Raymond N Kuo, Wanchi Chen, Wen-Yi Shau, Shan-Chwen Chang
{"title":"Nirmatrelvir-Ritonavir在台湾对COVID-19严重后果的实际有效性：一项全国性人群队列研究","authors":"Raymond N Kuo, Wanchi Chen, Wen-Yi Shau, Shan-Chwen Chang","doi":"10.1093/ofid/ofaf553","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Real-world data evaluating the effectiveness of nirmatrelvir-ritonavir across diverse age groups and vaccination statuses remain limited, particularly in East Asian populations. This study evaluates its effectiveness in reducing severe COVID-19 outcomes using a large, comprehensive nationwide healthcare database and to provide new evidence.</p><p><strong>Method: </strong>This retrospective observational cohort study involved outpatient COVID-19 patients diagnosed between 1 January 2022, and 1 December 2022, within Taiwan's National Health Insurance Research Database. Patients who received nirmatrelvir-ritonavir were compared with untreated patients. Primary outcomes include COVID-19-related hospitalization, ICU admission, invasive ventilatory support, death, and the composite outcome of hospital admission or death.</p><p><strong>Results: </strong>A total of 2 300 131 nonhospitalized patients with confirmed COVID-19 between 1 January 2022 and 1 December 2022, including 530 807 patients treated with nirmatrelvir-ritonavir and 1 769 324 untreated patients. Treatment with nirmatrelvir-ritonavir was associated with a significantly lower risk of COVID-19-related hospitalization (hazard ratio 0.32 [95% CI .31-.34]), ICU admission (0.41 [.38-.45]), invasive ventilatory support (0.38 [.33-.43]), death (0.42 [.40-.45]), and the composite outcome of hospital admission or death (0.34 [.33-.35]). Effectiveness was consistent across subgroups stratified by age and vaccination status, with the greatest benefit observed in unvaccinated individuals and those aged ≥65 years with additional risk factors.</p><p><strong>Conclusions: </strong>In a large, nationally representative cohort, outpatient use of nirmatrelvir-ritonavir was associated with a significantly lower risk of severe COVID-19-related outcomes, regardless of age or vaccination status. These findings reinforce the clinical value of early antiviral treatment, particularly in aging and unvaccinated populations.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf553"},"PeriodicalIF":3.8000,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451265/pdf/","citationCount":"0","resultStr":"{\"title\":\"Real-World Effectiveness of Nirmatrelvir-Ritonavir Against Severe Outcomes of COVID-19 in Taiwan: A Nationwide Population-Based Cohort Study.\",\"authors\":\"Raymond N Kuo, Wanchi Chen, Wen-Yi Shau, Shan-Chwen Chang\",\"doi\":\"10.1093/ofid/ofaf553\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Real-world data evaluating the effectiveness of nirmatrelvir-ritonavir across diverse age groups and vaccination statuses remain limited, particularly in East Asian populations. This study evaluates its effectiveness in reducing severe COVID-19 outcomes using a large, comprehensive nationwide healthcare database and to provide new evidence.</p><p><strong>Method: </strong>This retrospective observational cohort study involved outpatient COVID-19 patients diagnosed between 1 January 2022, and 1 December 2022, within Taiwan's National Health Insurance Research Database. Patients who received nirmatrelvir-ritonavir were compared with untreated patients. Primary outcomes include COVID-19-related hospitalization, ICU admission, invasive ventilatory support, death, and the composite outcome of hospital admission or death.</p><p><strong>Results: </strong>A total of 2 300 131 nonhospitalized patients with confirmed COVID-19 between 1 January 2022 and 1 December 2022, including 530 807 patients treated with nirmatrelvir-ritonavir and 1 769 324 untreated patients. Treatment with nirmatrelvir-ritonavir was associated with a significantly lower risk of COVID-19-related hospitalization (hazard ratio 0.32 [95% CI .31-.34]), ICU admission (0.41 [.38-.45]), invasive ventilatory support (0.38 [.33-.43]), death (0.42 [.40-.45]), and the composite outcome of hospital admission or death (0.34 [.33-.35]). Effectiveness was consistent across subgroups stratified by age and vaccination status, with the greatest benefit observed in unvaccinated individuals and those aged ≥65 years with additional risk factors.</p><p><strong>Conclusions: </strong>In a large, nationally representative cohort, outpatient use of nirmatrelvir-ritonavir was associated with a significantly lower risk of severe COVID-19-related outcomes, regardless of age or vaccination status. 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Real-World Effectiveness of Nirmatrelvir-Ritonavir Against Severe Outcomes of COVID-19 in Taiwan: A Nationwide Population-Based Cohort Study.
Background: Real-world data evaluating the effectiveness of nirmatrelvir-ritonavir across diverse age groups and vaccination statuses remain limited, particularly in East Asian populations. This study evaluates its effectiveness in reducing severe COVID-19 outcomes using a large, comprehensive nationwide healthcare database and to provide new evidence.
Method: This retrospective observational cohort study involved outpatient COVID-19 patients diagnosed between 1 January 2022, and 1 December 2022, within Taiwan's National Health Insurance Research Database. Patients who received nirmatrelvir-ritonavir were compared with untreated patients. Primary outcomes include COVID-19-related hospitalization, ICU admission, invasive ventilatory support, death, and the composite outcome of hospital admission or death.
Results: A total of 2 300 131 nonhospitalized patients with confirmed COVID-19 between 1 January 2022 and 1 December 2022, including 530 807 patients treated with nirmatrelvir-ritonavir and 1 769 324 untreated patients. Treatment with nirmatrelvir-ritonavir was associated with a significantly lower risk of COVID-19-related hospitalization (hazard ratio 0.32 [95% CI .31-.34]), ICU admission (0.41 [.38-.45]), invasive ventilatory support (0.38 [.33-.43]), death (0.42 [.40-.45]), and the composite outcome of hospital admission or death (0.34 [.33-.35]). Effectiveness was consistent across subgroups stratified by age and vaccination status, with the greatest benefit observed in unvaccinated individuals and those aged ≥65 years with additional risk factors.
Conclusions: In a large, nationally representative cohort, outpatient use of nirmatrelvir-ritonavir was associated with a significantly lower risk of severe COVID-19-related outcomes, regardless of age or vaccination status. These findings reinforce the clinical value of early antiviral treatment, particularly in aging and unvaccinated populations.
期刊介绍：
Open Forum Infectious Diseases provides a global forum for the publication of clinical, translational, and basic research findings in a fully open access, online journal environment. The journal reflects the broad diversity of the field of infectious diseases, and focuses on the intersection of biomedical science and clinical practice, with a particular emphasis on knowledge that holds the potential to improve patient care in populations around the world. Fully peer-reviewed, OFID supports the international community of infectious diseases experts by providing a venue for articles that further the understanding of all aspects of infectious diseases.
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