Comparative study of ensitrelvir and symptomatic therapy in healthcare workers with mild COVID-19: A single center retrospective analysis in Chiba, Japan

IF 1.9 4区 医学 Q3 INFECTIOUS DISEASES
Jun Hirai , Yuki Hanai
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引用次数: 0

Abstract

Background

Ensitrelvir, a novel oral antiviral targeting the 3CL protease of SARS-CoV-2, has demonstrated efficacy in reducing viral load in clinical trials. Rapid viral clearance in healthcare workers (HCWs) with mild COVID-19 is critical for symptom relief and minimizing secondary transmission. However, real-world evidence on ensitrelvir's effectiveness in this population is limited.

Methods

This single-center retrospective study analyzed 407 HCWs with mild COVID-19 treated with either ensitrelvir or symptomatic therapy. Viral load was assessed using reverse transcription-polymerase chain reaction cycle threshold (Ct) values. The primary endpoint was achieving a Ct > 30, indicating low infectivity, on days 5–8 or 9–12. Secondary endpoints included adverse events, hospitalization, disease progression, and all-cause mortality within 30 days of symptom onset. Multivariate logistic regression identified factors associated with achieving Ct > 30.

Results

Patients in the ensitrelvir group had significantly higher rates of achieving Ct > 30 on days 5–8 (38.0 % vs. 9.9 %, p < 0.01) and days 9–12 (77.8 % vs. 42.3 %, p < 0.01). Treatment with ensitrelvir was associated with a significantly higher likelihood of symptom improvement within 5–8 days compared to symptomatic therapy (p < 0.01). Multivariate analysis confirmed ensitrelvir as independently associated with Ct > 30 (adjusted odds ratio: 6.498; p < 0.01). No adverse events, hospitalizations, or mortality were observed.

Discussion

Ensitrelvir demonstrated superior viral clearance compared to symptomatic therapy, facilitating a safer and earlier return to work for HCWs. However, additional precautions, such as mask use, remain essential for HCWs working in high-risk environments, even after ensitrelvir treatment.

Conclusions

Ensitrelvir is a safe and effective option for reducing SARS-CoV-2 viral load in HCWs with mild COVID-19, supporting timely recovery and reducing infectivity.
对患有轻度 COVID-19 的医护人员进行 Ensitrelvir 和对症治疗的比较研究:日本千叶县单中心回顾性分析
背景:Ensitrelvir是一种针对SARS-CoV-2的3CL蛋白酶的新型口服抗病毒药物,在临床试验中显示出降低病毒载量的疗效。患有轻度COVID-19的卫生保健工作者(HCWs)的快速病毒清除对于缓解症状和减少二次传播至关重要。然而,关于ensitrelvir在这一人群中的有效性的实际证据是有限的。方法:本单中心回顾性研究分析了407例接受恩司他韦或对症治疗的轻型COVID-19 HCWs。采用逆转录-聚合酶链反应周期阈值(Ct)评估病毒载量。主要终点是在第5-8天或第9-12天达到Ct bb30,表明低传染性。次要终点包括不良事件、住院、疾病进展和症状出现30天内的全因死亡率。多因素logistic回归确定了与达到Ct值相关的因素。结果:ensitrelvir组患者在第5-8天(38.0%比9.9%,p < 0.01)和第9-12天(77.8%比42.3%,p < 0.01)达到ctb30的比率显著高于ensitrelvir组。与对症治疗相比,用恩司他韦治疗与5-8天内症状改善的可能性显著增加相关(p < 0.01)。多因素分析证实恩司他韦与Ct bb30独立相关(校正优势比:6.498;P < 0.01)。未观察到不良事件、住院或死亡。讨论:与对症治疗相比,Ensitrelvir显示出更好的病毒清除能力,促进医护人员更安全、更早地重返工作岗位。然而,对于在高风险环境中工作的卫生保健工作者,即使在接受恩司他韦治疗后,仍然必须采取额外的预防措施,例如使用口罩。结论:恩司替韦是降低轻症患者SARS-CoV-2病毒载量、支持患者及时康复和降低传染性的安全有效选择。
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 and Chemotherapy
Journal of Infection and Chemotherapy INFECTIOUS DISEASES-PHARMACOLOGY & PHARMACY
CiteScore
4.10
自引率
4.50%
发文量
303
审稿时长
47 days
期刊介绍: The Journal of Infection and Chemotherapy (JIC) — official journal of the Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases — welcomes original papers, laboratory or clinical, as well as case reports, notes, committee reports, surveillance and guidelines from all parts of the world on all aspects of chemotherapy, covering the pathogenesis, diagnosis, treatment, and control of infection, including treatment with anticancer drugs. Experimental studies on animal models and pharmacokinetics, and reports on epidemiology and clinical trials are particularly welcome.
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