Geriatric risk and protective factors for serious COVID-19 outcomes among older adults in Shanghai Omicron wave
et al., Emerging Microbes & Infections, doi:10.1080/22221751.2022.2109517, Aug 2022
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.
Resistance. Variants may be resistant to paxlovid1-8. Use may promote the emergence of variants that weaken host immunity and potentially contribute to long COVID9. Confounding by contraindication. Hoertel et al. find that over 50% of patients that died had a contraindication for the use of Paxlovid10. 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 paxlovid11. Kidney and liver injury. Studies show significantly increased risk of acute kidney injury12 and liver injury13.
Standard of Care (SOC) for COVID-19 in the study country,
China, is average with moderate efficacy for approved treatments14.
|
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 |
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8.
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Lu et al., 4 Aug 2022, retrospective, China, peer-reviewed, 13 authors.
Geriatric risk and protective factors for serious COVID-19 outcomes among older adults in Shanghai Omicron wave
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.
Supplementary materials
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