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

Shao et al., Composite interventions on outcomes of severely and critically ill patients with COVID-19 in Shanghai, China, medRxiv, doi:10.1101/2023.05.10.23289325

May 2023 Source PDF

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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] find that over 50% of patients that died had a contraindication for the use of Paxlovid. Retrospective studies that do not exclude contraindicated patients may significantly overestimate efficacy.

1. Hoertel et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2022.42140, Prevalence of Contraindications to Nirmatrelvir-Ritonavir Among Hospitalized Patients With COVID-19 at Risk for Progression to Severe Disease, https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2798450.

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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.

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Late treatment
is less effective

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