Abstract：
OBJECTIVE: Immunocompromised individuals, such as those diagnosed with cancer, are at a significantly higher risk for severe illness and mortality when infected with SARS-CoV-2 (COVID-19) than the general population. Two oral antiviral treatments are approved for COVID-19: Paxlovid® (nirmatrelvir/ritonavir) and Lagevrio® (molnupiravir). There is a paucity of data regarding the benefit from these antivirals among immunocompromised patients with cancer, and recent studies have questioned their efficacy among vaccinated patients, even those with risk factors for severe COVID-19.
METHODS: We evaluated the efficacy and safety of nirmatrelvir/ritonavir and molnupiravir in preventing severe illness and death using our database of 457 patients with cancer and COVID-19 from Brown University-affiliated hospitals.
RESULTS: Sixty-seven patients received nirmatrelvir/ritonavir or molnupiravir and were compared to 45 concurrent controls who received no antiviral treatment despite being eligible to receive it. Administration of nirmatrelvir/ritonavir or molnupiravir was associated with improved survival and lower 90-day all-cause and COVID-19-attributed mortality (p < 0.05) and with lower peak O2 requirements (ordinal odds ratio [OR] 1.52, 95% confidence interval [CI] 0.92-2.56).
CONCLUSIONS: Acknowledging the small size of our sample as a limitation, we concluded that early antiviral treatment might be beneficial to immunocompromised individuals, particularly those with cancer, when infected with SARS-CoV-2. Larger-scale, well-stratified studies are needed in this patient population.
METHODS: We evaluated the efficacy and safety of nirmatrelvir/ritonavir and molnupiravir in preventing severe illness and death using our database of 457 patients with cancer and COVID-19 from Brown University-affiliated hospitals.
RESULTS: Sixty-seven patients received nirmatrelvir/ritonavir or molnupiravir and were compared to 45 concurrent controls who received no antiviral treatment despite being eligible to receive it. Administration of nirmatrelvir/ritonavir or molnupiravir was associated with improved survival and lower 90-day all-cause and COVID-19-attributed mortality (p < 0.05) and with lower peak O2 requirements (ordinal odds ratio [OR] 1.52, 95% confidence interval [CI] 0.92-2.56).
CONCLUSIONS: Acknowledging the small size of our sample as a limitation, we concluded that early antiviral treatment might be beneficial to immunocompromised individuals, particularly those with cancer, when infected with SARS-CoV-2. Larger-scale, well-stratified studies are needed in this patient population.
摘要：
目标：免疫受损个体，比如那些被诊断患有癌症的人，感染SARS-CoV-2（COVID-19）时，患严重疾病和死亡的风险明显高于普通人群。两种口服抗病毒治疗方法被批准用于COVID-19：Paxlovid®（尼尔马特雷韦/利托那韦）和Lagevrio®（莫努普拉韦）。关于免疫功能低下的癌症患者从这些抗病毒药物中获益的数据很少，最近的研究质疑它们在接种疫苗的患者中的功效，即使是那些有严重COVID-19危险因素的人。
方法：我们使用来自布朗大学附属医院的457例癌症和COVID-19患者的数据库，评估了尼马特雷韦/利托那韦和莫诺比拉韦预防严重疾病和死亡的有效性和安全性。
结果：67名患者接受了尼马特雷韦/利托那韦或莫诺比拉韦，并与45名尽管有资格接受抗病毒治疗但未接受抗病毒治疗的并发对照进行了比较。服用尼马特雷韦/利托那韦或莫诺比拉韦与生存率提高、90天全因死亡率和COVID-19归因死亡率降低相关(p<0.05)，峰值O2需求降低(序数比值比[OR]1.52，95%置信区间[CI]0.92-2.56)。
结论：承认我们的样本规模较小是一个限制，我们得出结论，早期抗病毒治疗可能对免疫功能低下的个体有益，尤其是那些患有癌症的人，当感染SARS-CoV-2时。规模较大,在这一患者人群中需要进行良好的分层研究.
方法：我们使用来自布朗大学附属医院的457例癌症和COVID-19患者的数据库，评估了尼马特雷韦/利托那韦和莫诺比拉韦预防严重疾病和死亡的有效性和安全性。
结果：67名患者接受了尼马特雷韦/利托那韦或莫诺比拉韦，并与45名尽管有资格接受抗病毒治疗但未接受抗病毒治疗的并发对照进行了比较。服用尼马特雷韦/利托那韦或莫诺比拉韦与生存率提高、90天全因死亡率和COVID-19归因死亡率降低相关(p<0.05)，峰值O2需求降低(序数比值比[OR]1.52，95%置信区间[CI]0.92-2.56)。
结论：承认我们的样本规模较小是一个限制，我们得出结论，早期抗病毒治疗可能对免疫功能低下的个体有益，尤其是那些患有癌症的人，当感染SARS-CoV-2时。规模较大,在这一患者人群中需要进行良好的分层研究.
