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

All Studies   All Outcomes    Recent:   
0 0.5 1 1.5 2+ Mortality 13% Improvement Relative Risk Progression -22% Paxlovid for COVID-19  Wang et al.  EARLY TREATMENT Is early treatment with paxlovid beneficial for COVID-19? Retrospective 249 patients in China Higher progression with paxlovid (not stat. sig., p=0.49) c19early.org Wang et al., eClinicalMedicine, February 2024 Favors paxlovid Favors control

Antiviral effectiveness and survival correlation of azvudine and nirmatrelvir/ritonavir in elderly severe patients with COVID-19: a retrospective real-world study

Wang et al., eClinicalMedicine, doi:10.1016/j.eclinm.2024.102468
Feb 2024  
  Post
  Facebook
Share
  Source   PDF   All   Meta
Retrospective 249 elderly patients with severe COVID-19, 128 treated with azvudine, 66 treated with paxlovid, and 55 receiving neither treatment, showing no significant differences for Ct value changes, progression, or survival for either treatment. Early viral decline was faster with paxlovid, without statistical significance.
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.
Study covers azvudine and paxlovid.
risk of death, 13.2% lower, HR 0.87, p = 0.67, treatment 66, control 55, adjusted per study, multivariable, Cox proportional hazards.
risk of progression, 22.2% higher, HR 1.22, p = 0.49, treatment 66, control 55, adjusted per study, ICU, mechanical ventilation, or death, multivariable, Cox proportional hazards.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Wang et al., 9 Feb 2024, retrospective, China, peer-reviewed, 47 authors.
This PaperPaxlovidAll
Antiviral effectiveness and survival correlation of azvudine and nirmatrelvir/ritonavir in elderly severe patients with COVID-19: a retrospective real-world study
Shuxia Wang, Jin Sun, Xin Zhang, Man Li, Bangguo Qin, Miao Liu, Nan Zhang, Shengshu Wang, Tingyu Zhou, Wei Zhang, Cong Ma, Xinli Deng, Yongyi Bai, Geping Qu, Lin Liu, Hui Shi, Bo Zhou, Ke Li, Bo Yang, Suxia Li, Fan Wang, Jinling Ma, Lu Zhang, Yajuan Wang, Li An, Wenhui Liu, Qing Chang, Ru Zhang, Xi Yin, Yang Yang, Qiangguo Ao, Qiang Ma, Shuangtong Yan, Haili Huang, Peng Song, Linggen Gao, Wenning Lu, Lining Xu, Li Lei, Keyu Wang, Qi Zhang, Qing Song, Zhijian Zhang, Xiangqun Fang, Yao He, Tianzhi Li, Ping Zhu
eClinicalMedicine, doi:10.1016/j.eclinm.2024.102468
Background Azvudine and nirmatrelvir/ritonavir are approved to treat mild-to-moderate coronavirus disease 2019 (COVID-19) in adults with a high risk for progression to severe infection. We sought to compare the antiviral effectiveness and clinical outcomes of elderly severe patients with COVID-19 receiving these two antiviral agents. Methods In this observational study, we identified 249 elderly patients with severe COVID-19 infection who were admitted to the Second Medical Center of the People's Liberation Army General Hospital from December 2022 to January 2023, including 128 azvudine recipients, 66 nirmatrelvir/ritonavir recipients and 55 patients not received antiviral treatments. We compared the cycle threshold (Ct) value dynamic change of all three groups. The primary outcome was a composite outcome of disease progression, including all-cause death, intensive care unit admission, and initiation of invasive mechanical ventilation. The outcomes of all enrolled patients were followed up from the electronic medical record system. Kaplan-Meier and Cox risk proportional regression analyses were used to compare the clinical outcomes of all three groups. To more directly compare the effectiveness of the two antiviral drugs, we performed propensity-score matching between the two antiviral groups and compared antiviral efficacy and clinical outcomes in the matched population.
Appendix A. Supplementary data Supplementary data related to this article can be found at https://doi. org/10.1016/j.eclinm.2024.102468.
References
Amani, Amani, Efficacy and safety of nirmatrelvir/ritonavir (Paxlovid) for COVID-19: a rapid review and meta-analysis, J Med Virol
Anesi, Maguire, Nirmatrelvir plus ritonavir for ambulatory COVID-19: expanding evidence, expanding role, Ann Intern Med
Chen, Tian, Efficacy and safety of azvudine in patients with COVID-19: a systematic review and meta-analysis, Heliyon
Chuang, Wu, Liu, Efficacy of nirmatrelvir and ritonavir for post-acute COVID-19 sequelae beyond 3 months of SARS-CoV-2 infection, J Med Virol
Deng, Li, Sun, Real-world effectiveness of Azvudine versus nirmatrelvir-ritonavir in hospitalized patients with COVID-19: a retrospective cohort study, J Med Virol
Gao, Luo, Ren, Antiviral effect of azvudine and nirmatrelvir-ritonavir among hospitalized patients with COVID-19, J Infect
Gentry, Nguyen, Thind, Kurdgelashvili, Williams, Characteristics and outcomes of US Veterans at least 65 years of age at high risk of severe SARS-CoV-2 infection with or without receipt of oral antiviral agents, J Infect
Hammond, Leister-Tebbe, Gardner, Oral nirmatrelvir for high-risk, nonhospitalized adults with covid-19, N Engl J Med
Karita, Dong, Johnston, Trajectory of viral RNA load among persons with incident SARS-CoV-2 G614 infection (wuhan strain) in association with COVID-19 symptom onset and severity, JAMA Netw Open
Lamb, Nirmatrelvir plus ritonavir: first approval, Drugs
Liu, Pan, Zhang, Efficacy and safety of Paxlovid in severe adult patients with SARS-Cov-2 infection: a multicenter randomized controlled study, Lancet Reg Health West Pac
Mannucci, Nobili, Multimorbidity and polypharmacy in the elderly: lessons from REPOSI, Internal Emerg Med
Moderbacher, Ramirez, Dan, Antigenspecific adaptive immunity to SARS-CoV-2 in acute COVID-19 and associations with age and disease severity, Cell
Najjar-Debbiny, Gronich, Weber, Effectiveness of paxlovid in reducing severe coronavirus disease 2019 and mortality in high-risk patients, Clin Infect Dis
Reis, Metzendorf, Kuehn, Nirmatrelvir combined with ritonavir for preventing and treating COVID-19, Cochrane Database Syst Rev
Shao, Fan, Guo, Composite interventions on outcomes of severely and critically ill patients with COVID-19 in Shanghai, China, Microorganisms
Sun, Dian, Oral Azvudine for hospitalised patients with COVID-19 and pre-existing conditions: a retrospective cohort study, EClinicalMedicine
Wan, Yan, Mok, Effectiveness of molnupiravir and nirmatrelvir-ritonavir in hospitalized patients with COVID-19 : a target trial emulation study, Ann Intern Med
Wong, Au, Lau, Lau, Cowling et al., Real-world effectiveness of early molnupiravir or nirmatrelvirritonavir in hospitalised patients with COVID-19 without supplemental oxygen requirement on admission during Hong Kong's omicron BA.2 wave: a retrospective cohort study, Lancet Infect Dis
Zhang, Li, Wang, Azvudine is a thymus-homing anti-SARS-CoV-2 drug effective in treating COVID-19 patients, Signal Transduct Targeted Ther
Zhao, Cheng, Zhang, Efficacy of nirmatrelvir-ritonavir versus azvudine for COVID-19 treatment in Tibet: a retrospective study, Infect Drug Resist
Zheng, Yu, Viral load dynamics and disease severity in patients infected with SARS-CoV-2 in Zhejiang province, China, January-March 2020: retrospective cohort study, BMJ
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. Vaccines and treatments are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment, vaccine, 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