Nirmatrelvir-ritonavir significantly reduces severe COVID-19 outcomes in diverse Taiwanese populations: Comprehensive evidence from a large-scale longitudinal cohort study in Taiwan

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2025-03-18 DOI:10.1016/j.jiph.2025.102760

Fu-Der Wang , Yu-Hui Chang , Han-Chuan Chuang , Tsong-Yih Ou , Mei-Hui Lee , Phung-Anh Nguyen , Thanh Phuc Phan , Whitney Burton , Thi Kim Hien Nguyen , Min-Huei Hsu , Shiue-Ming Lin , Chieh Yang , Jason C. Hsu

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引用次数: 0

Abstract

Background

Nirmatrelvir-Ritonavir (NR) has proven effective for mild to moderate COVID-19 patients at risk of disease progression. Following its emergency use authorization in Taiwan in January 2022, this study aims to evaluate its impact on severe COVID-19 outcomes across different patient demographics in Taiwan.

Methods

We performed a retrospective analysis of a database that includes data from three hospitals in Northern Taiwan. Patients with COVID-19 in 2022 were paired by propensity score matching based on NR prescription. Cox proportional hazard regression analysis calculated hazard ratios (HR), adjusting for confounding factors. Subgroup analysis determined HRs across patient characteristics.

Results

Among 95,096 patients, 3329 were in the NR group, and 12,807 in the non-NR group. NR users demonstrated significantly better prevention of severe outcomes: intubation (HR=0.296 [95 % CI: 0.187–0.469], p = 0.0482); ICU admission (HR=0.327[0.108–0.991], p < 0.001); mortality (HR=0.195 [0.101–0.378], p < 0.001). Subgroup analysis revealed significantly lower intubation risks for NR users among both sexes, aged 18–65 or ≥ 65 years, BMI < 30, and patients with diabetes mellitus (DM), cardiovascular disease (CVD), or chronic obstructive pulmonary disease (COPD). ICU admission risk was lower for NR users among males, aged ≥ 65 years, and BMI < 30. Mortality risk was lower for NR users among both sexes, aged ≥ 65 years, BMI < 30, and patients with DM, CVD, or COPD.

Conclusion

NR significantly reduces the risk of severe COVID-19, particularly among older adults and those with pre-existing conditions, supporting NR as an essential treatment for high-risk COVID-19 patients.

查看原文本刊更多论文

Nirmatrelvir-ritonavir可显著降低台湾不同人群的COVID-19严重结局：来自台湾大规模纵向队列研究的综合证据

nirmatrelvir - ritonavir （NR）已被证明对有疾病进展风险的轻至中度COVID-19患者有效。在台湾于2022年1月获得紧急使用授权后，本研究旨在评估其对台湾不同患者人口统计的严重COVID-19结局的影响。方法对台湾北部三家医院的数据进行回顾性分析。采用基于NR处方的倾向评分匹配方法对2022年新冠肺炎患者进行配对。Cox比例风险回归分析计算风险比（HR），调整混杂因素。亚组分析确定了不同患者特征的hr。结果95096例患者中，NR组3329例，非NR组12807例。NR使用者表现出更好的预防严重后果：插管（HR=0.296[95 % CI: 0.187-0.469], p = 0.0482）；入住ICU (HR = 0.327 (0.108 - -0.991), p & lt; 0.001);死亡率(HR = 0.195 (0.101 - -0.378), p & lt; 0.001)。亚组分析显示，无论性别、年龄在18-65岁或≥ 65岁、BMI <； 30，以及患有糖尿病（DM）、心血管疾病（CVD）或慢性阻塞性肺疾病（COPD）的患者，NR使用者的插管风险均显著降低。在年龄≥ 65岁、BMI <； 30的男性中，NR使用者进入ICU的风险较低。NR使用者的死亡风险在男女、年龄≥ 65岁、BMI <； 30以及患有糖尿病、心血管疾病或慢性阻塞性肺病的患者中均较低。结论NR可显著降低严重COVID-19的风险，特别是在老年人和已有疾病患者中，支持NR作为高风险COVID-19患者的必要治疗方法。

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 Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.