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0 0.5 1 1.5 2+ Combined death/ventilat.. 19% Improvement Relative Risk Hospitalization 21% Paxlovid for COVID-19  Yip et al.  EARLY TREATMENT Is early treatment with paxlovid beneficial for COVID-19? Retrospective 88,075 patients in China (February - March 2022) Lower hospitalization with paxlovid (p=0.011) Yip et al., Clinical Infectious Diseases, May 2022 Favors paxlovid Favors control

Impact of the use of oral antiviral agents on the risk of hospitalization in community COVID-19 patients

Yip et al., Clinical Infectious Diseases, doi:10.1093/cid/ciac687 (date from preprint)
May 2022  
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Propensity score weighted retrospective of 93,883 outpatients in Hong Kong, 5,808 treated with molnupiravir and 4,921 treated with paxlovid, showing higher hospitalization and higher combined mortality/mechanical ventilation/ICU admission with molnupiravir, without statistical significance; and lower hospitalization and combined mortality/mechanical ventilation/ICU admission with paxlovid, statistically significant only for hospitalization.
Confounding by contraindication. Hoertel et al. find that over 50% of patients that died had a contraindication for the use of Paxlovid Hoertel. Retrospective studies that do not exclude contraindicated patients may significantly overestimate efficacy.
Black box warning. The FDA notes that "severe, life-threatening, and/or fatal adverse reactions due to drug interactions have been reported in patients treated with paxlovid" FDA.
This study includes paxlovid and molnupiravir.
combined death/ventilation/ICU, 19.0% lower, HR 0.81, p = 0.45, treatment 23 of 4,921 (0.5%), control 151 of 83,154 (0.2%), propensity score weighting, Cox proportional hazards, day 30.
risk of hospitalization, 21.0% lower, HR 0.79, p = 0.01, treatment 172 of 4,921 (3.5%), control 1,322 of 83,154 (1.6%), propensity score weighting, Cox proportional hazards, day 30.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Yip et al., 24 May 2022, retrospective, placebo-controlled, China, peer-reviewed, 11 authors, study period 16 February, 2022 - 31 March, 2022.
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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
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