Clinical Research Study
The Impact of Nirmatrelvir-Ritonavir in Reducing Hospitalizations Among High-Risk Patients With SARS-CoV-2 During the Omicron Predominant Era

https://doi.org/10.1016/j.amjmed.2023.02.022Get rights and content

Abstract

Background

The coronavirus disease 2019 (COVID-19) pandemic has caused significant morbidity and mortality in high-risk populations. Several therapeutics have been developed to reduce the risk of complications related to COVID-19, hospitalizations, and death. In several studies, nirmatrelvir-ritonavir (NR) was reported to reduce the risk of hospitalizations and death. We aimed to evaluate the efficacy of NR in preventing hospitalizations and death during the Omicron predominant period.

Methods

We retrospectively evaluated patients from June 1, 2022, through September 24, 2022. There were a total of 25,939 documented COVID-19 cases. Using propensity matching, we matched 5754 patients treated with NR with untreated patients.

Results

Postmatching, the median age of the NR-treated group was 58 years (interquartile range, 43-70 years) and 42% were vaccinated. Postmatching composite outcome of the 30-day hospitalization and mortality in the NR-treated group were 0.9% (95% confidence interval [CI]: 0.7%−1.2%) versus 2.1% (95% CI: 1.8%−2.5%) in the matched control group, with a difference of −1.2 (−1.7, −0.8), P value <.01. The difference rates (NR vs. control) in 30-day all-cause hospitalizations and mortality were −1.2% (95% CI: −1.6% to −0.7%, P value <.01) and −0.1% (95% CI: −0.2% to 0.0%, P value = 0.29), respectively. We found similar finding across different age groups (≥65 vs. <65) and the vaccinated group.

Conclusion

We report a significant benefit with the use of NR in reducing hospitalizations among various high-risk COVID-19 groups during the Omicron BA.5 predominant period.

Keywords

COVID-19
Omicron variant
Nirmatrelvir-ritonavir

Cited by (0)

Funding: None.

Conflicts of Interest: ABG, SM, BT, IM, RCW, and BT report none. MMA-O reports an honorarium from Shionogi Inc. and La Jolla Pharmaceuticals for serving on their advisory board. TTZ reports a research grant with AiCuris.

Authorship: All authors had access to the data and a role in writing this manuscript.

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