tetano
Editor, Senior Moderator
Infect Drug Resist
. 2023 Dec 22:16:7797-7808.
doi: 10.2147/IDR.S433186. eCollection 2023. Comparison of Azvudine and Nirmatrelvir/Ritonavir and Combined Use in Patients with COVID-19
Cheng-Yi Hu[SUP] 1 [/SUP], Wen-Shuai Cui[SUP] 1 [/SUP], Yi Lei[SUP] 1 [/SUP], Yu-Wen Tang[SUP] 1 [/SUP], Yan-Yan Zhang[SUP] 1 [/SUP], Qi-Min Su[SUP] 1 [/SUP], Fang Peng[SUP] 2 [/SUP], Yun-Fei Zeng[SUP] 1 [/SUP], Jia-Lin Song[SUP] 1 [/SUP], Cheng-Na Luo[SUP] 1 [/SUP], Yan Zhou[SUP] 1 [/SUP], Xin-Yan Li[SUP] 1 [/SUP], Zhu-Xiang Zhao[SUP] 1 [/SUP]
Affiliations
Purpose: To compare the effectiveness of azvudine and nirmatrelvir/ritonavir for the treatment of coronavirus disease (COVID-19).
Patients and methods: We conducted a retrospective analysis of data from 576 patients with COVID-19, comprising 195 patients without antiviral therapy, 226 patients treated with azvudine, 114 patients treated with nirmatrelvir/ritonavir, and 41 patients were treated with azvudine and nirmatrelvir/ritonavir concurrently. We compared their symptoms, mortality rates, and the length and cost of hospitalization.
Results: The incidence of symptoms was similar in patients treated with azvudine and in those treated with nirmatrelvir/ritonavir. However, among patients experiencing weakness, the duration of weakness was significantly shorter in the azvudine group than in the nirmatrelvir/ritonavir group (P=0.029). Mortality did not differ significantly between the azvudine group and the nirmatrelvir/ritonavir group (18.14% vs.10.53%, P=0.068). Among "severe patients", the mortality rate was markedly lower in patients treated with nirmatrelvir/ritonavir than in patients treated with azvudine (16.92% vs.32.17%, P=0.026). In patients with hepatic insufficiency, those treated with nirmatrelvir/ritonavir had substantially lower mortality than those treated with azvudine (15.09% vs.34.25%, P=0.016). In addition, patients treated with nirmatrelvir/ritonavir had longer hospital stays (P=0.002) and higher hospital costs (P<0.001) than those receiving azvudine. Compared with patients treated with nirmatrelvir/ritonavir or azvudine alone, patients taking nirmatrelvir/ritonavir and azvudine concurrently had no significant improvement in survival (P>0.05), length of stay (P>0.05), or hospital costs (P>0.05).
Conclusion: Azvudine is recommended for patients with non-severe COVID-19 with weakness. Nirmatrelvir/ritonavir is recommended for patients with severe COVID-19, to reduce mortality, and it could be the best choice for patients with hepatic insufficiency. The concurrent use of nirmatrelvir/ritonavir and azvudine in patients with COVID-19 could be not recommended.
Keywords: COVID-19; SARS-CoV-2; azvudine; nirmatrelvir/ritonavir.
. 2023 Dec 22:16:7797-7808.
doi: 10.2147/IDR.S433186. eCollection 2023. Comparison of Azvudine and Nirmatrelvir/Ritonavir and Combined Use in Patients with COVID-19
Cheng-Yi Hu[SUP] 1 [/SUP], Wen-Shuai Cui[SUP] 1 [/SUP], Yi Lei[SUP] 1 [/SUP], Yu-Wen Tang[SUP] 1 [/SUP], Yan-Yan Zhang[SUP] 1 [/SUP], Qi-Min Su[SUP] 1 [/SUP], Fang Peng[SUP] 2 [/SUP], Yun-Fei Zeng[SUP] 1 [/SUP], Jia-Lin Song[SUP] 1 [/SUP], Cheng-Na Luo[SUP] 1 [/SUP], Yan Zhou[SUP] 1 [/SUP], Xin-Yan Li[SUP] 1 [/SUP], Zhu-Xiang Zhao[SUP] 1 [/SUP]
Affiliations
- PMID: 38148771
- PMCID: PMC10750493
- DOI: 10.2147/IDR.S433186
Purpose: To compare the effectiveness of azvudine and nirmatrelvir/ritonavir for the treatment of coronavirus disease (COVID-19).
Patients and methods: We conducted a retrospective analysis of data from 576 patients with COVID-19, comprising 195 patients without antiviral therapy, 226 patients treated with azvudine, 114 patients treated with nirmatrelvir/ritonavir, and 41 patients were treated with azvudine and nirmatrelvir/ritonavir concurrently. We compared their symptoms, mortality rates, and the length and cost of hospitalization.
Results: The incidence of symptoms was similar in patients treated with azvudine and in those treated with nirmatrelvir/ritonavir. However, among patients experiencing weakness, the duration of weakness was significantly shorter in the azvudine group than in the nirmatrelvir/ritonavir group (P=0.029). Mortality did not differ significantly between the azvudine group and the nirmatrelvir/ritonavir group (18.14% vs.10.53%, P=0.068). Among "severe patients", the mortality rate was markedly lower in patients treated with nirmatrelvir/ritonavir than in patients treated with azvudine (16.92% vs.32.17%, P=0.026). In patients with hepatic insufficiency, those treated with nirmatrelvir/ritonavir had substantially lower mortality than those treated with azvudine (15.09% vs.34.25%, P=0.016). In addition, patients treated with nirmatrelvir/ritonavir had longer hospital stays (P=0.002) and higher hospital costs (P<0.001) than those receiving azvudine. Compared with patients treated with nirmatrelvir/ritonavir or azvudine alone, patients taking nirmatrelvir/ritonavir and azvudine concurrently had no significant improvement in survival (P>0.05), length of stay (P>0.05), or hospital costs (P>0.05).
Conclusion: Azvudine is recommended for patients with non-severe COVID-19 with weakness. Nirmatrelvir/ritonavir is recommended for patients with severe COVID-19, to reduce mortality, and it could be the best choice for patients with hepatic insufficiency. The concurrent use of nirmatrelvir/ritonavir and azvudine in patients with COVID-19 could be not recommended.
Keywords: COVID-19; SARS-CoV-2; azvudine; nirmatrelvir/ritonavir.