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0 0.5 1 1.5 2+ Mortality 38% Improvement Relative Risk Ventilation -67% ICU time -10% Progression -27% Time to viral- 5% Paxlovid  Liu et al.  EARLY TREATMENT  RCT Is early treatment with paxlovid beneficial for COVID-19? RCT 264 patients in China (April - May 2022) Lower mortality (p=0.57) and higher ventilation (p=0.44), not sig. Liu et al., The Lancent Regional Health, Feb 2023 Favors paxlovid Favors control

Efficacy and safety of Paxlovid in severe adult patients with SARS-Cov-2 infection: a multicenter randomized controlled study

Liu et al., The Lancent Regional Health, doi:10.1016/j.lanwpc.2023.100694
Feb 2023  
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RCT 264 patients in China, showing no significant difference in outcomes with paxlovid.
risk of death, 37.5% lower, RR 0.62, p = 0.57, treatment 5 of 132 (3.8%), control 8 of 132 (6.1%), NNT 44, day 28.
risk of mechanical ventilation, 66.7% higher, RR 1.67, p = 0.44, treatment 10 of 132 (7.6%), control 6 of 132 (4.5%).
ICU time, 9.5% higher, relative time 1.10, p = 0.80, treatment 132, control 132.
risk of progression, 26.7% higher, RR 1.27, p = 0.58, treatment 19 of 132 (14.4%), control 15 of 132 (11.4%), acute exacerbation of chronic disease.
time to viral-, 4.8% lower, relative time 0.95, p = 0.42, treatment 132, control 132.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Liu et al., 5 Feb 2023, Randomized Controlled Trial, China, peer-reviewed, 34 authors, study period 10 April, 2022 - 19 May, 2022.
This PaperPaxlovidAll
Efficacy and safety of Paxlovid in severe adult patients with SARS-Cov-2 infection: a multicenter randomized controlled study
Jiao Liu, Xiaojun Pan, Sheng Zhang, Ming Li, Ke Ma, Cunyi Fan, Ying Lv, Xiangdong Guan, Yi Yang, Xiaofei Ye, Xingqi Deng, Yunfeng Wang, Lunxiu Qin, Zhijie Xia, Zi Ge, Quanhong Zhou, Xian Zhang, Yun Ling, Tangkai Qi, Zhenliang Wen, Sisi Huang, Lidi Zhang, Tao Wang, Yongan Liu, Yanxia Huang, Wenzhe Li, Hangxiang Du, Yizhu Chen, Yan Xu, Qiang Zhao, Ren Zhao, Djillali Annane, Jieming Qu, Dechang Chen
The Lancet Regional Health - Western Pacific, doi:10.1016/j.lanwpc.2023.100694
Background Nirmatrelvir plus ritonavir (Paxlovid) reduced the risk of hospitalization or death by 89% in high-risk, ambulatory adults with COVID-19. We aimed at studying the efficacy and safety of Paxlovid in hospitalized adult patients with SARS-Cov-2 (Omicron BA.2.2 variant) infection and severe comorbidities. Methods We conducted an open-label, multicenter, randomized controlled trial in which hospitalized adult patients with severe comorbidities were eligible and assigned in a 1:1 ratio to receive either 300 mg of nirmatrelvir plus
Appendix A. Supplementary data Supplementary data related to this article can be found at https://doi. org/10.1016/j.lanwpc.2023.100694.
Bajaj, Gadi, Spihlman, Wu, Choi et al., Aging, immunity, and COVID-19: how age influences the host immune response to coronavirus infections?, Front Physiol
Bajema, Dahl, Evener, Comparative effectiveness and antibody responses to moderna and pfizer-BioNTech COVID-19 vaccines among hospitalized veterans -five veterans affairs medical centers, United States, february 1, MMWR Morbidity and mortality weekly report
Charlson, Pompei, Ales, Mackenzie, A new method of classifying prognostic comorbidity in longitudinal studies: development and validation, J Chron Dis
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Dro, Rosik, Lechowicz, An update on drugs with therapeutic potential for SARS-CoV-2 (COVID-19) treatment
Hammond, Leister-Tebbe, Gardner, Oral nirmatrelvir for high-risk, nonhospitalized adults with covid-19, N Engl J Med
Inc, PAXLOVID nirmatrelvir and ritonavir: US fact sheet for healthcare providers
Inc, Pfizer Reports Additional Data on PAXLOVID™ Supporting Upcoming New Drug Application Submission to U
Inc, Pfizer shares top-line results from phase 2/3 EPIC-PEP study of PAXLOVID™ for post-exposure prophylactic use
Madhi, Kwatra, Myers, Population immunity and covid-19 severity with omicron variant in South Africa, N Engl J Med
Najjar-Debbiny, Gronich, Weber, Effectiveness of Paxlovid in reducing severe COVID-19 and mortality in high risk patients. an official publication of the, Infectious Diseases Society of America Clin Infect Dis
Nhcotpsro, Guidelines on the Diagnosis and treatment of COVID-19
Organization, WHO coronavirus (COVID-19) dashboard
Owen, Allerton, Anderson, An oral SARS-CoV-2 M(pro) inhibitor clinical candidate for the treatment of COVID-19, Science
Perico, Benigni, Casiraghi, Ng, Renia et al., Immunity, endothelial injury and complement-induced coagulopathy in COVID-19, Nat Rev Nephrol
Pfizer, to household member(s) with a confirmed symptomatic COVID-19 infection
Radovanovic, Seifert, Urban, Validity of Charlson Comorbidity Index in patients hospitalised with acute coronary syndrome. Insights from the nationwide AMIS Plus registry 2002-2012, Heart (British Cardiac Society)
Rosenberg, Holtgrave, Dorabawila, New COVID-19 cases and hospitalizations among adults, by vaccination status -New York, MMWR Morb Mortal Wkly Rep
Sun, Lin, Wang, Gao, Ye, Paxlovid in patients who are immunocompromised and hospitalised with SARS-CoV-2 infection, Lancet Infect Dis
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Vincent, De Mendonça, Cantraine, Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: results of a multicenter, prospective study. Working group on "sepsis-related problems" of the European Society of Intensive Care Medicine, Crit Care Med
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Zhang, Zhang, Chen, Shanghai's life-saving efforts against the current omicron wave of the COVID-19 pandemic, Lancet
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