Real-World Effectiveness of Nirmatrelvir/Ritonavir in Hospitalized Older Adults with Severe Omicron COVID-19: A Retrospective Cohort Study from China.

IF 2.9 3区医学 Q2 INFECTIOUS DISEASES

Infection and Drug Resistance Pub Date : 2025-06-07 eCollection Date: 2025-01-01 DOI:10.2147/IDR.S518205

Yangxi Chen, Lika Liu, Yu Liu, Fang Huang, Lei Guo, Wenhui Wan, Haiyang Jiang

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Abstract

Background: The real-world effectiveness of Nirmatrelvir/ritonavir (NMV/RTV) against the SARS-CoV-2 Omicron variant in older patients remains uncertain. We aimed to estimate the effectiveness in older patients aged 80 and above with severe COVID-19.

Methods: A retrospective study analyzed 263 COVID-19 patients aged 80 and above, admitted to the Department of Geriatrics at Jinling Hospital, affiliated with Nanjing University, between December 15, 2022, and January 15, 2023. Among them, 136 cases were non-severe, and 127 were severe. The severe cases were further categorized into a survival group (n=74) and a death group (n=53) based on 28-day mortality. Kaplan-Meier survival curves assessed 28-day survival, and Cox regression models identified factors influencing survival.

Results: Among the 127 severe cases, the death group had significantly higher rates of stroke history, renal impairment, endotracheal intubation, renal replacement therapy (RRT), bacterial infection, but significantly lower rates of NMV/RTV use and anticoagulation (p<0.05). Kaplan-Meier analysis indicated that NMV/RTV improved 28-day survival in severe older COVID-19 patients. Multivariate Cox regression identified NMV/RTV as a protective factor (adjusted hazard ratio [HR] 0.307, 95% confidence interval [CI] 0.152-0.620, p=0.001), while COPD (adjusted HR 2.993, 95% CI 1.563-5.731, p=0.001), stroke history (adjusted HR 3.871, 95% CI 1.953-7.671, p<0.001), and endotracheal intubation (adjusted HR 5.058, 95% CI 2.809-9.108, p<0.001) were significant risk factors for increased 28-day mortality.

Conclusion: NMV/RTV may improve the 28-day survival rate of older patients aged 80 and above with severe COVID-19.

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来自中国的一项回顾性队列研究：尼马特瑞韦/利托那韦治疗重症Omicron COVID-19住院老年人的实际疗效

背景：Nirmatrelvir/ritonavir （NMV/RTV）在老年患者中对抗SARS-CoV-2 Omicron变体的实际有效性仍不确定。我们的目的是评估80岁及以上老年重症COVID-19患者的有效性。方法：对2022年12月15日至2023年1月15日南京大学附属金陵医院老年科收治的263例80岁及以上的新冠肺炎患者进行回顾性研究。其中，非重症136例，重症127例。根据28天死亡率将重症病例进一步分为生存组（n=74）和死亡组（n=53）。Kaplan-Meier生存曲线评估28天生存率，Cox回归模型确定影响生存率的因素。结果：127例重症患者中，死亡组卒中史、肾损害、气管插管、肾替代治疗（RRT）、细菌感染发生率显著高于死亡组，NMV/RTV使用和抗凝（pCI）发生率显著低于死亡组（0.152 ~ 0.620,p=0.001）， COPD（调整HR 2.993, 95% CI 1.563 ~ 5.731, p=0.001）、卒中史（调整HR 3.871, 95% CI 1.953 ~ 7.671, pCI 2.809 ~ 9.108, p=0.001）。NMV/RTV可提高80岁及以上老年重症患者28天生存率。

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

Infection and Drug Resistance Medicine-Pharmacology (medical)

CiteScore

5.60

自引率

7.70%

发文量

826

审稿时长

16 weeks

期刊介绍： About Journal Editors Peer Reviewers Articles Article Publishing Charges Aims and Scope Call For Papers ISSN: 1178-6973 Editor-in-Chief: Professor Suresh Antony An international, peer-reviewed, open access journal that focuses on the optimal treatment of infection (bacterial, fungal and viral) and the development and institution of preventative strategies to minimize the development and spread of resistance.