■这项研究旨在评估尼马特雷韦/利托那韦治疗2019年冠状病毒病(COVID-19)患者的疗效,尤其是那些60岁及以上的人。使用真实世界的数据,将BN.1Omicron变体占主导地位的时期与BA.5变体占主导地位的时期进行比较。
■在这项回顾性队列研究中,我们收集了2022年7月24日至2023年3月31日期间2,665,281例感染严重急性呼吸综合征冠状病毒2的患者的数据.使用倾向评分匹配来匹配在BN.1和BA.5变体组之间以1:4比例接受尼马特雷韦/利托那韦的患者。采用多变量逻辑回归分析来评估这些组中尼马特雷韦/利托那韦的效果。
■与上一期相比,在大韩民国,在OmicronBN.1变异体优势期间期,尼马特雷韦/利托那韦的疗效无显著差异.在接受尼马特雷韦/利托那韦治疗的患者中,在BN.1组中观察到显著较低的死亡风险(比值比[OR],0.698;95%置信区间[CI],0.557-0.875)与BA.5组相比。然而,这种治疗并没有显着降低严重或危重疾病的风险,包括死亡,对于BN.1组中的人(或,0.856;95%CI,0.728-1.007)。
■Nirmatrelvir/利托那韦保持了对COVID-19的有效性,即使出现了BN.1Omicron亚变体。因此,我们强烈建议对出现COVID-19相关症状的患者给予尼马特雷韦/利托那韦,无论主要的Omicron变体或其疫苗接种状态如何,减轻疾病严重程度并降低死亡风险。
BACKGROUND: This study was conducted to assess the efficacy of
nirmatrelvir/ritonavir treatment in patients with coronavirus disease 2019 (COVID-19), particularly those aged 60 years and older. Using real-world data, the period during which the BN.1 Omicron variant was dominant was compared to the period dominated by the BA.5 variant.
METHODS: In this retrospective cohort study, data were collected regarding 2,665,281 patients infected with severe acute respiratory syndrome coronavirus 2 between July 24, 2022, and March 31, 2023. Propensity score matching was utilized to match patients who received
nirmatrelvir/ ritonavir in a 1:4 ratio between BN.1 and BA.5 variant groups. Multivariable logistic regression analysis was employed to assess the effects of
nirmatrelvir/ritonavir within these groups.
RESULTS: Compared to the prior period, the efficacy of nirmatrelvir/ritonavir did not significantly differ during the interval of Omicron BN.1 variant dominance in the Republic of Korea. Among patients treated with
nirmatrelvir/ritonavir, a significantly lower risk of mortality was observed in the BN.1 group (odds ratio [OR], 0.698; 95% confidence interval [CI], 0.557-0.875) compared to the BA.5 group. However, this treatment did not significantly reduce the risk of severe or critical illness, including death, for those in the BN.1 group (OR, 0.856; 95% CI, 0.728-1.007).
CONCLUSIONS: Nirmatrelvir/ritonavir has maintained its effectiveness against COVID-19, even with the emergence of the BN.1 Omicron subvariant. Consequently, we strongly recommend the administration of nirmatrelvir/ritonavir to patients exhibiting COVID-19-related symptoms, irrespective of the dominant Omicron variant or their vaccination status, to mitigate disease severity and decrease the risk of mortality.