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Oral azvudine for mild‐to‐moderate COVID‐19 in high risk, nonhospitalized adults: Results of a real‐world study

Yang et al., Journal of Medical Virology, doi:10.1002/jmv.28947
Jul 2023  
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Mortality 91% Improvement Relative Risk Hospitalization 75% Recovery 16% Azvudine for COVID-19  Yang et al.  EARLY TREATMENT Is early treatment with azvudine beneficial for COVID-19? Retrospective 804 patients in China (December 2022 - January 2023) Lower hospitalization with azvudine (p=0.047) c19early.org Yang et al., J. Medical Virology, July 2023 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 = 0.000011 from 26 studies.
Lower risk for mortality, progression, and viral clearance.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 109 treatments. c19early.org
PSM retrospective 804 high-risk, nonhospitalized adults with mild to moderate COVID-19 in China. The study compared outcomes between 317 patients who received azvudine with 487 patients who received standard supportive treatment only. The azvudine group had a lower rate of disease progression (composite of death or COVID-19 hospitalization) at 28 days, as well as a lower rate of COVID-19 hospitalization specifically after adjusting for factors. In addition, azvudine shortened the duration of fever if given within 3 days of symptom onset. However, azvudine treatment was associated with a higher incidence of adverse effects, including mainly mild gastrointestinal and nervous system effects.
risk of death, 90.8% lower, RR 0.09, p = 0.09, treatment 0 of 317 (0.0%), control 6 of 487 (1.2%), NNT 81, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm).
risk of hospitalization, 74.8% lower, RR 0.25, p = 0.047, treatment 317, control 487, propensity score weighting.
risk of no recovery, 16.0% lower, RR 0.84, p = 0.19, treatment 317, control 487, propensity score weighting.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Yang et al., 20 Jul 2023, retrospective, China, peer-reviewed, 11 authors, study period 19 December, 2022 - 5 January, 2023. Contact: anzhuoling@bjcyh.com, tongzhaohuicy@sina.com.
This PaperAzvudineAll
Oral azvudine for mild‐to‐moderate COVID‐19 in high risk, nonhospitalized adults: Results of a real‐world study
Hui Yang, Zhaojian Wang, Chunguo Jiang, Yi Zhang, Ying Zhang, Man Xu, Yi Zhang, Yushu Wang, Xuefeng Liu, Zhuoling An, Zhaohui Tong
Journal of Medical Virology, doi:10.1002/jmv.28947
Azvudine is recommended by Chinese health authorities for COVID-19 treatment but has not been tested in real-world clinical studies. This study aimed to evaluate the realworld effectiveness of Azvudine among COVID-19 nonhospitalized patients. This was a retrospective cohort study, looking at nonhospitalized patients who tested positive for SARS-CoV-2. Patients admitted between December 19, 2022 and January 5, 2023 were included. Those who received Azvudine treatment were in the Azvudine group, while those who received supportive treatment were the control group. The primary outcome was the disease progression rate by Day 28. Secondary outcomes were individual disease progression outcomes (death or COVID-19-related hospitalization) and duration of fever. The safety outcomes were assessed based on adverse events (AEs) overall, as well as AEs that were considered to be related to the drug. A total of 804 patients with high risk for progression were enrolled in our study. Among them, 317 (39.43%) received treatment with Azvudine. Our study found that Azvudine could reduce the rate of disease progression, as well as rate of COVID-19-related hospitalization in patients comparing the control group. Furthermore, if taken within 3 days of the onset of symptoms, it could also shorten the duration of fever. Despite a higher incidence of drug-related AEs compared to supportive treatment, the majority of these were mild. Azvudine has been found to be effective in reducing the rate of disease progression of COVID-19, albeit with a slight increase in AEs.
AUTHOR CONTRIBUTIONS Zhuoling An and Zhaohui Tong designed the experiments. Chunguo Jiang was responsible for clinical assessment of patients. Hui Yang, Zhaojian Wang, Yi Zhang, Man Xu, Ying Zhang, Yushu Wang, and Yi Zhang collected the data. Zhaojian Wang was responsible for data management. Hui Yang and Zhaojian Wang conducted the statistical analysis. This article was written by Hui Yang, and reviewed by Xuefeng Liu, Zhuoling An, and Zhaohui Tong. All authors reviewed the article. CONFLICT OF INTEREST STATEMENT The authors declare no conflict of interest. SUPPORTING INFORMATION Additional supporting information can be found online in the Supporting Information section at the end of this article.
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