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0 0.5 1 1.5 2+ Viral clearance 12% Improvement Relative Risk Paxlovid for COVID-19  Lu et al.  EARLY TREATMENT Is early treatment with paxlovid beneficial for COVID-19? Retrospective study in China Improved viral clearance with paxlovid (p=0.022) Lu et al., Emerging Microbes & Infecti.., Aug 2022 Favors paxlovid Favors control

Geriatric risk and protective factors for serious COVID-19 outcomes among older adults in Shanghai Omicron wave

Lu et al., Emerging Microbes & Infections, doi:10.1080/22221751.2022.2109517
Aug 2022  
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Retrospective 1,377 patients in China, showing significantly faster viral clearance with Paxlovid. Authors analyze progression to severe/critical disease, but do not provide results for Paxlovid.
Confounding by contraindication. Hoertel et al. find that over 50% of patients that died had a contraindication for the use of Paxlovid Hoertel. 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 paxlovid" FDA.
risk of no viral clearance, 12.3% lower, HR 0.88, p = 0.02, inverted to make HR<1 favor treatment, Cox proportional hazards, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Lu et al., 4 Aug 2022, retrospective, China, peer-reviewed, 13 authors.
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This PaperPaxlovidAll
Geriatric risk and protective factors for serious COVID-19 outcomes among older adults in Shanghai Omicron wave
Guanzhu Lu, Yi Zhang, Haocheng Zhang, Jingwen Ai, Liu He, Xiaoling Yuan, Suxia Bao, Xiaohua Chen, Hongyu Wang, Jianpeng Cai, Sen Wang, Wenhong Zhang, Jie Xu
Emerging Microbes & Infections, doi:10.1080/22221751.2022.2109517
Background Omicron variant was featured with high transmissibility and striking antibody evasion. Shanghai has been experiencing Omicron wave since March 2022. Though several studies have evaluated the risk factors of severe infections, the analyses of BA.2 infection risk and protective factors among geriatric people was much limited. Methods This multicenter cohort study described clinical characteristics of geriatric Omicron infections (aged more than 60), and assessed risk and protective factors for severe infections. Results A total of 1377 patients older than 60 were enrolled, with 75.96% had comorbidities. The median viral shedding time and hospitalization time was 9 and 8 days, respectively. Severe/critical were associated with longer virus clearance time (aOR [95%CI]:0.706(0.533-0.935), P=0.015)), while fully vaccinated/booster and paxlovid use shortened viral shedding time (1.
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