Independent mortality predictors in older COVID-19 patients with delayed hospitalization: A retrospective study from Eastern China, 2023
et al., Medicine, doi:10.1097/MD.0000000000049099, May 2026
Retrospective 300 elderly hospitalized COVID-19 patients in China, showing no mortality benefit with antivirals (paxlovid and molnupiravir) in multivariable analysis, OR 1.15 [0.28-4.74], without statistical significance.
Resistance. Variants may be resistant to paxlovid1-9. Use may promote the emergence of variants that weaken host immunity and potentially contribute to long COVID10. Confounding by contraindication. Hoertel et al. find that over 50% of patients that died had a contraindication for the use of Paxlovid11. Retrospective studies that do not exclude contraindicated patients may significantly overestimate efficacy. Black box warning. The FDA notes that severe, life-threatening, and/or fatal adverse reactions due to drug interactions have been reported in patients treated with paxlovid12. Kidney and liver injury. Studies show significantly increased risk of acute kidney injury13 and liver injury14,15. Viral rebound. Studies show significantly increased risk of replication-competent viral rebound16-18.
Study covers molnupiravir and paxlovid.
1.
Zhou et al., Nirmatrelvir-resistant SARS-CoV-2 variants with high fitness in an infectious cell culture system, Science Advances, doi:10.1126/sciadv.add7197.
2.
Moghadasi et al., Rapid resistance profiling of SARS-CoV-2 protease inhibitors, npj Antimicrobials and Resistance, doi:10.1038/s44259-023-00009-0.
3.
Jochmans et al., The Substitutions L50F, E166A, and L167F in SARS-CoV-2 3CLpro Are Selected by a Protease Inhibitor In Vitro and Confer Resistance To Nirmatrelvir, mBio, doi:10.1128/mbio.02815-22.
4.
Lopez et al., SARS-CoV-2 Resistance to Small Molecule Inhibitors, Current Clinical Microbiology Reports, doi:10.1007/s40588-024-00229-6.
5.
Zvornicanin et al., Molecular Mechanisms of Drug Resistance and Compensation in SARS-CoV-2 Main Protease: The Interplay Between E166 and L50, bioRxiv, doi:10.1101/2025.01.24.634813.
6.
Vukovikj et al., Impact of SARS-CoV-2 variant mutations on susceptibility to monoclonal antibodies and antiviral drugs: a non-systematic review, April 2022 to October 2024, Eurosurveillance, doi:10.2807/1560-7917.ES.2025.30.10.2400252.
7.
Deschenes et al., Functional and structural characterization of treatment-emergent nirmatrelvir resistance mutations at low frequencies in the main protease (Mpro) reveals a unique evolutionary route for SARS-CoV-2 to gain resistance, The Journal of Infectious Diseases, doi:10.1093/infdis/jiaf294.
8.
Zhou (B) et al., SARS-CoV-2 Mpro inhibitor ensitrelvir: asymmetrical cross-resistance with nirmatrelvir and emerging resistance hotspots, Emerging Microbes & Infections, doi:10.1080/22221751.2025.2552716.
9.
Chen et al., SARS-CoV-2 3CLpro mutations T21I and E166A confer differential resistance to simnotrelvir, bofutrelvir, and ensitrelvir, Journal of Virology, doi:10.1128/jvi.02223-25.
10.
Thomas et al., Nirmatrelvir-Resistant Mutations in SARS-CoV-2 Mpro Enhance Host Immune Evasion via Cleavage of NF-κB Essential Modulator, bioRxiv, doi:10.1101/2024.10.18.619137.
11.
Hoertel et al., Prevalence of Contraindications to Nirmatrelvir-Ritonavir Among Hospitalized Patients With COVID-19 at Risk for Progression to Severe Disease, JAMA Network Open, doi:10.1001/jamanetworkopen.2022.42140.
12.
FDA, Fact sheet for healthcare providers: emergency use authorization for paxlovid, www.fda.gov/media/155050/download.
13.
Kamo et al., Association of Antiviral Drugs for the Treatment of COVID-19 With Acute Renal Failure, In Vivo, doi:10.21873/invivo.13637.
14.
Wang et al., Development and validation of a nomogram to assess the occurrence of liver dysfunction in patients with COVID-19 pneumonia in the ICU, BMC Infectious Diseases, doi:10.1186/s12879-025-10684-1.
15.
Siby et al., Temporal Trends in Serious Adverse Events Associated with Oral Antivirals During the COVID-19 Pandemic: Insights from the FAERS Database (2020–2023), Open Forum Infectious Diseases, doi:10.1093/ofid/ofaf695.1825.
16.
Edelstein et al., SARS-CoV-2 virologic rebound with nirmatrelvir-ritonavir therapy, medRxiv, doi:10.1101/2023.06.23.23288598.
Liu et al., 29 May 2026, retrospective, China, peer-reviewed, median age 82.0, 6 authors, study period 8 December, 2022 - 12 January, 2023.
Contact: mhf1988@126.com.
Abstract: ®
Independent mortality predictors in older COVID19 patients with delayed hospitalization A retrospective study from Eastern China, 2023
Qiaoli Liu, MD a , Lifu Zhao, MD a , Mei Li, MD a , Chunwei Shi, MD a , Piao Hu, MD a , Haifeng Miao, MD a, *
Abstract
Delayed hospitalization of older patients with COVID-19 results in the loss of the early antiviral treatment window, as well as the progression to critical illness involving shock, hypoxemia, and corticosteroid therapy. Nevertheless, the hierarchy of independent mortality predictors in this specific context remains to be fully established. The study aimed to identify and rank these predictors to inform clinical management. This retrospective observational study was conducted at the First People's Hospital of Xiaoshan District, China (January-February 2023). The present study included hospitalized patients aged ≥ 60 years with first-time severe acute respiratory syndrome coronavirus-2 infection and delayed hospitalization (>5 days from symptom onset). The data were predominantly collected electronically. Univariate and multivariate logistic regression were performed to identify independent risk factors for mortality. A total of 300 older hospitalized COVID-19 patients (median age 82 years; 57.3% male) were included. Overall mortality was 17.3% (52/300). In multivariable logistic regression, independent factors associated with mortality included older age (OR: 1.11, 95% CI: 1.03-1.19), elevated cardiac troponin I (OR: 1.01, 95% CI: 1.0-1.02), presence of shock (OR: 26.72, 95% CI: 7.27-98.18), prolonged corticosteroid use (OR: 8.19, 95% CI: 2.39-28.05), and requirement of oxygen therapy for hypoxia (OR: 2.98, 95% CI: 1.70-5.23). Shock was the strongest independent predictor of mortality in older COVID-19 patients with delayed hospitalization, outweighing prolonged corticosteroid use and hypoxemia. These findings emphasize the critical importance of early shock recognition in this vulnerable population, while also highlighting the need for judicious corticosteroid use. The identified risk hierarchy may serve as a framework for clinical decision-making in resource-constrained settings.
Abbreviations: ALT = alanine aminotransferase, BUN = blood urea nitrogen, CI = confidence interval, COVID-19 = coronavirus disease 2019, CRP = C-reactive protein, Hb = hemoglobin, IMV = invasive mechanical ventilation, L = lymphocyte, OR = odds Ratio, PLT = platelet, RCT = randomized controlled trial, SARS-CoV-2 = severe acute respiratory syndrome coronavirus-2, SCR = serum creatinine, WBC = white blood cell.
Keywords: COVID-19, delayed hospitalization, mortality, older, SARS-CoV-2
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"abstract": "<jats:sec>\n <jats:title/>\n <jats:p>Delayed hospitalization of older patients with COVID-19 results in the loss of the early antiviral treatment window, as well as the progression to critical illness involving shock, hypoxemia, and corticosteroid therapy. Nevertheless, the hierarchy of independent mortality predictors in this specific context remains to be fully established. The study aimed to identify and rank these predictors to inform clinical management. This retrospective observational study was conducted at the First People’s Hospital of Xiaoshan District, China (January–February 2023). The present study included hospitalized patients aged ≥ 60 years with first-time severe acute respiratory syndrome coronavirus-2 infection and delayed hospitalization (>5 days from symptom onset). The data were predominantly collected electronically. Univariate and multivariate logistic regression were performed to identify independent risk factors for mortality. A total of 300 older hospitalized COVID-19 patients (median age 82 years; 57.3% male) were included. Overall mortality was 17.3% (52/300). In multivariable logistic regression, independent factors associated with mortality included older age (OR: 1.11, 95% CI: 1.03–1.19), elevated cardiac troponin I (OR: 1.01, 95% CI: 1.0–1.02), presence of shock (OR: 26.72, 95% CI: 7.27–98.18), prolonged corticosteroid use (OR: 8.19, 95% CI: 2.39–28.05), and requirement of oxygen therapy for hypoxia (OR: 2.98, 95% CI: 1.70–5.23). Shock was the strongest independent predictor of mortality in older COVID-19 patients with delayed hospitalization, outweighing prolonged corticosteroid use and hypoxemia. These findings emphasize the critical importance of early shock recognition in this vulnerable population, while also highlighting the need for judicious corticosteroid use. The identified risk hierarchy may serve as a framework for clinical decision-making in resource-constrained settings.</jats:p>\n </jats:sec>",
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Late treatment
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