Durations of fever and other symptoms among COVID-19 outpatients administered ensitrelvir during the 2023 Japanese XBB epidemic period

IF 1.7 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy Pub Date : 2025-12-01 Epub Date: 2025-11-04 DOI:10.1016/j.jiac.2025.102852

Naoki Kawai , Takuma Bando , Takeyuki Goto , Shinro Matsuura , Shin Nagao , Osame Tanaka , Takashi Kawashima , Young Chong , Hideyuki Ikematsu

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引用次数: 0

Abstract

Background

This retrospective study evaluated factors influencing fever and symptom durations and the real-world effectiveness of ensitrelvir in mild to moderate COVID-19 outpatients during Japan's 2023 Omicron XBB epidemic.

Methods

Clinical data were collected via questionnaire. Multiple regression identified factors associated with fever and symptom durations. Durations were compared between patients treated with or without ensitrelvir using stratified analysis and three propensity score matchings (PSM): first (age, sex, vaccination, prior infection), second (fever ≥38 °C, ≥3 symptoms, ≥3 vaccine doses), and third (fatigue, sore throat, gastrointestinal symptoms).

Results

Data from 126 outpatients were analyzed: 85 received ensitrelvir, 41 did not. Ensitrelvir use and ≥3 vaccinations were independently associated with shorter fever duration. Median fever duration was significantly shorter with ensitrelvir (43 vs. 67 h, p = 0.0017). Stratified analysis showed shorter fever duration in patients with ≥38 °C (p = 0.0022) and shorter symptom duration with ≥3 symptoms (p = 0.031). Both durations remained significantly shorter after first (p < 0.001; p = 0.011), second (p = 0.0044; p = 0.025), and third PSM (p = 0.0058; p = 0.015).

Conclusions

Ensitrelvir significantly shortened fever and symptom durations in mild to moderate COVID-19 outpatients. Patients with higher fever or more symptoms may benefit, even with repeated COVID-19 vaccination.

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2023年日本XBB流行期间使用恩司他韦门诊患者发热和其他症状持续时间

背景：本回顾性研究评估了日本2023年Omicron XBB流行期间轻中度COVID-19门诊患者发烧和症状持续时间的影响因素以及恩司他韦的实际疗效。方法：采用问卷调查法收集临床资料。多元回归确定了与发热和症状持续时间相关的因素。使用分层分析和三种倾向评分匹配（PSM）比较使用或不使用恩司替韦治疗的患者的持续时间：第一（年龄、性别、疫苗接种、既往感染），第二（发烧≥38°C，≥3种症状，≥3种疫苗剂量），第三（疲劳、喉咙痛、胃肠道症状）。结果：126例门诊患者的数据分析：85例接受了ensitrelvir治疗，41例未接受。使用恩司替韦和接种≥3次疫苗与发热持续时间缩短独立相关。ensitrelvir组的中位发热持续时间显著缩短（43小时vs. 67小时，p = 0.0017）。分层分析显示，≥38℃患者发热持续时间较短（p = 0.0022），≥3种症状患者发热持续时间较短（p = 0.031）。在第一次PSM （p < 0.001; p = 0.011）、第二次（p = 0.0044; p = 0.025）和第三次PSM （p = 0.0058; p = 0.015）之后，两种持续时间都显著缩短。结论：恩司替韦可显著缩短轻中度COVID-19门诊患者发热和症状持续时间。即使反复接种COVID-19疫苗，高烧或症状较多的患者也可能受益。

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 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.