Wong: Real-world effectiveness of early molnupiravir or nirmatrelvir–ritonavir in hospitalised patients with COVID-19 without supplemental oxygen requirement on admission during Hong Kong's omicron BA.2 wave: a retrospective cohort study [Paxlovid]

Real-world effectiveness of early molnupiravir or nirmatrelvir–ritonavir in hospitalised patients with COVID-19 without supplemental oxygen requirement on admission during Hong Kong's omicron BA.2 wave: a retrospective cohort study

Wong et al., The Lancet Infectious Diseases, doi:10.1016/S1473-3099(22)00507-2 (date from earlier preprint)

Wong et al., Real-world effectiveness of early molnupiravir or nirmatrelvir–ritonavir in hospitalised patients with.., The Lancet Infectious Diseases, doi:10.1016/S1473-3099(22)00507-2 (date from earlier preprint)

May 2022 Source PDF

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PSM retrospective 40,776 patients in Hong Kong, showing lower mortality and lower combined mortality, ventilation, ICU, and oxygen therapy with paxlovid treatment.

[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, 66.0% lower, HR 0.34, p < 0.001, treatment 890, control 890, propensity score matching.

risk of mechanical ventilation, 3.0% lower, HR 0.97, p = 0.96, treatment 890, control 890, propensity score matching.

combined death/ventilation/ICU/oxygen, 43.0% lower, HR 0.57, p < 0.001, treatment 890, control 890, propensity score matching.

hospitalization time, 4.3% lower, relative time 0.96, p = 0.32, treatment 890, control 890, propensity score matching.

Ct<30, 27.5% lower, HR 0.72, p = 0.01, treatment 890, control 890, inverted to make HR<1 favor treatment, propensity score matching.

Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates

Wong et al., 20 May 2022, retrospective, China, peer-reviewed, 6 authors, study period 26 February, 2022 - 26 April, 2022.

Contact: carlosho@hku.hk, bcowling@hku.hk.

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