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c19early.org COVID-19 treatment researchAzvudineAzvudine (more..)
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All Studies   Meta Analysis       

Antiviral effectiveness and safety of azvudine in hospitalized SARS‐CoV‐2 patients with pre‐existing chronic respiratory diseases: A multicenter, retrospective cohort study

Feb 2025  
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Mortality 27% Improvement Relative Risk Progression -15% Azvudine for COVID-19  Sun et al.  LATE TREATMENT Is late treatment with azvudine beneficial for COVID-19? PSM retrospective 2,924 patients in China (December 2022 - January 2023) Lower mortality with azvudine (p=0.023) c19early.org Sun et al., VIEW, February 2025 Favorsazvudine Favorscontrol 0 0.5 1 1.5 2+
Azvudine for COVID-19
44th treatment shown to reduce risk in July 2023, now with p = 0.000000082 from 31 studies.
Lower risk for mortality, progression, and viral clearance.
No treatment is 100% effective. Protocols combine treatments.
5,300+ studies for 116 treatments. c19early.org
Retrospective 2,924 hospitalized COVID-19 patients with chronic respiratory diseases in China, showing lower all-cause mortality with azvudine, but no significant difference in composite disease progression.
Standard of Care (SOC): SOC for COVID-19 in the study country, China, is average with moderate average efficacy for approved treatments1.
risk of death, 27.0% lower, HR 0.73, p = 0.02, treatment 1,462, control 1,462, adjusted per study, propensity score matching, multivariable, Cox proportional hazards.
risk of progression, 15.0% higher, HR 1.15, p = 0.16, treatment 1,462, control 1,462, adjusted per study, progression to severe or death, propensity score matching, multivariable, Cox proportional hazards.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Sun et al., 5 Feb 2025, retrospective, China, peer-reviewed, 18 authors, study period 5 December, 2022 - 31 January, 2023, trial NCT06349655 (history). Contact: fccrenzg@zzu.edu.cn, fcccuigy@zzu.edu.cn.
This PaperAzvudineAll
Antiviral effectiveness and safety of azvudine in hospitalized SARS‐CoV‐2 patients with pre‐existing chronic respiratory diseases: A multicenter, retrospective cohort study
Junyi Sun, Mengzhao Yang, Daoke Yao, Yongjian Zhou, Xiaobo Hu, Guowu Qian, Yiqiang Yuan, Silin Li, Hong Luo, Shixi Zhang, Guangming Li, Donghua Zhang, Guotao Li, Yanyang Zhang, Xinjun Hu, Zujiang Yu, Guangying Cui, Zhigang Ren
VIEW, doi:10.1002/viw.20240133
Although azvudine has become a priority in the treatment of SARS-CoV-2, its effectiveness and safety among COVID-19 patients who already have chronic respiratory diseases (CRDs) have not been sufficiently validated. A retrospective, multicenter cohort study involving 10 hospitals in Henan Province was
C O N F L I C T O F I N T E R E S T S TAT E M E N T The authors declare no conflict of interest. D ATA AVA I L A B I L I T Y S TAT E M E N T All data relevant to the study are included in the article. O R C I D Zhigang Ren https://orcid.org/0000-0003-0798-3444 R E F E R E N C E S
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DOI record: { "DOI": "10.1002/viw.20240133", "ISSN": [ "2688-3988", "2688-268X" ], "URL": "http://dx.doi.org/10.1002/VIW.20240133", "abstract": "<jats:title>Abstract</jats:title><jats:p>Although azvudine has become a priority in the treatment of SARS‐CoV‐2, its effectiveness and safety among COVID‐19 patients who already have chronic respiratory diseases (CRDs) have not been sufficiently validated. A retrospective, multicenter cohort study involving 10 hospitals in Henan Province was performed to assess inpatients with COVID‐19 and CRDs (Clinical Trial Registration Number: NCT06349655). Azvudine recipients and the control group were matched at a 1:1 ratio using propensity scores. The clinical outcomes (all‐cause death and composite disease progression) were analyzed using Kaplan‒Meier and Cox regression analyses, with additional subgroup and sensitivity analyses performed. Eighteen clinical features were included to construct a nomogram for predicting the survival of inpatients with COVID‐19 and CRDs. Out of 37,606 hospitalized COVID‐19 patients, 1462 azvudine recipients and 1462 matched controls were included in the analysis. The results of Kaplan‒Meier and multivariate Cox regression analyses demonstrated that in contrast to the controls, azvudine use was associated with a decreased risk of all‐cause death in patients with COVID‐19 and pre‐existing CRDs (log‐rank: <jats:italic>p</jats:italic> = .012; HR: 0.73; 95% CI: 0.553‒0.956); but was not significantly different in terms of composite disease progression (log‐rank: <jats:italic>p</jats:italic> = .82; HR: 1.15; 95% CI: 0.948‒1.383). An analysis of subgroups and three sensitivity appraisals validate the above outcomes. The number and type of adverse events associated with azvudine treatment were acceptable. The concordance index (0.8499, 0.8497) and area under the curve (86.1%, 80.4%) of the nomogram showed satisfactory discriminative ability in the training and test sets. Azvudine could be effective in reducing all‐cause death among inpatients with COVID‐19 and CRDs and had few serious adverse events.</jats:p>", "alternative-id": [ "10.1002/VIW.20240133" ], "assertion": [ { "group": { "label": "Publication History", "name": "publication_history" }, "label": "Received", "name": "received", "order": 0, "value": "2024-11-30" }, { "group": { "label": "Publication History", "name": "publication_history" }, "label": "Accepted", "name": "accepted", "order": 2, "value": "2025-01-13" }, { "group": { "label": "Publication History", "name": "publication_history" }, "label": "Published", "name": "published", "order": 3, "value": "2025-02-05" } ], "author": [ { "affiliation": [ { "name": "Department of Infectious Diseases State Key Laboratory of Antiviral Drugs Pingyuan Laboratory The First Affiliated Hospital of Zhengzhou University Zhengzhou China" } ], "family": "Sun", "given": "Junyi", "sequence": "first" }, { "affiliation": [ { "name": "Department of Infectious 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"Department of Gastrointestinal Surgery Nanyang Central Hospital Nanyang China" } ], "family": "Qian", "given": "Guowu", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Cardiovascular Medicine Henan Provincial Chest Hospital Affiliated to Zhengzhou University Zhengzhou China" } ], "family": "Yuan", "given": "Yiqiang", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Respiratory and Critical Care Medicine Fengqiu County People's Hospital Xinxiang China" } ], "family": "Li", "given": "Silin", "sequence": "additional" }, { "affiliation": [ { "name": "Guangshan County People's Hospital Guangshan County Xinyang China" } ], "family": "Luo", "given": "Hong", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Infectious Diseases Shangqiu Municipal Hospital Shangqiu Henan Province China" } ], "family": "Zhang", "given": "Shixi", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Liver Disease The Affiliated Infectious Disease Hospital of Zhengzhou University Zhengzhou China" } ], "family": "Li", "given": "Guangming", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Infectious Diseases Anyang City Fifth People's Hospital Anyang China" } ], "family": "Zhang", "given": "Donghua", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Infectious Diseases Luoyang Central Hospital Affiliated to Zhengzhou University Luoyang China" } ], "family": "Li", "given": "Guotao", "sequence": "additional" }, { "affiliation": [ { "name": "Henan Center for Disease Control and Prevention Zhengzhou China" } ], "family": "Zhang", "given": "Yanyang", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Infectious Diseases The First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and Technology Luoyang China" } ], "family": "Hu", "given": "Xinjun", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Infectious Diseases State Key Laboratory of Antiviral Drugs Pingyuan Laboratory The First Affiliated Hospital of Zhengzhou University Zhengzhou China" } ], "family": "Yu", "given": "Zujiang", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Infectious Diseases State Key Laboratory of Antiviral Drugs Pingyuan Laboratory The First Affiliated Hospital of Zhengzhou University Zhengzhou China" } ], "family": "Cui", "given": "Guangying", "sequence": "additional" }, { "ORCID": "https://orcid.org/0000-0003-0798-3444", "affiliation": [ { "name": "Department of Infectious Diseases State Key Laboratory of Antiviral Drugs Pingyuan Laboratory The First Affiliated Hospital of Zhengzhou University Zhengzhou China" } ], "authenticated-orcid": false, "family": "Ren", "given": "Zhigang", "sequence": "additional" } ], "container-title": "VIEW", "container-title-short": "VIEW", "content-domain": { "crossmark-restriction": true, "domain": [ "onlinelibrary.wiley.com" ] }, "created": { 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Late treatment
is less effective
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.
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