PhD Terry Cheuk-Fung Yip, MD Chung-Yan Lui, BSc Mandy Sze-Man Lai, MD Wai-Sun Wong, MPhil Yee-Kit Tse, Hon-Ming Bosco, MD Ma, MD Elsie Hui, MFM Maria Kw Leung, Henry Lik-Yuen, MD Chan, MD Shu-Cheong Hui, Lai-Hung Grace, MBChB Wong
Impact of the use of oral antiviral agents on the risk of hospitalization in community COVID-19 patients
References
Ahmad, Batool, Ain, Kim, Choi, Exploring the Binding Mechanism of PF-07321332 SARS-CoV-2 Protease Inhibitor through Molecular Dynamics and Binding Free Energy Simulations, Int J Mol Sci
Balint, Voros-Horvath, Szechenyi, Omicron: increased transmissibility and decreased pathogenicity, Signal Transduct Target Ther
Bernal, Da Silva, Musungaie, Molnupiravir for Oral Treatment of Covid-19 in Nonhospitalized Patients, N Engl J Med
Bhimraj, Morgan, Shumaker, Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19, Clin Infect Dis
Bloomberg, Hong Kong's Nursing Homes Are Unvaccinated Hotbeds of Covid
Cheung, Fung, Chow, Tung, Structured data entry of clinical information for documentation and data collection, Stud Health Technol Inform
Consortium, Whost, Pan, Peto, Repurposed Antiviral Drugs for Covid-19 -Interim WHO Solidarity Trial Results, N Engl J Med
Dal-Re, Becker, Bottieau, Holm, Availability of oral antivirals against SARS-CoV-2 infection and the requirement for an ethical prescribing approach, Lancet Infect Dis
De Anda, Johnson, Pedley, Molnupiravir for Covid-19 in Nonhospitalized Patients. Reply, N Engl J Med
Gandhi, Malani, Rio, COVID-19 Therapeutics for Nonhospitalized Patients, JAMA
Hammond, Leister-Tebbe, Gardner, Oral Nirmatrelvir for High-Risk, Nonhospitalized Adults with Covid-19, N Engl J Med
Hksar Government, Overall first-dose COVID-19 vaccination rate of RCHEs and RCHDs rises to 84 per cent on 11
Hui, Zumla, Advances in the epidemiology, clinical features, diagnosis, clinical management and prevention of coronavirus disease 2019, Curr Opin Pulm Med
Jo, Kim, Radnaabaatar, Model-based cost-effectiveness analysis of oral antivirals against SARS-CoV-2 in Korea, Epidemiol Health
Kabinger, Stiller, Schmitzova, Mechanism of molnupiravir-induced SARS-CoV-2 mutagenesis, Nat Struct Mol Biol
Krammer, SARS-CoV-2 vaccines in development, Nature
Lui, Yip, Wong, Significantly Lower Case-fatality Ratio of Coronavirus Disease 2019 (COVID-19) than Severe Acute Respiratory Syndrome (SARS) in Hong Kong-A Territory-Wide Cohort Study, Clin Infect Dis
Najjar-Debbiny, Gronich, Weber, Effectiveness of Paxlovid in Reducing Severe COVID-19 and Mortality in High Risk Patients, Clin Infect Dis
Pfizer, Evaluation of Protease Inhibition for COVID-19 in Standard-Risk Patients (EPIC-SR
Roth, Emmons-Bell, Alger, Trends in Patient Characteristics and COVID-19 In-Hospital Mortality in the United States During the COVID-19 Pandemic, JAMA Netw Open
Saravolatz, Depcinski, Sharma, Molnupiravir and Nirmatrelvir-Ritonavir: Oral COVID Antiviral Drugs, Clin Infect Dis
Thorlund, Sheldrick, Meyerowitz-Katz, Singh, Hill, Making Statistical Sense of the Molnupiravir MOVe-OUT Clinical Trial, Am J Trop Med Hyg
Vangeel, Chiu, Jonghe, Molnupiravir and Nirmatrelvir remain active against SARS-CoV-2 Omicron and other variants of concern, Antiviral Res
Wong, Au, Lau, Lau, Cowling et al., community-dwelling, ambulatory COVID-19 patients during the BA.2.2 wave in Hong Kong: an observational study,
doi:10.1101/2022.05.26.22275631Yip, Wong, Lui, Current and Past Infections of HBV Do Not Increase Mortality in Patients With COVID-19, Hepatology
{ 'indexed': {'date-parts': [[2022, 8, 29]], 'date-time': '2022-08-29T02:11:14Z', 'timestamp': 1661739074182},
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'abstract': '<jats:title>ABSTRACT</jats:title>\n'
' <jats:sec>\n'
' <jats:title>Background</jats:title>\n'
' <jats:p>We examined the effectiveness of molnupiravir and '
'nirmatrelvir/ritonavir in reducing hospitalization and deaths in a real-world cohort of '
'non-hospitalized COVID-19 patients.</jats:p>\n'
' </jats:sec>\n'
' <jats:sec>\n'
' <jats:title>Methods</jats:title>\n'
' <jats:p>This was a territory-wide retrospective cohort study in Hong Kong. '
'Non-hospitalized COVID-19 patients who attended designated outpatient clinics between 16 '
'February and 31 March 2022 were identified. Patients hospitalized on the day of the first '
'clinic appointment or used both oral antivirals were excluded. The primary endpoint was '
'hospitalization. The secondary endpoint was a composite of intensive care unit admission, '
'invasive mechanical ventilation use, and/or death.</jats:p>\n'
' </jats:sec>\n'
' <jats:sec>\n'
' <jats:title>Results</jats:title>\n'
' <jats:p>Of 93,883 patients, 83,154 (88.6%), 5,808 (6.2%), and 4,921 (5.2%) '
'were oral antiviral non-users, molnupiravir users, and nirmatrelvir/ritonavir users '
'respectively. Compared to non-users, oral antiviral users were older and had more '
'comorbidities, lower complete vaccination rate, and more hospitalizations in the previous '
'year. Molnupiravir users were older, and had more comorbidities, lower complete vaccination '
'rate, and more hospitalizations in the previous year than nirmatrelvir/ritonavir users. At a '
'median follow-up of 30 days, 1,931 (2.1%) patients were hospitalized and 225 (0.2%) patients '
'developed the secondary endpoint. After propensity score weighting, nirmatrelvir/ritonavir '
'use (weighted hazard ratio 0.79, 95%CI 0.65-0.95, P\u2009=\u20090.011) but not molnupiravir '
'use (weighted hazard ratio 1.17, 95%CI 0.99-1.39, P\u2009=\u20090.062) was associated with a '
'reduced risk of hospitalization than non-users. The use of molnupiravir or '
'nirmatrelvir/ritonavir was not associated with a lower risk of the secondary endpoint as '
'compared to non-users.</jats:p>\n'
' </jats:sec>\n'
' <jats:sec>\n'
' <jats:title>Conclusion</jats:title>\n'
' <jats:p>Use of nirmatrelvir/ritonavir but not molnupiravir was associated '
'with a reduced risk of hospitalization in real-world non-hospitalized COVID-19 '
'patients.</jats:p>\n'
' </jats:sec>',
'DOI': '10.1093/cid/ciac687',
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'title': 'Impact of the use of oral antiviral agents on the risk of hospitalization in community COVID-19 '
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'affiliation': [ { 'name': 'Department of Family Medicine, Prince of Wales Hospital, '
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