Effectiveness and Safety of Simnotrelvir/Ritonavir and Nirmatrelvir/Ritonavir in the Treatment of Moderate to Severe COVID-19

IF 3.1 4区医学 Q3 IMMUNOLOGY

Immunity, Inflammation and Disease Pub Date : 2025-04-14 DOI:10.1002/iid3.70174

Xin Chen, Xiao-Qing Lin, Fang Cheng, Shi-Lin Zheng, Qiang Zhang, Te Wu, Xian-Gao Jiang, Ji-Chan Shi

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Abstract

Background and Aim

Simnotrelvir/ritonavir and nirmatrelvir/ritonavir are major treatments for COVID-19, but their comparative efficacy and safety, especially in patients with moderate to severe COVID-19, remain unclear.

Methods

This was a retrospective cohort study using electronic medical record data. From May 30, 2023, to October 8, 2023, 115 patients with moderate to severe COVID-19 were retrospectively collected from Wenzhou Central Hospital. They were treated with simnotrelvir/ritonavir or nirmatrelvir/ritonavir. The clinical effectiveness and adverse reactions were analyzed and compared between the two groups.

Results

A total of 115 hospitalized patients were included in the study. They were 65 (56.5%) men and 50 (43.5%) women, with a mean age of 61 years. 58 (50.4%) were treated with simnotrelvir/ritonavir and 57 (49.6%) with nirmatrelvir/ritonavir. There was a similar rate of composite disease progression (10.3% vs. 7.0%, χ² = 0.401, p = 0.527) and mortality (5.2% vs. 3.5%, χ² = 0.191, p = 0.662) between the two groups. The progression rate from moderate COVID-19 to severe COVID-19 was not significantly different between the two groups (4.5% vs. 6.4%, χ² = 0.148, p = 0.701). Median time for hospitalization was 7.0 (6.0, 8.0) days and 9.0 (8.0, 10.0) days (p = 0.338), and time for SARS-CoV-2 negative conversion was 6.0 (6.0, 7.0) days and 7.0 (6.0, 7.0) days (p = 0.934) in the simnotrelvir/ritonavir group and nirmatrelvir/ritonavir group, respectively. Among moderate patients, time for hospitalization was shorter in the simnotrelvir/ritonavir group [6.0 (6.0, 7.0) vs. 8.0 (8.0, 10.0) days, log-rank p = 0.004, HR = 1.838 (95% CI 1.199–2.815)]. And 5 (8.6%) had adverse drug reactions (ADRs) in the simnotrelvir/ritonavir group and 6 (10.5%) had ADRs in the nirmatrelvir/ritonavir group.

Conclusion

This is the first study comparing the effectiveness of simnotrelvir/ritonavir and nirmatrelvir/ritonavir in moderate and severe COVID-19 patients. Patients who received simnotrelvir/ritonavir exhibited shorter hospitalization. Disease progression, viral clearance times, and symptom resolution time were similar between the two groups.

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辛诺瑞韦/利托那韦与尼马特利韦/利托那韦治疗中重度COVID-19的有效性和安全性

背景与目的辛诺瑞韦/利托那韦和尼马特利韦/利托那韦是治疗COVID-19的主要药物，但它们的相对疗效和安全性，特别是对中重度COVID-19患者的疗效和安全性尚不清楚。方法采用电子病历资料进行回顾性队列研究。回顾性收集2023年5月30日至2023年10月8日温州市中心医院收治的115例中重度新冠肺炎患者。他们用辛诺瑞韦/利托那韦或尼马特利韦/利托那韦治疗。分析比较两组患者的临床疗效及不良反应。结果共纳入115例住院患者。男性65例（56.5%），女性50例（43.5%），平均年龄61岁。58例（50.4%）采用辛诺瑞韦/利托那韦治疗，57例（49.6%）采用尼马特利韦/利托那韦治疗。两组患者的综合疾病进展率（10.3%比7.0%,χ2 = 0.401, p = 0.527）和死亡率（5.2%比3.5%,χ2 = 0.191, p = 0.662）相似。两组患者从中度到重度的进展率差异无统计学意义（4.5% vs. 6.4%, χ2 = 0.148, p = 0.701）。中位住院时间分别为7.0（6.0,8.0）天和9.0（8.0,10.0）天（p = 0.338），辛诺瑞韦/利托那韦组和尼马特瑞韦/利托那韦组SARS-CoV-2阴性转化时间分别为6.0（6.0,7.0）天和7.0（6.0,7.0）天（p = 0.934）。在中度患者中，辛诺瑞韦/利托那韦组住院时间较短[6.0（6.0,7.0）对8.0（8.0,10.0）天，log-rank p = 0.004, HR = 1.838 (95% CI 1.199-2.815)]。辛诺瑞韦/利托那韦组有5例（8.6%）出现药物不良反应，尼马特瑞韦/利托那韦组有6例（10.5%）出现药物不良反应。结论本研究首次比较了辛诺瑞韦/利托那韦与尼马特利韦/利托那韦治疗中、重度COVID-19患者的疗效。接受辛诺瑞韦/利托那韦治疗的患者住院时间较短。两组之间的疾病进展、病毒清除时间和症状缓解时间相似。

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来源期刊

Immunity, Inflammation and Disease Medicine-Immunology and Allergy

CiteScore

3.60

自引率

0.00%

发文量

146

审稿时长

8 weeks

期刊介绍： Immunity, Inflammation and Disease is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research across the broad field of immunology. Immunity, Inflammation and Disease gives rapid consideration to papers in all areas of clinical and basic research. The journal is indexed in Medline and the Science Citation Index Expanded (part of Web of Science), among others. It welcomes original work that enhances the understanding of immunology in areas including: • cellular and molecular immunology • clinical immunology • allergy • immunochemistry • immunogenetics • immune signalling • immune development • imaging • mathematical modelling • autoimmunity • transplantation immunology • cancer immunology