Systematic evaluation of therapeutic effectiveness of Azvudine in treating COVID-19 hospitalized patients: a retrospective cohort study

DOI record: { "DOI": "10.3389/fcimb.2024.1453234", "ISSN": [ "2235-2988" ], "URL": "http://dx.doi.org/10.3389/fcimb.2024.1453234", "abstract": "<jats:sec><jats:title>Background</jats:title><jats:p>Azvudine, a repurposed oral small molecule antiviral drug, has potential effects in combating the SARS-CoV-2 virus. However, studies on its clinical efficacy in patients with COVID-19 are still limited and controversial, and further research and validation are necessary.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>A retrospective cohort study was conducted on COVID-19 patients who were hospitalized in the General Hospital of Central Theater Command from 1 December 2022 to 31 January 2023. We included 132 patients treated with Azvudine and 132 controls after screening and propensity score matching. The primary outcomes including all-cause mortality and a composite outcome of disease progression such as non-invasive respiratory support, invasive respiratory support, admission to intensive care unit (ICU), and death were compared.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Azvudine recipients had a much lower incidence rate of composite disease progression outcome than controls (13.9075/1000 person-days versus 25.7731/1000 person-days, <jats:italic>P</jats:italic>&amp;lt;0.05). Azvudine recipients also possessed a lower all-cause mortality rate than controls (2.6797/1000 person-days versus 8.5910/1000 person-days, <jats:italic>P</jats:italic>&amp;lt;0.01). Azvudine treatment significantly reduced the risk of composite disease progression (HR: 0.37, 95% CI: 0.16-0.84, <jats:italic>P</jats:italic>=0.017) and all-cause death (HR: 0.25, 95% CI: 0.08-0.81, <jats:italic>P</jats:italic>=0.021) after adjusting potential confounding factors such as age, sex, severity of COVID-19, complications, concomitant therapy, time from symptoms to treatment, and important laboratory indicators. The subgroup analyses of composite disease progression outcome and all-cause death indicated robustness of Azvudine’s in treating COVID-19 patients in general.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Our study demonstrates that Azvudine has a significant positive impact on the clinical recovery of hospitalized patients with COVID-19. These findings provide important support for the use of Azvudine as a therapeutic option for COVID-19, given the current divergent views on its therapeutic efficacy and its importance in public health and medical care.</jats:p></jats:sec>", "alternative-id": [ "10.3389/fcimb.2024.1453234" ], "author": [ { "affiliation": [], "family": "Xu", "given": "Yingkai", "sequence": "first" }, { "affiliation": [], "family": "Huang", "given": "Yuan", "sequence": "additional" }, { "affiliation": [], "family": "Yuan", "given": "Zihan", "sequence": "additional" }, { "affiliation": [], "family": "Liu", "given": "Wanbing", "sequence": "additional" }, { "affiliation": [], "family": "Wang", "given": "Li", "sequence": "additional" }, { "affiliation": [], "family": "Liu", "given": "Lei", "sequence": "additional" } ], "container-title": "Frontiers in Cellular and Infection Microbiology", "container-title-short": "Front. Cell. Infect. Microbiol.", "content-domain": { "crossmark-restriction": true, "domain": [ "frontiersin.org" ] }, "created": { "date-parts": [ [ 2024, 11, 7 ] ], "date-time": "2024-11-07T06:12:18Z", "timestamp": 1730959938000 }, "deposited": { "date-parts": [ [ 2024, 11, 7 ] ], "date-time": "2024-11-07T06:12:20Z", "timestamp": 1730959940000 }, "indexed": { "date-parts": [ [ 2024, 11, 8 ] ], "date-time": "2024-11-08T05:15:19Z", "timestamp": 1731042919890, "version": "3.28.0" }, "is-referenced-by-count": 0, "issued": { "date-parts": [ [ 2024, 11, 7 ] ] }, "license": [ { "URL": "https://creativecommons.org/licenses/by/4.0/", "content-version": "vor", "delay-in-days": 0, "start": { "date-parts": [ [ 2024, 11, 7 ] ], "date-time": "2024-11-07T00:00:00Z", "timestamp": 1730937600000 } } ], "link": [ { "URL": "https://www.frontiersin.org/articles/10.3389/fcimb.2024.1453234/full", "content-type": "unspecified", "content-version": "vor", "intended-application": "similarity-checking" } ], "member": "1965", "original-title": [], "prefix": "10.3389", "published": { "date-parts": [ [ 2024, 11, 7 ] ] }, "published-online": { "date-parts": [ [ 2024, 11, 7 ] ] }, "publisher": "Frontiers Media SA", "reference": [ { "DOI": "10.1002/bimj.200810488", "article-title": "Some methods of propensity-score matching had superior performance to others: Results of an empirical investigation and monte carlo simulations", "author": "Austin", "doi-asserted-by": "publisher", "first-page": "171", "journal-title": "Biom J.", "key": "B1", "volume": "51", "year": "2009" }, { "DOI": "10.3201/eid3002.230835", "article-title": "Public health impact of paxlovid as treatment for covid-19, United States", "author": "Bai", "doi-asserted-by": "publisher", "first-page": "262", "journal-title": "Emerging Infect. 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