tetano
Editor, Senior Moderator
J Med Virol
. 2024 Feb;96(2):e29434.
doi: 10.1002/jmv.29434. Effectiveness of nirmatrelvir-ritonavir on severe outcomes of COVID-19 in the era of vaccination and Omicron: An updated meta-analysis
Sien Ombelet[SUP] 1 [/SUP], Diego Castanares-Zapatero[SUP] 1 [/SUP], Fabian Desimpel[SUP] 1 [/SUP], Frank Hulstaert[SUP] 1 [/SUP], Sabine Stordeur[SUP] 2 [/SUP], Dominique Roberfroid[SUP] 1 [/SUP]
Affiliations
Nirmatrelvir-ritonavir (NR) was approved to treat SARS-CoV-2 positive outpatients at high risk of progression to severe disease, based on a randomized trial in unvaccinated patients. Effectiveness in vaccinated patients and against Omicron has not yet been confirmed by clinical trial data, but a recent meta-analysis suggested good real-world effectiveness based on 12 studies. We updated this meta-analysis by searching Medline and Embase databases for studies assessing effectiveness of NR on mortality, hospitalization, composite outcome of hospitalization and/or death, and progression to severe disease, published between October 1, 2022 and May 22, 2023. Random effects meta-analysis and subgroup analysis for vaccinated patients was performed. A total of 32 studies were included in the meta-analysis. Pooled RR for the effect of NR on mortality, hospitalization, hospitalization and/or mortality, and progression to severe disease were 0.36 (95% confidence interval [CI]: 0.25-0.52), 0.43 (CI: 0.37-0.51), 0.52 (CI: 0.45-0.61) and 0.54 (CI: 0.41-0.73), respectively. A subgroup analysis on vaccinated patients indicated lower effectiveness of NR on mortality (RR: 0.55, CI: 0.45-0.68), but similar effectiveness for hospitalization, hospitalization and/or mortality, or progression to severe disease (RR: 0.52, 0.58, and 0.66, respectively). This updated meta-analysis robustly confirms the protective effects of NR on severe COVID-19 outcomes.
Keywords: COVID-19; Paxlovid; SARS-CoV-2; meta-analysis; nirmatrelvir-ritonavir; systematic review.
. 2024 Feb;96(2):e29434.
doi: 10.1002/jmv.29434. Effectiveness of nirmatrelvir-ritonavir on severe outcomes of COVID-19 in the era of vaccination and Omicron: An updated meta-analysis
Sien Ombelet[SUP] 1 [/SUP], Diego Castanares-Zapatero[SUP] 1 [/SUP], Fabian Desimpel[SUP] 1 [/SUP], Frank Hulstaert[SUP] 1 [/SUP], Sabine Stordeur[SUP] 2 [/SUP], Dominique Roberfroid[SUP] 1 [/SUP]
Affiliations
- PMID: 38376947
- DOI: 10.1002/jmv.29434
Nirmatrelvir-ritonavir (NR) was approved to treat SARS-CoV-2 positive outpatients at high risk of progression to severe disease, based on a randomized trial in unvaccinated patients. Effectiveness in vaccinated patients and against Omicron has not yet been confirmed by clinical trial data, but a recent meta-analysis suggested good real-world effectiveness based on 12 studies. We updated this meta-analysis by searching Medline and Embase databases for studies assessing effectiveness of NR on mortality, hospitalization, composite outcome of hospitalization and/or death, and progression to severe disease, published between October 1, 2022 and May 22, 2023. Random effects meta-analysis and subgroup analysis for vaccinated patients was performed. A total of 32 studies were included in the meta-analysis. Pooled RR for the effect of NR on mortality, hospitalization, hospitalization and/or mortality, and progression to severe disease were 0.36 (95% confidence interval [CI]: 0.25-0.52), 0.43 (CI: 0.37-0.51), 0.52 (CI: 0.45-0.61) and 0.54 (CI: 0.41-0.73), respectively. A subgroup analysis on vaccinated patients indicated lower effectiveness of NR on mortality (RR: 0.55, CI: 0.45-0.68), but similar effectiveness for hospitalization, hospitalization and/or mortality, or progression to severe disease (RR: 0.52, 0.58, and 0.66, respectively). This updated meta-analysis robustly confirms the protective effects of NR on severe COVID-19 outcomes.
Keywords: COVID-19; Paxlovid; SARS-CoV-2; meta-analysis; nirmatrelvir-ritonavir; systematic review.