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Real-world efficacy and safety of azvudine in hospitalized older patients with COVID-19 during the omicron wave in China: A retrospective cohort study

Zhu et al., Acta Pharmaceutica Sinica B, doi:10.1016/j.apsb.2024.12.004, ChiCTR2300072750
Dec 2024  
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Mortality 22% Improvement Relative Risk Discharge 13% Hospitalization time 1% Time to viral- 10% Azvudine for COVID-19  Zhu et al.  LATE TREATMENT Is late treatment with azvudine beneficial for COVID-19? Retrospective 3,998 patients in China (December 2022 - February 2023) Lower mortality (p=0.001) and higher discharge (p=0.045) c19early.org Zhu et al., Acta Pharmaceutica Sinica B, Dec 2024 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 = 0.0000034 from 27 studies.
Lower risk for mortality, progression, and viral clearance.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 112 treatments. c19early.org
PSM retrospective 3,998 hospitalized COVID-19 patients aged 60 years and older in China showing lower all-cause mortality, higher rate of discharge, and shorter time to viral clearance with azvudine treatment.
risk of death, 22.0% lower, RR 0.78, p = 0.001, treatment 265 of 1,999 (13.3%), control 341 of 1,999 (17.1%), NNT 26, propensity score matching.
risk of no hospital discharge, 13.2% lower, RR 0.87, p = 0.045, treatment 323 of 1,999 (16.2%), control 372 of 1,999 (18.6%), NNT 41, propensity score matching.
hospitalization time, 1.4% lower, relative time 0.99, p = 0.43, treatment mean 13.8 (±6.2) n=1,676, control mean 14.0 (±8.2) n=1,623.
time to viral-, 10.4% lower, relative time 0.90, p < 0.001, treatment mean 12.9 (±6.6) n=1,676, control mean 14.4 (±9.5) n=1,623.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Zhu et al., 12 Dec 2024, retrospective, China, peer-reviewed, 55 authors, study period 1 December, 2022 - 28 February, 2023, trial ChiCTR2300072750. Contact: j790101@163.com.
This PaperAzvudineAll
Real-world efficacy and safety of azvudine in hospitalized older patients with COVID-19 during the omicron wave in China: A retrospective cohort study
Yuanchao Zhu, Fei Zhao, Yubing Zhu, Xingang Li, Deshi Dong, Bolin Zhu, Jianchun Li, Xin Hu, Zinan Zhao, Wenfeng Xu, Yang Jv, Dandan Wang, Yingming Zheng, Yiwen Dong, Lu Li, Shilei Yang, Zhiyuan Teng, Ling Lu, Jingwei Zhu, Linzhe Du, Yunxin Liu, Lechuan Jia, Qiujv Zhang, Hui Ma, Ana Zhao, Hongliu Jiang, Xin Xu, Jinli Wang, Xuping Qian, Wei Zhang, Tingting Zheng, Chunxia Yang, Xuguang Chen, Kun Liu, Huanhuan Jiang, Dongxiang Qu, Jia Song, Hua Cheng, Wenfang Sun, Hanqiu Zhan, Xiao Li, Yafeng Wang, Aixia Wang, Li Liu, Lihua Yang, Nan Zhang, Shumin Chen, Jingjing Ma, Wei Liu, Xiaoxiang Du, Meiqin Zheng, Liyan Wan, Guangqing Du, Hangmei Liu, Pengfei Jin
Acta Pharmaceutica Sinica B, doi:10.1016/j.apsb.2024.12.004
This multicenter, retrospective cohort study indicates that azvudine can reduce the all-cause mortality rate and shorten the time to nucleic acid-negative conversion in the elderly Chinese patients hospitalized due to COVID-19 infection.
Author contributions Yuanchao Zhu, Fei Zhao, and Pengfei Jin designed the study. Pengfei Jin led the study team. The underlying data at each subcenter were acquired by Xingang Fei Zhao and Yubing Zhu analysed the data. Yubing Zhu and Fei Zhao wrote the first draft of the manuscript, which was revised by Pengfei Jin and Yuanchao Zhu. All authors interpreted data, provided critical review and revision of the text, and approved the final version of the manuscript. All authors had access to the data underlying the study and accept responsibility for the decision to submit for publication. Conflicts of interest All researchers can confirm their independence from funders, and all authors, external and internal, had full access to all the data (including statistical reports and tables) in the study and can take responsibility for the integrity of the data and the accuracy of the data analysis. National Health Commission Clinical Research Projects for Innovative Drugs and National High Level Hospital Clinical Research Funding had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or J o u r n a l P r e -p r o o f
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Late treatment
is less effective
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