Real-world effectiveness of Azvudine in hospitalized patients with COVID-19: a retrospective cohort study
Minxue Shen, Chenggen Xiao, Yuming Sun, Daishi Li, Ping Wu, Liping Jin, Qingrong Wu, Yating Dian, Yu Meng, Furong Zeng, Xiang Chen, Guangtong Deng
doi:10.1101/2023.01.23.23284899
Current guidelines prioritize the use of the Azvudine in coronavirus disease 2019 (COVID-19) patients. However, the clinical effectiveness of Azvudine in real-world studies was lacking, despite the clinical trials showed shorter time of nucleic acid negative conversion. To evaluate the clinical effectiveness following Azvudine treatment in hospitalized COVID-19 patients, we identified 1505 hospitalized COVID-19 patients during the study period, with a follow-up of up to 29 days. After exclusions and propensity score matching, we included 226 Azvudine recipients and 226 matched controls. The lower crude incidence rate of composite disease progression outcome (4.21 vs. 10.39 per 1000 person-days, P=0.041) and all-cause mortality (1.57 vs. 6.00 per 1000 person-days, P=0.027) were observed among Azvudine recipients compared with matched controls. The incidence rates of initiation of invasive mechanical ventilation were also statistically different between the groups according to the log-rank tests (P=0.020). Azvudine treatment was associated with significantly lower risks of composite disease progression outcome (hazard ratio [HR]: 0.43; 95% confidence interval [CI]: 0.18 to 0.99) and all-cause death (HR: 0.26; 95% CI: 0.07 to 0.94) compared with matched controls. Subgroup analyses indicated robustness of the point estimates of HRs (ranged from 0.14 to 0.84). Notably, male Azvudine recipients had a stronger effectiveness than female recipients with respect to both composite outcome and all-cause death. These findings suggest that Azvudine treatment showed substantial clinical benefits in hospitalized COVID-19 patients, and should be considered for use in this population of patients.
CONFLICT OF INTERESTS The authors declare no conflicts of interest that pertain to this work.
CONTRIBUTIONS Conception and design: Guangtong, Xiang Chen, Furong Zeng, and Minxue Shen. Acquisition of data: Furong Zeng, Chenggen Xiao, Yuming Sun, Daishi Li, Ping Wu. Interpretation of data, statistical analysis and manuscript writing: Guangtong Deng, Furong Zeng, and Minxue Shen.
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'abstract': '<jats:p>Current guidelines prioritize the use of the Azvudine in coronavirus disease 2019 '
'(COVID-19) patients. However, the clinical effectiveness of Azvudine in real-world studies '
'was lacking, despite the clinical trials showed shorter time of nucleic acid negative '
'conversion. To evaluate the clinical effectiveness following Azvudine treatment in '
'hospitalized COVID-19 patients, we identified 1505 hospitalized COVID-19 patients during the '
'study period, with a follow-up of up to 29 days. After exclusions and propensity score '
'matching, we included 226 Azvudine recipients and 226 matched controls. The lower crude '
'incidence rate of composite disease progression outcome (4.21 vs. 10.39 per 1000 person-days, '
'P=0.041) and all-cause mortality (1.57 vs. 6.00 per 1000 person-days, P=0.027) were observed '
'among Azvudine recipients compared with matched controls. The incidence rates of initiation '
'of invasive mechanical ventilation were also statistically different between the groups '
'according to the log-rank tests (P=0.020). Azvudine treatment was associated with '
'significantly lower risks of composite disease progression outcome (hazard ratio [HR]: 0.43; '
'95% confidence interval [CI]: 0.18 to 0.99) and all-cause death (HR: 0.26; 95% CI: 0.07 to '
'0.94) compared with matched controls. Subgroup analyses indicated robustness of the point '
'estimates of HRs (ranged from 0.14 to 0.84). Notably, male Azvudine recipients had a stronger '
'effectiveness than female recipients with respect to both composite outcome and all-cause '
'death. These findings suggest that Azvudine treatment showed substantial clinical benefits in '
'hospitalized COVID-19 patients, and should be considered for use in this population of '
'patients.</jats:p>',
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'title': 'Real-world effectiveness of Azvudine in hospitalized patients with COVID-19: a retrospective '
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