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Risk prediction and early intervention strategies for persistent SARS-CoV-2 infection in patients with non-Hodgkin lymphoma: a retrospective cohort study

Zou et al., BMC Pulmonary Medicine, doi:10.1186/s12890-025-03524-0
Mar 2025  
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Viral clearance 9% Improvement Relative Risk Azvudine for COVID-19  Zou et al.  EARLY TREATMENT Is early treatment with azvudine beneficial for COVID-19? Retrospective 660 patients in China (January 2020 - June 2024) No significant difference in viral clearance c19early.org Zou et al., BMC Pulmonary Medicine, Mar 2025 Favorsazvudine Favorscontrol 0 0.5 1 1.5 2+
Azvudine for COVID-19
45th treatment shown to reduce risk in July 2023, now with p = 0.000008 from 33 studies.
Lower risk for mortality, progression, and viral clearance.
No treatment is 100% effective. Protocols combine treatments.
5,500+ studies for 119 treatments. c19early.org
Retrospective 660 patients with non-Hodgkin lymphoma (NHL) and SARS-CoV-2 infection, identifying risk factors for persistent COVID-19. There was no significant difference in persistent SARS-CoV-2 infection with paxlovid, molnupiravir, or azvudine treatment in unadjusted results. The extended study time period adds potential confounding by time, however this should result in overestimating treatment effects due to the later availability of these treatments and reducing severity of infection over time.
Standard of Care (SOC) for COVID-19 in the study country, China, is poor with low average efficacy for approved treatments1.
This study is excluded in the after exclusion results of meta analysis: unadjusted results with no group details; significant confounding by time possible.
Study covers paxlovid, azvudine, and molnupiravir.
risk of no viral clearance, 8.8% lower, RR 0.91, p = 0.88, treatment 14 of 91 (15.4%), control 96 of 569 (16.9%), NNT 67, day 14.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Zou et al., 15 Mar 2025, retrospective, China, peer-reviewed, 14 authors, study period January 2020 - June 2024. Contact: 15301050459@163.com, 604939512@qq.com.
This PaperAzvudineAll
Risk prediction and early intervention strategies for persistent SARS-CoV-2 infection in patients with non-Hodgkin lymphoma: a retrospective cohort study
Wailong Zou, Jia Zhang, Yulin Li, Yuwei Cao, Jiaxin Li, Zhe Zhang, Xin Zhang, Chuan Song, Rui Yang, Yaxin Yan, Yumin Wang, Xinjun Zhang, Zhe Xu, Jichao Chen
BMC Pulmonary Medicine, doi:10.1186/s12890-025-03524-0
Background Patients with non-Hodgkin lymphoma (NHL) face heightened mortality and accelerated disease progression when persistently infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This critical situation underscores the urgent need to identify risk factors and establish early intervention strategies tailored to this vulnerable population. The primary aim of this study was to investigate the risk factors associated with persistent SARS-CoV-2 infection in NHL patients during the COVID-19 pandemic. Methods A retrospective cohort study was conducted using data from January 2020 to June 2024, obtained from the Aerospace Center Hospital's database, electronic health records, and laboratory archives. Inclusion criteria comprised patients with confirmed NHL and SARS-CoV-2 infection, with persistence defined as positive viral test results beyond 14 days after initial diagnosis. Patients with incomplete medical records or loss of follow-up were excluded. Predictive models were developed and refined using logistic regression and random forest algorithms. The models incorporated data on demographics, comorbidities, laboratory findings, and imaging results. Model performance was evaluated using accuracy, precision, and the area under the receiver operating characteristic curve (AUC-ROC). Validation was conducted on an independent dataset to ensure generalizability, and the best-performing model guided the development of a prediction tool for early risk assessment and intervention. Results Key risk factors for persistent SARS-CoV-2 infection in NHL patients included advanced age, hypertension, diabetes, immunosuppressed status, low lymphocyte count, elevated C-reactive protein, high body mass index, anemia, reduced CD4 + cell count, and the presence of lung lesions. The random forest model demonstrated superior predictive performance, achieving an AUC of 0.93. The study further highlighted that prompt antiviral therapy, adjustments to immunosuppressive regimens, and enhanced monitoring significantly reduced infection persistence.
Abbreviations Declarations Ethics approval and consent to participate The study protocol was approved by the Institutional Review Board of the Aerospace Center Hospital (no. 2022-075) and was conducted according to the tenets of the Declaration of Helsinki. The need for informed consent was waived because of the retrospective nature of the study. Consent for publication Not applicable. Competing interests The authors declare no competing interests. Publisher's note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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JAMA Cardiol. 2020;5:811–8.", "volume": "5", "year": "2020" } ], "reference-count": 26, "references-count": 26, "relation": {}, "resource": { "primary": { "URL": "https://bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-025-03524-0" } }, "score": 1, "short-title": [], "source": "Crossref", "subject": [], "subtitle": [], "title": "Risk prediction and early intervention strategies for persistent SARS-CoV-2 infection in patients with non-Hodgkin lymphoma: a retrospective cohort study", "type": "journal-article", "update-policy": "https://doi.org/10.1007/springer_crossmark_policy", "volume": "25" }
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Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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