Reduced Viral Shedding Time in High-Risk COVID-19 Patients Infected by Omicron and Treated with Paxlovid: A Real-World Study from China
Wei Yang, Yahui Peng, Changsong Wang, Hongliu Cai, Lina Zhang, Jun Xu, Yongjie Wang, Maonan Wang, Mingyan Zhao, Kaijiang Yu
Infection and Drug Resistance, doi:10.2147/idr.s443574
Introduction: The purpose of this study was to compare the viral shedding time in patients infected with the Omicron variant during Paxlovid therapy and conventional therapy and to analyze the effects of Paxlovid on patients infected with COVID-19. Methods: In this study, the demographic and clinical characteristics and laboratory data of 3159 patients infected with the SARS-CoV -2 Omicron variant treated at Jilin Province People's Hospital were collected and analyzed. A total of 362 patients received Paxlovid therapy, and 2797 patients received conventional therapy. After propensity score matching (PSM), 1086 patients were obtained.
Results: The difference in platelet (PLT) count between the two groups was statistically significant but within the normal range (P < 0.05). CT value revealed that the nucleic acid test results became negative more quickly in the Paxlovid therapy group. Analysis of the Paxlovid therapy group showed that IgG and IgM levels were increased after Paxlovid therapy administration.
Conclusion: The CT value of the Paxlovid therapy group became negative more quickly. This finding suggests that Paxlovid treatment after early diagnosis of the Omicron variant may achieve good therapeutic efficacy.
Conclusions Our data show that the CT value of the Paxlovid therapy group became negative faster than that of the control group, suggesting that the use of the Paxlovid in Omicron variant may achieve excellent therapeutic efficacy after early diagnosis. Moreover, Paxlovid should be used with caution and only in high-risk patients.
Author Contributions All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.
Disclosure The authors declare that they have no conflicts of interest in this work.
References
Cegolon, Magnano, Negro, Filon, SARS-CoV-2 reinfections in health-care workers, 1 March 2020-31, Viruses,
doi:10.3390/v15071551Cegolon, Negro, Mastrangelo, Filon, Primary SARS-CoV-2 infections, re-infections and vaccine effectiveness during the Omicron transmission period in healthcare workers of Trieste and Gorizia (Northeast Italy), Viruses,
doi:10.3390/v14122688Cegolon, Pol, Simonetti, Filon, Luzzati, Molnupiravir, nirmatrelvir/ritonavir, or sotrovimab for high-risk COVID-19 patients infected by the Omicron variant: hospitalization, mortality, and time until negative swab test in real life, Pharmaceuticals,
doi:10.3390/ph16050721Chen, Gao, Wang, Wei, Prediction and mitigation of mutation threats to COVID-19 vaccines and antibody therapies, Chem. Sci,
doi:10.1039/D1SC01203GHammond, Leister-Tebbe, Gardner, Oral nirmatrelvir for high-risk, nonhospitalized adults with Covid-19, New Engl J Med,
doi:10.1056/NEJMoa2118542Li, Guan, Wu, Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia, New Engl J Med,
doi:10.1056/NEJMoa2001316Li, Li, Li, Zhang, Ma, Clinical characteristics and analysis of factors associated with severe COVID-19 patients in Liaoning, China: a multicenter retrospective study, J Transl Crit Care Med,
doi:10.4103/jtccm.jtccm_7_21Liu, Rocklöv, The reproductive number of the Delta variant of SARS-CoV-2 is far higher compared to the ancestral SARS-CoV-2 virus, J Travel Med,
doi:10.1093/jtm/taab124Long, Carius, Chavez, Clinical update on COVID-19 for the emergency clinician: presentation and evaluation, Am J Emergency Med,
doi:10.1016/j.ajem.2022.01.028Mahase, Covid-19: UK becomes first country to authorise antiviral molnupiravir, BMJ
Owen, Allerton, Anderson, An oral SARS-CoV-2 M(pro) inhibitor clinical candidate for the treatment of COVID-19, Science,
doi:10.1126/science.abl4784Vito, Moi, Saderi, Vaccination and antiviral treatment reduce the time to negative SARS-CoV-2 Swab: a real-life study,
doi:10.3390/v15112180{ 'indexed': {'date-parts': [[2024, 3, 30]], 'date-time': '2024-03-30T01:17:47Z', 'timestamp': 1711761467663},
'reference-count': 19,
'publisher': 'Informa UK Limited',
'license': [ { 'start': { 'date-parts': [[2024, 3, 1]],
'date-time': '2024-03-01T00:00:00Z',
'timestamp': 1709251200000},
'content-version': 'unspecified',
'delay-in-days': 0,
'URL': 'https://creativecommons.org/licenses/by-nc/3.0/'}],
'content-domain': {'domain': [], 'crossmark-restriction': False},
'DOI': '10.2147/idr.s443574',
'type': 'journal-article',
'created': {'date-parts': [[2024, 3, 29]], 'date-time': '2024-03-29T07:25:09Z', 'timestamp': 1711697109000},
'page': '1267-1279',
'source': 'Crossref',
'is-referenced-by-count': 0,
'title': 'Reduced Viral Shedding Time in High-Risk COVID-19 Patients Infected by Omicron and Treated with '
'Paxlovid: A Real-World Study from China',
'prefix': '10.2147',
'volume': 'Volume 17',
'author': [ {'given': 'Wei', 'family': 'Yang', 'sequence': 'additional', 'affiliation': []},
{'given': 'Yahui', 'family': 'Peng', 'sequence': 'additional', 'affiliation': []},
{ 'ORCID': 'http://orcid.org/0000-0002-0079-5259',
'authenticated-orcid': True,
'given': 'Changsong',
'family': 'Wang',
'sequence': 'additional',
'affiliation': []},
{'given': 'Hongliu', 'family': 'Cai', 'sequence': 'additional', 'affiliation': []},
{'given': 'Lina', 'family': 'Zhang', 'sequence': 'additional', 'affiliation': []},
{'given': 'Jun', 'family': 'Xu', 'sequence': 'additional', 'affiliation': []},
{'given': 'Yongjie', 'family': 'Wang', 'sequence': 'additional', 'affiliation': []},
{'given': 'Maonan', 'family': 'Wang', 'sequence': 'additional', 'affiliation': []},
{'given': 'Mingyan', 'family': 'Zhao', 'sequence': 'additional', 'affiliation': []},
{'given': 'Kaijiang', 'family': 'Yu', 'sequence': 'additional', 'affiliation': []}],
'member': '301',
'published-online': {'date-parts': [[2024, 3]]},
'reference': [ { 'key': 'ref1',
'doi-asserted-by': 'publisher',
'first-page': '727',
'DOI': '10.1056/NEJMoa2001017',
'volume': '382',
'author': 'Zhu',
'year': '2020',
'journal-title': 'New Engl J Med'},
{ 'key': 'ref2',
'doi-asserted-by': 'publisher',
'first-page': '1199',
'DOI': '10.1056/NEJMoa2001316',
'volume': '382',
'author': 'Li',
'year': '2020',
'journal-title': 'New Engl J Med'},
{ 'key': 'ref3',
'doi-asserted-by': 'publisher',
'first-page': '90',
'DOI': '10.4103/jtccm.jtccm_7_21',
'volume': '2',
'author': 'Li',
'year': '2020',
'journal-title': 'J Transl Crit Care Med'},
{ 'key': 'ref4',
'unstructured': 'World Health Organization. WHO Director-General’s opening remarks at the '
'media briefing on COVID-19; 2020. Available from: '
'https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-The-media-briefing-on-covid-19---11-march-2020. '
'Accessed March 11, 2020.'},
{ 'key': 'ref5',
'unstructured': 'World Health Organization. Tracking SARS-CoV-2 variants. Available from: '
'https://www.who.int/en/activities/tracking-SARS-CoV-2-variants. Accessed '
'February 21, 2022.'},
{ 'key': 'ref6',
'doi-asserted-by': 'publisher',
'first-page': '679',
'DOI': '10.1038/s41586-022-04411-y',
'volume': '603',
'author': 'Viana',
'year': '2022',
'journal-title': 'Nature'},
{ 'key': 'ref7',
'doi-asserted-by': 'publisher',
'first-page': '19',
'DOI': '10.1038/d41586-021-01390-4',
'volume': '594',
'author': 'Adam',
'year': '2021',
'journal-title': 'Nature'},
{ 'key': 'ref8',
'unstructured': 'Centers for Disease Control and Prevention. COVID data tracker: variant '
'pro-portions; 2022. Available from: '
'https://covid.cdc.gov/covid-data-tracker/#variant-proportions. Accessed '
'March 25, 2024.'},
{ 'key': 'ref9',
'doi-asserted-by': 'publisher',
'first-page': '6929',
'DOI': '10.1039/D1SC01203G',
'volume': '12',
'author': 'Chen',
'year': '2021',
'journal-title': 'Chem. Sci.'},
{ 'key': 'ref10',
'doi-asserted-by': 'publisher',
'DOI': '10.1093/jtm/taab124',
'volume': '28',
'author': 'Liu',
'year': '2021',
'journal-title': 'J Travel Med'},
{ 'key': 'ref11',
'doi-asserted-by': 'publisher',
'first-page': '46',
'DOI': '10.1016/j.ajem.2022.01.028',
'volume': '54',
'author': 'Long',
'year': '2022',
'journal-title': 'Am J Emergency Med'},
{ 'key': 'ref12',
'doi-asserted-by': 'publisher',
'first-page': '1551',
'DOI': '10.3390/v15071551',
'volume': '15',
'author': 'Cegolon',
'year': '2023',
'journal-title': 'Viruses'},
{ 'key': 'ref13',
'doi-asserted-by': 'publisher',
'first-page': '2688',
'DOI': '10.3390/v14122688',
'volume': '14',
'author': 'Cegolon',
'year': '2022',
'journal-title': 'Viruses'},
{ 'key': 'ref14',
'doi-asserted-by': 'publisher',
'first-page': '1586',
'DOI': '10.1126/science.abl4784',
'volume': '374',
'author': 'Owen',
'year': '2021',
'journal-title': 'Science'},
{ 'key': 'ref15',
'doi-asserted-by': 'crossref',
'first-page': 'n2697',
'DOI': '10.1136/bmj.n2697',
'volume': '375',
'author': 'Mahase',
'year': '2021',
'journal-title': 'BMJ'},
{ 'key': 'ref16',
'doi-asserted-by': 'crossref',
'first-page': 'n2713',
'DOI': '10.1136/bmj.n2713',
'volume': '375',
'author': 'Mahase',
'year': '2021',
'journal-title': 'BMJ'},
{ 'key': 'ref17',
'doi-asserted-by': 'publisher',
'first-page': '721',
'DOI': '10.3390/ph16050721',
'volume': '16',
'author': 'Cegolon',
'year': '2023',
'journal-title': 'Pharmaceuticals'},
{ 'key': 'ref18',
'doi-asserted-by': 'publisher',
'first-page': '1397',
'DOI': '10.1056/NEJMoa2118542',
'volume': '386',
'author': 'Hammond',
'year': '2022',
'journal-title': 'New Engl J Med'},
{ 'key': 'ref19',
'doi-asserted-by': 'publisher',
'first-page': '2180',
'DOI': '10.3390/v15112180',
'volume': '15',
'author': 'De Vito',
'year': '2023',
'journal-title': 'Viruses'}],
'container-title': 'Infection and Drug Resistance',
'original-title': [],
'language': 'en',
'link': [ { 'URL': 'https://www.dovepress.com/getfile.php?fileID=97994',
'content-type': 'application/pdf',
'content-version': 'vor',
'intended-application': 'text-mining'},
{ 'URL': 'https://www.dovepress.com/getfile.php?fileID=97994',
'content-type': 'application/pdf',
'content-version': 'vor',
'intended-application': 'similarity-checking'}],
'deposited': { 'date-parts': [[2024, 3, 29]],
'date-time': '2024-03-29T07:25:14Z',
'timestamp': 1711697114000},
'score': 1,
'resource': { 'primary': { 'URL': 'https://www.dovepress.com/reduced-viral-shedding-time-in-high-risk-covid-19-patients-infected-by-peer-reviewed-fulltext-article-IDR'}},
'subtitle': [],
'short-title': [],
'issued': {'date-parts': [[2024, 3]]},
'references-count': 19,
'URL': 'http://dx.doi.org/10.2147/IDR.S443574',
'relation': {},
'ISSN': ['1178-6973'],
'subject': ['Pharmacology (medical)', 'Infectious Diseases', 'Pharmacology'],
'container-title-short': 'IDR',
'published': {'date-parts': [[2024, 3]]}}
