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Can Commun Dis Rep . Characteristics and clinical outcomes of nirmatrelvir/ritonavir (PaxlovidTM) recipients in Canada, 2022: a descriptive cohort s

tetano

Editor, Senior Moderator
Can Commun Dis Rep


. 2023 Oct 1;49(10):440-445.
doi: 10.14745/ccdr.v49i10a05. Characteristics and clinical outcomes of nirmatrelvir/ritonavir (Paxlovid[SUP]TM[/SUP]) recipients in Canada, 2022: a descriptive cohort study

Nadine Sicard[SUP] 1 [/SUP], Susan Squires[SUP] 2 [/SUP], Muhammad Mullah[SUP] 3 [/SUP], Peter Daley[SUP] 4 [/SUP]



Affiliations
Abstract

Background: Nirmatrelvir/ritonavir (N/R) (Paxlovid[SUP]TM[/SUP]) was introduced in Canada in January 2022. This was the first oral coronavirus disease 2019 (COVID-19) antiviral therapy that was deployed on a large scale in Canada. Since N/R was a new therapeutic option to reduce severe outcomes in high-risk populations, clinical and implementation questions were raised about its real-world utilization and impact. The objective of this retrospective observational study was to describe the characteristics and clinical outcomes of recipients of N/R in the first several months of its availability in Canada, during the Omicron wave.
Methods: Provincial summary data were pooled together for the analysis. Descriptive statistics were used to explore the characteristics and clinical outcomes of the recipients. Pearson's Chi-square test and unadjusted odds ratio along with 95% confidence intervals were used to identify the potential risk factors for severe outcomes. Data were generally collected between January and September 2022.
Results: Seventy-six percent of N/R recipients were 60 years of age and older and 56% were female. Eighty-four percent of recipients had received three or more COVID-19 vaccinations and 67% had comorbidities. All-cause severe 30-day outcomes were uncommon, with 0.4% reported as deceased, 0.1% admitted to the intensive care unit and 2.0% hospitalized after N/R administration. Risk factors statistically associated with severe outcomes were immunosuppression, comorbidities, age of 60 years and older, and being unvaccinated.
Conclusion: In the first months of its availability in Canada, N/R was mostly used in vaccinated patients 60 years and older with one or more comorbidities. Severe outcomes in N/R recipients were uncommon and mostly reported in patients with risk factors.

Keywords: COVID-19; Paxlovid; antiviral therapy; health databases; nirmatrelvir/ritonavir; provincial summary data.

 
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