Clinical effectiveness of oral antiviral agents for treating non-hospitalized COVID-19 patients with chronic kidney disease.

IF 4.2 2区医学 Q1 INFECTIOUS DISEASES

Expert Review of Anti-infective Therapy Pub Date : 2024-08-01 Epub Date: 2024-03-26 DOI:10.1080/14787210.2024.2334052

Chia-Chen Chen, Chi-Ya Huang, Jheng-Yan Wu, Mei-Yuan Liu, Min-Hsiang Chuang, Ting-Hui Liu, Ya-Wen Tsai, Wan-Hsuan Hsu, Po-Yu Huang, Ming-Hui Chen, Su-Yen Liu, Mei-Chuan Lee, Kuo-Chuan Hung, Chih-Cheng Lai, I-Ning Yang

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引用次数: 0

Abstract

Objectives: This study examined the effectiveness of nirmatrelvir plus ritonavir (NMV-r) and molnupiravir (MOV) in treating COVID-19 among chronic kidney disease (CKD) patients.

Methods: This retrospective cohort study, using the TriNetX research network, identified stage 3-5 CKD and end-stage kidney disease (ESKD) patients with non-hospitalized COVID-19 between 1 January 2022, and 31 May 2023. Propensity score matching (PSM) was used to compare patients on NMV-r or MOV (antiviral group) against those not receiving these treatments (control group). The primary composite outcome was the cumulative hazard ratio (HR) for all-cause hospitalization or death within the 30-day follow-up.

Results: After PSM, two balanced cohorts of 6,275 patients each were established. The antiviral group exhibited a lower incidence of all-cause hospitalization or mortality (5.93% vs. 9.53%; HR: 0.626; 95% CI: 0.550-0.713) than controls. Additionally, antiviral recipients were associated with a lower risk of all-cause hospitalization (HR: 0.679; 95% CI: 0.594-0.777) and mortality (HR: 0.338; 95% CI: 0.227-0.504). The beneficial effects of antiviral agents were consistent across sex, age, vaccination status, antiviral type, and CKD stage.

Conclusion: Oral antiviral agents could be associated with lower rates of all-cause hospitalization or death among non-hospitalized COVID-19 patients with CKD.

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口服抗病毒药物治疗非住院COVID-19慢性肾病患者的临床效果。

研究目的本研究探讨了尼马瑞韦加利托那韦（NMV-r）和莫鲁吡拉韦（MOV）治疗慢性肾病（CKD）患者COVID-19的有效性：这项回顾性队列研究利用 TriNetX 研究网络，确定了 2022 年 1 月 1 日至 2023 年 5 月 31 日期间非住院 COVID-19 的 3-5 期 CKD 和终末期肾病 (ESKD) 患者。采用倾向得分匹配法（PSM）将接受 NMV-r 或 MOV 治疗的患者（抗病毒组）与未接受这些治疗的患者（对照组）进行比较。主要综合结果是随访30天内全因住院或死亡的累积危险比（HR）：在 PSM 之后，建立了两个平衡的队列，每个队列有 6275 名患者。与对照组相比，抗病毒组的全因住院或死亡发生率较低（5.93% 对 9.53%；HR：0.626；95% CI：0.550-0.713）。此外，接受抗病毒治疗者的全因住院风险（HR：0.679；95% CI：0.594-0.777）和死亡率（HR：0.338；95% CI：0.227-0.504）也较低。不同性别、年龄、疫苗接种情况、抗病毒类型和慢性肾脏病分期对抗病毒药物的有利影响是一致的：结论：口服抗病毒药物可降低非住院COVID-19慢性肾脏病患者的全因住院率或死亡率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Anti-infective Therapy 医学-药学

CiteScore

11.20

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： Expert Review of Anti-Infective Therapy (ISSN 1478-7210) provides expert reviews on therapeutics and diagnostics in the treatment of infectious disease. Coverage includes antibiotics, drug resistance, drug therapy, infectious disease medicine, antibacterial, antimicrobial, antifungal and antiviral approaches, and diagnostic tests.