Analgesics
Antiandrogens
Antihistamines
Azvudine
Bromhexine
Budesonide
Colchicine
Conv. Plasma
Curcumin
Famotidine
Favipiravir
Fluvoxamine
Hydroxychlor..
Ivermectin
Lifestyle
Melatonin
Metformin
Minerals
Molnupiravir
Monoclonals
Naso/orophar..
Nigella Sativa
Nitazoxanide
PPIs
Paxlovid
Quercetin
Remdesivir
Thermotherapy
Vitamins
More

Other
Feedback
Home
Top
Results
Abstract
All paxlovid studies
Meta analysis
 
Feedback
Home
next
study
previous
study
c19early.org COVID-19 treatment researchPaxlovidPaxlovid (more..)
Melatonin Meta
Metformin Meta
Antihistamines Meta
Azvudine Meta Molnupiravir Meta
Bromhexine Meta
Budesonide Meta
Colchicine Meta Nigella Sativa Meta
Conv. Plasma Meta Nitazoxanide Meta
Curcumin Meta PPIs Meta
Famotidine Meta Paxlovid Meta
Favipiravir Meta Quercetin Meta
Fluvoxamine Meta Remdesivir Meta
Hydroxychlor.. Meta Thermotherapy Meta
Ivermectin Meta

All Studies   All Outcomes       

Clinical Progression and Outcome of Hospitalized Patients Infected with SARS-CoV-2 Omicron Variant in Shanghai, China

Shao et al., Vaccines, doi:10.3390/vaccines10091409
Aug 2022  
  Post
  Facebook
Share
  Source   PDF   All Studies   Meta AnalysisMeta
Time to viral- 20% Improvement Relative Risk Paxlovid for COVID-19  Shao et al.  EARLY TREATMENT Is early treatment with paxlovid beneficial for COVID-19? Retrospective 131 patients in China (April - May 2022) Study compares with lianhuaqingwen, results vs. placebo may differ Faster viral clearance with paxlovid (p=0.00056) c19early.org Shao et al., Vaccines, August 2022 Favorspaxlovid Favorslianhuaqingwen 0 0.5 1 1.5 2+
Retrospective 226 patients in China, showing faster viral clearance with paxlovid. Age range and severity differed between groups.
Confounding by contraindication. Hoertel et al. find that over 50% of patients that died had a contraindication for the use of Paxlovid1. 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"2.
Use may promote the emergence of variants that weaken host immunity and potentially contribute to long COVID3.
Kamo et al. show significantly increased risk of acute kidney injury. Resistant variants are likely5,6.
This study is excluded in the after exclusion results of meta analysis: significant unadjusted differences between groups.
time to viral-, 20.0% lower, relative time 0.80, p < 0.001, treatment 17, control 114.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Shao et al., 28 Aug 2022, retrospective, China, peer-reviewed, median age 52.0, 12 authors, study period 6 April, 2022 - 11 May, 2022, average treatment delay 3.0 days, this trial compares with another treatment - results may be better when compared to placebo. Contact: huanggang@sumhs.edu.cn (corresponding author).
This PaperPaxlovidAll
Clinical Progression and Outcome of Hospitalized Patients Infected with SARS-CoV-2 Omicron Variant in Shanghai, China
Jiasheng Shao, Rong Fan, Jianrong Hu, Tiejun Zhang, Catherine Lee, Xuyuan Huang, Fei Wang, Haiying Liang, Ye Jin, Ying Jiang, Yanhua Gu, Gang Huang
Vaccines, doi:10.3390/vaccines10091409
Background: Studies on the Omicron variant infection have generally been restricted to descriptions of its initial clinical and epidemiological characteristics. We investigated the timelinerelated progression and clinical outcome in hospitalized individuals with the Omicron variant. Methods: We conducted a retrospective, single-centered study including 226 laboratory-confirmed cases with the Omicron variant between 6 April and 11 May 2022 in Shanghai, China. The final date of follow-up was 30 May 2022. Results: Among 226 enrolled patients, the median age was 52 years, and 118 (52.2%) were female. The duration from onset of symptoms to hospitalization was 3 days (interquartile range (IQR): 2-4 days) for symptomatic patients. Cough occurred in 168 patients (74.3%). The median interval to negative reverse-transcriptase PCR tests of nasopharynx swab was 10 days ((IQR): 8-13 days). No radiographic progressions were found in 196 patients on the 7th day after onset of symptoms. The median duration of fever in all participants was 5 days (IQR: 4-6 days). The median PCR conversion time of Paxlovid-treated patients was 8 days (IQR: 7-10 days) compared with that of a traditional Chinese herb medicine lianhuaqingwen (10 days, IQR: 8-13 days) (p = 0.00056). Booster vaccination can significantly decrease the severity of Omicron infection when compared with unvaccinated patients (p = 0.009). In multivariate logistic analysis, erythrocyte sedimentation rate (ESR) (OR = 1.05) was independently related to the severity of the infection. Conclusions: The majority of clinical symptoms of Omicron infection were not severe. Early and aggressive administration of Paxlovid can significantly reduce the PCR conversion time. Booster vaccination should also be highly recommended in the population over 14 years old.
Factors Related to the Severity of the Infection To figure out factors that were associated with the severity of the disease, we compared clinical laboratory characters and vaccination status of asymptomatic (n = 4), mild (n = 180), and moderate (n = 41) patients. In univariate analysis, older age, comorbidity, lymphopenia, high levels of CRP, ESR, lactate, estimated glomerular filtration rate (e-GFR), low levels of albumin, and fewer vaccination doses are all associated with the severity of Omicron infection. In multivariate logistic analysis, ESR (OR = 1.05) was independently related to the severity of the infection (Table 3 ). Discussion On 24 November 2021, the World Health Organization (WHO) announced a new variant of SARS-CoV-2 Omicron in South Africa, and 17 days later, the first case infected with Omicron in China was identified [15] . Recent investigations on the Omicron variant have described the epidemiologic characteristics, initial clinical, laboratory, and radiological findings [4, 6, 16] . To our knowledge, we are the first to describe the temporal clinical progression of Omicron variant infection to date. Our investigation has several distinguished features from current research. As one of the megacities and most important economic centers in China, the policy of "Dynamic zero" was implemented strictly in Shanghai. The whole city underwent completely lockdown during the pandemic outbreak since the end of March 2022 [17] . Under the policy of..
References
Abas, Marfuah, Idroes, Kusumawaty, Fatimawali, None
Anjos, Fiaccadori, Servian, Da Fonseca, Guilarde et al., SARS-CoV-2 loads in urine, sera and stool specimens in association with clinical features of COVID-19 patients, J. Clin. Virol. Plus, doi:10.1016/j.jcvp.2021.100059
Bennasrallah, Zemni, Dhouib, Sriha, Mezhoud et al., Factors associated with a prolonged negative conversion of viral RNA in patients with COVID-19, Int. J. Infect. Dis, doi:10.1016/j.ijid.2021.02.089
Butt, Dargham, Loka, Shaik, Chemaitelly et al., COVID-19 Disease Severity in Children Infected with the Omicron Variant, Clin. Infect. Dis, doi:10.1093/cid/ciac275
Cann, Fever: Could A Cardinal Sign of COVID-19 Infection Reduce Mortality?, Am. J. Med. Sci, doi:10.1016/j.amjms.2021.01.004
Chen, Qi, Liu, Ling, Qian et al., Clinical progression of patients with COVID-19 in Shanghai, China, J. Infect, doi:10.1016/j.jinf.2020.03.004
Graham, Daily briefing: Omicron struggles to infect the lungs, Nature, doi:10.1038/d41586-022-00039-0
Guan, Ni, Hu, Liang, Ou et al., Clinical Characteristics of Coronavirus Disease 2019 in China, N. Engl. J. Med, doi:10.1056/NEJMoa2002032
Gupta, SARS-CoV-2 Omicron spike mediated immune escape and tropism shift, Res. Sq, doi:10.21203/rs.3.rs-1191837/v1
He, Lau, Wu, Deng, Wang et al., Temporal dynamics in viral shedding and transmissibility of COVID-19, Nat. Med, doi:10.1038/s41591-020-0869-5
Huang, Zeng, Letter to the editor: Epidemiology of the SARS-CoV-2 variant Omicron BA.2-vigilance needed, Euro Surveill, doi:10.2807/1560-7917.ES.2022.27.13.2200254
Hui, Ho, Cheung, Ng, Ching et al., SARS-CoV-2 Omicron variant replication in human bronchus and lung ex vivo, Nature, doi:10.1038/s41586-022-04479-6
Kim, Lee, Choi, Um, Lee et al., Clinical Characteristics of 40 Patients Infected With the SARS-CoV-2 Omicron Variant in Korea, J. Korean Med. Sci, doi:10.3346/jkms.2022.37.e31
Kozlov, Omicron's feeble attack on the lungs could make it less dangerous, Nature, doi:10.1038/d41586-022-00007-8
Lee, Choe, Jeong, Kim, Kim et al., Importation and Transmission of SARS-CoV-2 B.1.1.529 (Omicron) Variant of Concern in Korea, J. Korean Med. Sci, doi:10.3346/jkms.2021.36.e346
Liang, Hui, Liu, Qiao, Li et al., Insights into forsythia honeysuckle (Lianhuaqingwen) capsules: A Chinese herbal medicine repurposed for COVID-19 pandemic, Phytomed. Plus, doi:10.1016/j.phyplu.2021.100027
Liu, Gao, Yuan, Yang, Shi et al., Efficacy and safety of herbal medicine (Lianhuaqingwen) for treating COVID-19: A systematic review and meta-analysis, Integr. Med. Res, doi:10.1016/j.imr.2020.100644
Martin, Dewitt, Russell, Sanchez-Pinto, Haendel et al., Acute Upper Airway Disease in Children With the Omicron (B.1.1.529) Variant of SARS-CoV-2-A Report from the US National COVID Cohort Collaborative, JAMA Pediatr, doi:10.1001/jamapediatrics.2022.1110
Maslo, Friedland, Toubkin, Laubscher, Akaloo et al., Characteristics and Outcomes of Hospitalized Patients in South Africa During the COVID-19 Omicron Wave Compared With Previous Waves, JAMA, doi:10.1001/jama.2021.24868
Mesfin, Chen, Bond, Lam, Cheung et al., Epidemiology of infections with SARS-CoV-2 Omicron BA.2 variant in Hong Kong, medRxiv, doi:10.1101/2022.04.07.22273595
Nhcotpsro, Notice on printing and distributing the COVID-19 Pneumonia Diagnosis and Treatment Plan (Ninth Trial Version
Park, Siyadatpanah, Alhumaydhi, Mahmud, Tallei, Can the SARS-CoV-2 Omicron Variant Confer Natural Immunity against COVID-19?, Molecules
Rossler, Riepler, Bante, Von Laer, Kimpel, SARS-CoV-2 Omicron Variant Neutralization in Serum from Vaccinated and Convalescent Persons, N. Engl. J. Med, doi:10.1056/NEJMc2119236
Runfeng, Yunlong, Jicheng, Weiqi, Qinhai et al., Lianhuaqingwen exerts anti-viral and anti-inflammatory activity against novel coronavirus (SARS-CoV-2), Pharmacol. Res, doi:10.1016/j.phrs.2020.104761
Shen, Li, Tu, Wu, Peng et al., Positive effects of Lianhuaqingwen granules in COVID-19 patients: A retrospective study of 248 cases, J. Ethnopharmacol, doi:10.1016/j.jep.2021.114220
Singhal, The Emergence of Omicron: Challenging Times Are Here Again!, Indian J. Pediatr, doi:10.1007/s12098-022-04077-4
Sun, Li, Huang, Shi, Xing et al., Case Report of China/Tianjin's First Novel Coronavirus Variant Omicron, Iran J. Immunol, doi:10.22034/IJI.2022.94050.2278
Team, -R, Omicron) Variant-United States, doi:10.15585/mmwr.mm7050e1
Thakur, Ratho, Omicron, A new SARS-CoV-2 variant of concern mounting worldwide fear, J. Med. Virol, doi:10.1002/jmv.27541
Torjesen, Covid-19: Peak of viral shedding is later with omicron variant, Japanese data suggest, BMJ, doi:10.1136/bmj.o89
Wang, Prather, Sznitman, Jimenez, Lakdawala et al., Airborne transmission of respiratory viruses, Science, doi:10.1126/science.abd9149
Wang, Yang, In the age of Omicron variant: Paxlovid raises new hopes of COVID-19 recovery, J. Med. Virol, doi:10.1002/jmv.27540
Widders, Broom, Broom, SARS-CoV-2: The viral shedding vs infectivity dilemma, Infect. Dis. Health
Wu, Guo, Tang, Hong, Zhou et al., Prolonged presence of SARS-CoV-2 viral RNA in faecal samples, Lancet Gastroenterol. Hepatol, doi:10.1016/S2468-1253(20)30083-2
Yan, Zhang, Chen, Jiang, Liu et al., Characteristics of Viral Shedding Time in SARS-CoV-2 Infections: A Systematic Review and Meta-Analysis, Front. Public Health
Yuan, Hou, Lin, Chen, Ren, How China responds to Omicron, J. Infect, doi:10.1016/j.jinf.2022.04.017
{ 'indexed': {'date-parts': [[2022, 8, 31]], 'date-time': '2022-08-31T07:41:17Z', 'timestamp': 1661931677965}, 'reference-count': 37, 'publisher': 'MDPI AG', 'issue': '9', 'license': [ { 'start': { 'date-parts': [[2022, 8, 28]], 'date-time': '2022-08-28T00:00:00Z', 'timestamp': 1661644800000}, 'content-version': 'vor', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0/'}], 'funder': [ { 'DOI': '10.13039/501100015377', 'name': 'Shanghai Key Laboratory of Molecular Imaging', 'doi-asserted-by': 'publisher', 'award': ['18DZ2260400']}], 'content-domain': {'domain': [], 'crossmark-restriction': False}, 'abstract': '<jats:p>Background: Studies on the Omicron variant infection have generally been restricted ' 'to descriptions of its initial clinical and epidemiological characteristics. We investigated ' 'the timeline-related progression and clinical outcome in hospitalized individuals with the ' 'Omicron variant. Methods: We conducted a retrospective, single-centered study including 226 ' 'laboratory-confirmed cases with the Omicron variant between 6 April and 11 May 2022 in ' 'Shanghai, China. The final date of follow-up was 30 May 2022. Results: Among 226 enrolled ' 'patients, the median age was 52 years, and 118 (52.2%) were female. The duration from onset ' 'of symptoms to hospitalization was 3 days (interquartile range (IQR): 2–4 days) for ' 'symptomatic patients. Cough occurred in 168 patients (74.3%). The median interval to negative ' 'reverse-transcriptase PCR tests of nasopharynx swab was 10 days ((IQR): 8–13 days). No ' 'radiographic progressions were found in 196 patients on the 7th day after onset of symptoms. ' 'The median duration of fever in all participants was 5 days (IQR: 4–6 days). The median PCR ' 'conversion time of Paxlovid-treated patients was 8 days (IQR: 7–10 days) compared with that ' 'of a traditional Chinese herb medicine lianhuaqingwen (10 days, IQR: 8–13 days) (p = ' '0.00056). Booster vaccination can significantly decrease the severity of Omicron infection ' 'when compared with unvaccinated patients (p = 0.009). In multivariate logistic analysis, ' 'erythrocyte sedimentation rate (ESR) (OR = 1.05) was independently related to the severity of ' 'the infection. Conclusions: The majority of clinical symptoms of Omicron infection were not ' 'severe. Early and aggressive administration of Paxlovid can significantly reduce the PCR ' 'conversion time. Booster vaccination should also be highly recommended in the population over ' '14 years old.</jats:p>', 'DOI': '10.3390/vaccines10091409', 'type': 'journal-article', 'created': {'date-parts': [[2022, 8, 31]], 'date-time': '2022-08-31T06:09:36Z', 'timestamp': 1661926176000}, 'page': '1409', 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': 'Clinical Progression and Outcome of Hospitalized Patients Infected with SARS-CoV-2 Omicron ' 'Variant in Shanghai, China', 'prefix': '10.3390', 'volume': '10', 'author': [ {'given': 'Jiasheng', 'family': 'Shao', 'sequence': 'first', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0002-0814-0548', 'authenticated-orcid': False, 'given': 'Rong', 'family': 'Fan', 'sequence': 'additional', 'affiliation': []}, {'given': 'Jianrong', 'family': 'Hu', 'sequence': 'additional', 'affiliation': []}, {'given': 'Tiejun', 'family': 'Zhang', 'sequence': 'additional', 'affiliation': []}, {'given': 'Catherine', 'family': 'Lee', 'sequence': 'additional', 'affiliation': []}, {'given': 'Xuyuan', 'family': 'Huang', 'sequence': 'additional', 'affiliation': []}, {'given': 'Fei', 'family': 'Wang', 'sequence': 'additional', 'affiliation': []}, {'given': 'Haiying', 'family': 'Liang', 'sequence': 'additional', 'affiliation': []}, {'given': 'Ye', 'family': 'Jin', 'sequence': 'additional', 'affiliation': []}, {'given': 'Ying', 'family': 'Jiang', 'sequence': 'additional', 'affiliation': []}, {'given': 'Yanhua', 'family': 'Gu', 'sequence': 'additional', 'affiliation': []}, {'given': 'Gang', 'family': 'Huang', 'sequence': 'additional', 'affiliation': []}], 'member': '1968', 'published-online': {'date-parts': [[2022, 8, 28]]}, 'reference': [ { 'key': 'ref1', 'doi-asserted-by': 'publisher', 'DOI': '10.2807/1560-7917.ES.2022.27.13.2200254'}, {'key': 'ref2', 'doi-asserted-by': 'publisher', 'DOI': '10.1002/jmv.27541'}, {'key': 'ref3', 'doi-asserted-by': 'publisher', 'DOI': '10.1007/s12098-022-04077-4'}, {'key': 'ref4', 'doi-asserted-by': 'publisher', 'DOI': '10.3346/jkms.2022.37.e31'}, {'key': 'ref5', 'doi-asserted-by': 'publisher', 'DOI': '10.3346/jkms.2021.36.e346'}, {'key': 'ref6', 'doi-asserted-by': 'publisher', 'DOI': '10.15585/mmwr.mm7050e1'}, { 'key': 'ref7', 'unstructured': 'COVID-19 Coronavirus Pandemic: Reported Cases and Deaths by Country or ' 'Territory\n' 'https://www.worldometers.info/coronavirus/'}, {'key': 'ref8', 'article-title': 'Shanghai Municipal Health Commission', 'year': '2022'}, {'key': 'ref9', 'doi-asserted-by': 'publisher', 'DOI': '10.1002/jmv.27540'}, {'key': 'ref10', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.jep.2021.114220'}, {'key': 'ref11', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.imr.2020.100644'}, { 'key': 'ref12', 'article-title': 'Notice on printing and distributing the COVID-19 Pneumonia Diagnosis ' 'and Treatment Plan (Ninth Trial Version) 2022', 'author': 'China NHCotPsRo', 'year': '2022'}, {'key': 'ref13', 'doi-asserted-by': 'publisher', 'DOI': '10.1056/NEJMoa2002032'}, {'key': 'ref14', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.amjms.2021.01.004'}, {'key': 'ref15', 'doi-asserted-by': 'publisher', 'DOI': '10.22034/IJI.2022.94050.2278'}, {'key': 'ref16', 'doi-asserted-by': 'publisher', 'DOI': '10.1001/jama.2021.24868'}, {'key': 'ref17', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.jinf.2022.04.017'}, {'key': 'ref18', 'doi-asserted-by': 'publisher', 'DOI': '10.1038/s41586-022-04479-6'}, {'key': 'ref19', 'doi-asserted-by': 'publisher', 'DOI': '10.21203/rs.3.rs-1191837/v1'}, {'key': 'ref20', 'doi-asserted-by': 'publisher', 'DOI': '10.1126/science.abd9149'}, {'key': 'ref21', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.ijid.2021.02.089'}, {'key': 'ref22', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.idh.2020.05.002'}, {'key': 'ref23', 'doi-asserted-by': 'publisher', 'DOI': '10.1038/s41591-020-0869-5'}, {'key': 'ref24', 'doi-asserted-by': 'publisher', 'DOI': '10.1136/bmj.o89'}, {'key': 'ref25', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.jinf.2020.03.004'}, {'key': 'ref26', 'doi-asserted-by': 'publisher', 'DOI': '10.1038/d41586-022-00039-0'}, {'key': 'ref27', 'doi-asserted-by': 'publisher', 'DOI': '10.1038/d41586-022-00007-8'}, {'key': 'ref28', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.phrs.2020.104761'}, {'key': 'ref29', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.phyplu.2021.100027'}, {'key': 'ref30', 'doi-asserted-by': 'publisher', 'DOI': '10.1101/2022.04.07.22273595'}, {'key': 'ref31', 'doi-asserted-by': 'publisher', 'DOI': '10.1056/NEJMc2119236'}, {'key': 'ref32', 'doi-asserted-by': 'publisher', 'DOI': '10.3390/molecules27072221'}, {'key': 'ref33', 'doi-asserted-by': 'publisher', 'DOI': '10.1093/cid/ciac275'}, {'key': 'ref34', 'doi-asserted-by': 'publisher', 'DOI': '10.1001/jamapediatrics.2022.1110'}, {'key': 'ref35', 'doi-asserted-by': 'publisher', 'DOI': '10.3389/fpubh.2021.652842'}, {'key': 'ref36', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.jcvp.2021.100059'}, {'key': 'ref37', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/S2468-1253(20)30083-2'}], 'container-title': 'Vaccines', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://www.mdpi.com/2076-393X/10/9/1409/pdf', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2022, 8, 31]], 'date-time': '2022-08-31T07:10:13Z', 'timestamp': 1661929813000}, 'score': 1, 'resource': {'primary': {'URL': 'https://www.mdpi.com/2076-393X/10/9/1409'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2022, 8, 28]]}, 'references-count': 37, 'journal-issue': {'issue': '9', 'published-online': {'date-parts': [[2022, 9]]}}, 'alternative-id': ['vaccines10091409'], 'URL': 'http://dx.doi.org/10.3390/vaccines10091409', 'relation': {}, 'ISSN': ['2076-393X'], 'subject': [ 'Pharmacology (medical)', 'Infectious Diseases', 'Drug Discovery', 'Pharmacology', 'Immunology'], 'container-title-short': 'Vaccines', 'published': {'date-parts': [[2022, 8, 28]]}}
Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
  or use drag and drop   
Submit