative respiratory conversion of SARS-CoV-2 in patients with coronavirus disease 2019 (COVID-19) might reduce viral transmission. Nirmatrelvir/ritonavir is a new antiviral agent recently approved for treatment of COVID-19 that has the potential to facilitate negative conversion. Methods: A cohort of hospitalized adult patients with mild-to-moderate COVID-19 who had a high-risk for progression to severe disease were studied. These patients presented with COVID-19 symptoms between March 5 and April 5, 2022. The time from positive to negative upper respiratory RT-PCR conversion was assessed by Kaplan-Meier plots and Cox proportional hazards regression with the adjustment for patients baseline demographic and clinical characteristics. Results: There were 258 patients treated with nirmatrelvir/ritonavir and 224 nontreated patients who had mild-to-moderate COVID-19. The median (interquartile range) time for patients who converted from positive to negative RT-PCR was 10 Conclusion: This cohort study of high-risk patients with mild-to-moderate COVID-19 found an association between nirmatrelvir/ritonavir treatment and accelerated negative RT-PCR respiratory SARS-CoV-2 conversion that might reduce the risk of viral shedding and disease transmission.
Conflict of Interest Disclosures: None reported. Funding/Support: None.
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'abstract': '<jats:title>Abstract</jats:title>\n'
' <jats:sec>\n'
' <jats:title>Background</jats:title>\n'
' <jats:p>Acceleration of negative respiratory conversion of SARS-CoV-2 in '
'patients with coronavirus disease 2019 (COVID-19) might reduce viral transmission. '
'Nirmatrelvir/ritonavir is a new antiviral agent recently approved for treatment of COVID-19 '
'that has the potential to facilitate negative conversion.</jats:p>\n'
' </jats:sec>\n'
' <jats:sec>\n'
' <jats:title>Methods</jats:title>\n'
' <jats:p>A cohort of hospitalized adult patients with mild-to-moderate '
'COVID-19 who had a high-risk for progression to severe disease were studied. These patients '
'presented with COVID-19 symptoms between March 5 and April 5, 2022. The time from positive to '
'negative upper respiratory RT-PCR conversion was assessed by Kaplan-Meier plots and Cox '
'proportional hazards regression with the adjustment for patients baseline demographic and '
'clinical characteristics.</jats:p>\n'
' </jats:sec>\n'
' <jats:sec>\n'
' <jats:title>Results</jats:title>\n'
' <jats:p>There were 258 patients treated with nirmatrelvir/ritonavir and 224 '
'non-treated patients who had mild-to-moderate COVID-19. The median (interquartile range) time '
'for patients who converted from positive to negative RT-PCR was 10 days (7-12 days) in '
'patients treated ≤5 days after symptom onset and 17 days (12-21 days) in non-treated '
'patients, respectively. The proportions of patients with a negative conversion at day 15 were '
'89.7% and 42.0% in treated patients and non-treated patients, corresponding to a hazard ratio '
'of 4.33 (95% CI, 3.31-5.65). Adjustment for baseline differences between the groups had '
'little effect on the association. Subgroup analysis on treated patients suggests that time to '
'negative conversion did not vary with the patients’ baseline characteristics.</jats:p>\n'
' </jats:sec>\n'
' <jats:sec>\n'
' <jats:title>Conclusion</jats:title>\n'
' <jats:p>This cohort study of high-risk patients with mild-to-moderate '
'COVID-19 found an association between nirmatrelvir/ritonavir treatment and accelerated '
'negative RT-PCR respiratory SARS-CoV-2 conversion that might reduce the risk of viral '
'shedding and disease transmission.</jats:p>\n'
' </jats:sec>',
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