Effectiveness of Nirmatrelvir-Ritonavir for the Prevention of COVID-19–Related Hospitalization and Mortality: A Systematic Literature Review

American Journal of Therapeutics, Journal Year: 2024, Volume and Issue: 31(3), P. e246 - e257

Published: April 29, 2024

Background: Nirmatrelvir/ritonavir (NMV/r) is an oral antiviral drug used to treat mild-to-moderate coronavirus disease 2019 (COVID-19) in patients aged 12 years or older at high risk of progression severe (eg, hospitalization and death). Despite being the preferred option for outpatient treatment majority countries worldwide, NMV/r currently underutilized real-world clinical practice. Areas Uncertainty: As numerous studies have described patient outcomes following with NMV/r, this systematic literature review provides a comprehensive summary evidence on effectiveness against mortality further organized by clinically meaningful categories, such as acute versus longer-term follow-up, age, underlying health conditions, vaccination status, help inform care decision making. Data Sources: We searched Embase PubMed (December 22, 2021–March 31, 2023) congress abstracts 1, 2021–December 2022) reports describing effectiveness. Therapeutic Advances: In total, 18 met final selection criteria. The showed that significantly reduced postinfection all-cause COVID-19-related both (≤30 days) (21%–92%) (>30 (1%–61%) follow-up. reduction was higher when received within 5 days symptom onset. Real-world observed regardless high-risk status. Conclusion: findings demonstrated during Omicron period among individuals COVID-19 disease.

Language: Английский

---

Does early combination vs. Monotherapy improve clinical outcomes of clinically extremely vulnerable patients with COVID-19? Results from a retrospective propensity-weighted analysis

European journal of medical research, Journal Year: 2024, Volume and Issue: 29(1)

Published: Oct. 4, 2024

Language: Английский

---

Efficacy and safety of antiviral therapies for the treatment of persistent COVID-19 in immunocompromised patients since the Omicron surge: a systematic review

Journal of Antimicrobial Chemotherapy, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 13, 2025

Abstract Background Persistent COVID-19 (pCOVID-19) in immunocompromised patients is characterized by unspecific symptoms and pulmonary infiltrates due to ongoing severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) replication. Treatment options remain unclear, leading different approaches, including combination therapy extended durations. The purpose of this study was assess the efficacy safety antiviral therapies for pCOVID-19 since Omicron surge. Methods We searched MEDLINE Scopus from 1 January 2022 6 August 2024 cohort studies case series on nirmatrelvir/ritonavir, remdesivir, ensitrelvir molnupiravir. Evidence certainty rated using Grading Recommendations Assessment, Development, Evaluation outcomes viral clearance, recurrence/relapse, mortality, adverse events (AEs) symptom resolution. Results Thirteen involving 127 cases were included. very low. In with at least two direct agents, clearance 79%, a 16% recurrence rate. All-cause mortality 9%, 6% while SARS-CoV-2 positive. 47 cases, AEs reported 11%. Symptom resolution ranged 3 days studies. one agent passive immunization, 89%, an 11% rate no deaths. four documented observed. monotherapy, 100%, 15% One death, unrelated SARS-CoV-2, occurred. 12 Conclusions Based low evidence, combining immunization resulted high rates few recurrences. occurred treated antivirals. Controlled are needed.

Language: Английский

---

Efficacy of antiviral therapy and disease outcomes in COVID-19 patients previously treated with obinutuzumab for follicular lymphoma

Tenri Medical Bulletin, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 1, 2025

Language: Английский

---

SARS-CoV-2 outbreak in lions, tigers, and hyenas at Denver Zoo

mSphere, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 6, 2025

ABSTRACT In late 2019, SARS-CoV-2 spilled over from an animal host into humans, where it efficiently spread, resulting in the COVID-19 pandemic. Through both natural and experimental infections, we learned that many species are susceptible to SARS-CoV-2. Importantly, animals close proximity including companion, farmed, those at zoos aquariums, became infected, studies demonstrated transmission to/from humans these settings. this study, first review literature of infections tigers lions compare species, sex, age, virus antibody detection assay, types, frequency, length clinical signs, demonstrating broad heterogeneity among infections. We then describe a outbreak lions, tigers, hyenas Denver Zoo 2021. Animals were tested for viral RNA (vRNA) 4 months. Lions had significantly more vRNA nasal swabs than hyenas, individual experienced recrudescence after weeks undetectable vRNA. Infectious was correlated with high levels likely be detected earlier during infection. Four months post-infection, all generated robust neutralizing titers. infected Delta lineage AY.20 identical variant circulating less 1% Colorado time, suggesting single spillover event human spread within between housed zoo. Better understanding epidemiology susceptibility is critical limit current future protect health. IMPORTANCE Surveillance testing have shown wildlife, conservatory, Early pandemic, big cats zoological institutions documented cases naturally animals; however, challenges ability collect longitudinal samples zoo limited our kinetics clearance measured RNA, infectious virus, antibodies, initial clearance. found longer higher compared other species. All by rare population, followed interspecies transmission. These data important better spillover, infection multiple animals.

Language: Английский

---

Nirmatrelvir treatment duration and frequency of COVID-19 rebound

Antiviral Therapy, Journal Year: 2025, Volume and Issue: 30(1)

Published: Feb. 1, 2025

Background Nirmatrelvir has been shown to reduce morbidity and mortality associated with COVID-19. However, it is underutilized due concerns regarding COVID-19 symptom rebound following nirmatrelvir’s standard 5-day course. This study aims identify evaluate a nirmatrelvir dosage regimen that lowers rebound. Methods Based on pharmacokinetics, we propose novel 8-day regimen: two doses twice-daily followed by six once-daily frequency. We then carried out retrospective case series of clinical outcomes among our patients investigate their frequency usage. Results Among the 58 prescribed patients, 49 filled initiated prescription. Of those four took medication for fewer than 5 days, 24 days (standard regimen), 21 7 or 8 (extended regimen). treatment cases ( n = 24), (33%) experienced rebound, whereas 7-day 21), 2 (9.5%) Conclusions These findings suggest longer nirmatrelvir/ritonavir course might symptoms compared regimen.

Language: Английский

---

Effects of Nirmatrelvir/ritonavir (paxlovid) on the nervous system: analysis on adverse events released by FDA

Expert Opinion on Drug Safety, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 8

Published: Feb. 27, 2025

Nirmatrelvir/ritonavir, commonly known as Paxlovid, is one of the main drugs used to treat COVID-19. Neurological disorders are among adverse drug reactions (ADRs) linked yet comprehensive data-mining studies based on real-world neurological events induced by Paxlovid lacking. It an observational study, reduce risk bias affected COVID-19 disease, our study included only patients with disease. In this case, disproportionate analysis performed using Report Odds Ratio (ROR) and its 95% Confidence Interval (CI). We screened compared all medications associated (N = 439) found that 22 these were reactions. was a threefold greater number other combined 11,792), strong signal value (ROR 2.27). Compared COVID-19-related drugs, has highest stronger for neurologic-related Clinicians should pay special attention female taking within first 30 days, monitoring symptoms such dysgeusia, ageusia, headache, anosmia. addition, headache anosmia not uncommon occurrences mentioned in instructions be noted.

Language: Английский

---

Suspect Screening of Pharmaceuticals and Their Transformation Products (TPs) in Wastewater during COVID-19 Infection Peak: Identification of New TPs and Elevated Risks

Environmental Science & Technology, Journal Year: 2025, Volume and Issue: unknown

Published: March 5, 2025

Pharmaceuticals and their transformation products (TPs) in wastewater are emerging contaminants that pose risks to ecosystems human health. Here, a typical period marked by the easing of "zero-COVID" policy December 2022, resulting unprecedented infections China, was chosen illustrate environmental impact pharmaceutical usage during COVID-19 pandemic. A suspect screening workflow developed identify pharmaceuticals influent effluent from treatment plant (WWTP) peak postpeak periods COVID-19, integrating medication recommendations TPs' prediction. total 114 TPs were identified (13 detected for first time WWTP) using liquid chromatography coupled with high-resolution mass spectrometry (LC-HRMS). Wastewater-based epidemiology analysis showed most predominant nonsteroidal anti-inflammatory drugs. Interestingly, consumption propafenone increased after infection peak, possibly linked long symptoms. Risks further evaluated based on concentration, detection frequency, PMT (persistence, mobility, toxicity) properties, revealing aminopyrine, acetaminophen, etc. even greater ToxPi scores than parent compounds. This study highlights elevated posed discharge epidemics necessity monitoring.

Language: Английский

---

Clinical Manifestations of SARS-CoV-2 Infection in Immunocompetent Adults in the Era of Widespread Population Immunity and Omicron Sublineage Viruses

Infectious Disease Clinics of North America, Journal Year: 2025, Volume and Issue: unknown

Published: March 1, 2025

Language: Английский

---

Pharmacologic Treatment and Management of Coronavirus Disease 2019

Infectious Disease Clinics of North America, Journal Year: 2025, Volume and Issue: unknown

Published: March 1, 2025

Language: Английский

---