Impact of early antiviral therapy on SARS-CoV-2 clearance time in high-risk COVID-19 subjects: A propensity score matching study

IF 4.8 2区医学 Q1 INFECTIOUS DISEASES

International Journal of Infectious Diseases Pub Date : 2024-10-10 DOI:10.1016/j.ijid.2024.107265

Marta Colaneri , Federico Fama , Federico Fassio , Darcy Holmes , Giovanni Scaglione , Chiara Mariani , Lucia Galli , Alessia Lai , Spinello Antinori , Andrea Gori , Agostino Riva , Monica Schiavini , Ospedale Luigi Sacco “COVID-19 Hotspot” study group

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引用次数: 0

Abstract

Background

Effective treatments for COVID-19 are needed to mitigate disease progression and reduce the burden on healthcare systems. This study investigates the impact of early treatments on SARS-CoV-2 viral shedding duration among high-risk individuals with mild symptoms.

Methods

A single-center, retrospective observational study was conducted at Luigi Sacco Hospital in Milan from December 2021 to March 2023. Hospitalized and nonhospitalized adults with a confirmed SARS-CoV-2 infection and at high-risk of disease progression were enrolled. Unadjusted and adjusted negative binomial regression models and a Random Forest regression model were performed before and after matching subjects based on their propensity of being treated or not.

Results

Results from 518 subjects (428 treated and 90 untreated) revealed a significant reduction in SARS-CoV-2 viral shedding duration among those who received early treatment compared to untreated individuals. Propensity score matching and multivariable regression analyses confirmed this finding. Early treatment significantly reduced the risk of COVID-19-related hospitalization and pneumonia development. Subgroup analysis identified COPD as a potential factor influencing effectiveness of early treatments.

Conclusions

Early treatments play a crucial role in reducing SARS-CoV-2 viral shedding and preventing disease progression among high-risk individuals. Shorter viral shedding duration also contributes to improved healthcare resource utilization and infection control measures.

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早期抗病毒治疗对高危 COVID-19 受试者 SARS-CoV-2 清除时间的影响：倾向得分匹配研究

背景：需要对 COVID-19 进行有效治疗，以缓解疾病进展并减轻医疗系统的负担。本研究调查了早期治疗对症状轻微的高危人群中 SARS-CoV-2 病毒脱落持续时间的影响：方法：2021 年 12 月至 2023 年 3 月在米兰 Luigi Sacco 医院开展了一项单中心回顾性观察研究。研究对象包括确诊感染 SARS-CoV-2 并有疾病进展高风险的住院和非住院成人。在根据受试者是否接受治疗的倾向进行匹配之前和之后，对受试者进行了未经调整和调整的负二项回归模型和随机森林回归模型：518例受试者（428例接受治疗，90例未接受治疗）的研究结果显示，与未接受治疗者相比，接受早期治疗者的SARS-CoV-2病毒脱落持续时间明显缩短。倾向得分匹配和多变量回归分析证实了这一结果。早期治疗大大降低了与 COVID-19 相关的住院和肺炎发病风险。亚组分析发现慢性阻塞性肺病是影响早期治疗效果的潜在因素：结论：早期治疗在减少 SARS-CoV-2 病毒脱落和预防高危人群病情恶化方面起着至关重要的作用。缩短病毒脱落持续时间也有助于提高医疗资源利用率和改善感染控制措施。

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

International Journal of Infectious Diseases 医学-传染病学

CiteScore

18.90

自引率

2.40%

发文量

1020

审稿时长

30 days

期刊介绍： International Journal of Infectious Diseases (IJID) Publisher: International Society for Infectious Diseases Publication Frequency: Monthly Type: Peer-reviewed, Open Access Scope: Publishes original clinical and laboratory-based research. Reports clinical trials, reviews, and some case reports. Focuses on epidemiology, clinical diagnosis, treatment, and control of infectious diseases. Emphasizes diseases common in under-resourced countries.