Outcome differences of starting Paxlovid for COVID-19 within or after five days of symptoms onset in the elderly: a retrospective study.

IF 1.4 4区医学 Q4 INFECTIOUS DISEASES

Journal of Infection in Developing Countries Pub Date : 2024-09-30 DOI:10.3855/jidc.19265

Junjun Chen, Quanjun Yang, Xiaohong Xu, Xia Wu, Yonglong Han, Cheng Guo, Jiao Yang

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Abstract

Introduction: The study aimed to compare the outcomes of nirmatrelvir and ritonavir drug combination (Paxlovid) therapy in patients who received treatment within or after five days of COVID-19 confirmed in the elderly.

Methodology: This was a single-center, retrospective cohort study of older COVID-19 patients (≥ 60 years) admitted from April 7 to May 30, 2022. Patients were categorized into the EP group (starting Paxlovid within five days) and the LP group (starting Paxlovid after five days) following symptoms onset. Length of stay and positive SARS-CoV-2 duration were compared between the two groups. Severe case conversion from mild and moderate COVID-19 patients were also analyzed.

Results: In total, 273 patients were included: 137 in the EP group and 136 in the LP group. Compared to the LP group, the EP group had a significantly shorter length of stay (12.4 vs. 14.7 days, p = 0.001) and positive SARS-CoV-2 duration (11.7 vs. 15.8 days, p < 0.001). The EP group had lower severe case conversion (4.4% vs. 15.4%, p = 0.002). Additionally, abnormal IL-6 and lower lymphocyte count indicated increased length of stay. Older age was associated with a decreased risk in SARS-CoV-2 negative test (HR = 0.98) and an increased risk in severe case conversion (OR = 1.11).

Conclusions: Starting Paxlovid within five days of COVID-19 symptoms onset reduced the length of stay and SARS-CoV-2 duration compared to initiating treatment after five days. While severe case conversion among mild COVID-19 patients might be comparable whether starting Paxlovid within or after five days.

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老年人在症状出现五天内或五天后开始使用 Paxlovid 治疗 COVID-19 的结果差异：一项回顾性研究。

简介该研究旨在比较老年COVID-19确诊后5天内或5天后接受治疗的患者接受nirmatrelvir和利托那韦联合用药（Paxlovid）治疗的结果：这是一项单中心回顾性队列研究，研究对象为2022年4月7日至5月30日收治的COVID-19老年患者（≥60岁）。患者在出现症状后被分为 EP 组（在五天内开始使用 Paxlovid）和 LP 组（在五天后开始使用 Paxlovid）。两组患者的住院时间和 SARS-CoV-2 阳性持续时间进行了比较。此外，还分析了从轻度和中度 COVID-19 患者转为重症病例的情况：结果：共纳入 273 名患者：结果：共纳入 273 例患者：EP 组 137 例，LP 组 136 例。与 LP 组相比，EP 组的住院时间（12.4 天对 14.7 天，P = 0.001）和 SARS-CoV-2 阳性持续时间（11.7 天对 15.8 天，P < 0.001）明显较短。EP 组的严重病例转化率较低（4.4% 对 15.4%，P = 0.002）。此外，IL-6异常和淋巴细胞计数降低表明住院时间延长。年龄越大，SARS-CoV-2阴性检测的风险越低（HR = 0.98），而严重病例转阴的风险则越高（OR = 1.11）：结论：与五天后开始治疗相比，在COVID-19症状出现后五天内开始使用Paxlovid可缩短住院时间和SARS-CoV-2持续时间。结论：与五天后开始治疗相比，五天内开始使用 Paxlovid 可缩短住院时间，缩短 SARS-CoV-2 持续时间。

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

Journal of Infection in Developing Countries INFECTIOUS DISEASES-

CiteScore

3.70

自引率

5.30%

发文量

239

审稿时长

4-8 weeks

期刊介绍： The Journal of Infection in Developing Countries (JIDC) is an international journal, intended for the publication of scientific articles from Developing Countries by scientists from Developing Countries. JIDC is an independent, on-line publication with an international editorial board. JIDC is open access with no cost to view or download articles and reasonable cost for publication of research artcles, making JIDC easily availiable to scientists from resource restricted regions.