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0 0.5 1 1.5 2+ Mortality 29% Improvement Relative Risk HRQoL score -28% Paxlovid for COVID-19  Shao et al.  LATE TREATMENT Is late treatment with paxlovid beneficial for COVID-19? Retrospective 1,082 patients in China (December 2022 - February 2023) Lower mortality with paxlovid (not stat. sig., p=0.16) Shao et al., medRxiv, May 2023 Favors paxlovid Favors control

Composite interventions on outcomes of severely and critically ill patients with COVID-19 in Shanghai, China

Shao et al., medRxiv, doi:10.1101/2023.05.10.23289325
May 2023  
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Retrospective 1,082 hospitalized COVID-19 patients in China, showing lower mortality and worse quality of life with 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 death, 29.0% lower, HR 0.71, p = 0.16, treatment 280, control 802, day 60.
relative HRQoL score, 28.3% worse, RR 1.28, p < 0.001, treatment mean 0.46 (±0.42) n=237, control mean 0.59 (±0.41) n=456, day 60.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Shao et al., 14 May 2023, retrospective, China, peer-reviewed, 9 authors, study period 8 December, 2022 - 9 February, 2023.
This PaperPaxlovidAll
Composite interventions on outcomes of severely and critically ill patients with COVID-19 in Shanghai, China
Jiasheng Shao, Rong Fan, Chengnan Guo, Xuyuan Huang, Runsheng Guo, Fengdi Zhang, Jianrong Hu, Gang Huang, Liou Cao
All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.
Author contributions Conflict of Interest All authors in the article declared that they have no competing interests. Ethical approval Statement This study was approved by the Ethics Committee of Jiading District Central Hospital affiliated to Shanghai University of Medicine and Health Sciences (Approval code 2023K15)
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Late treatment
is less effective
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