Paxlovid (Nirmatrelvir and Ritonavir) Use in Pregnant and Lactating Woman: Current Evidence and Practice Guidelines—A Scoping Review

Vaccines, Год журнала: 2023, Номер 11(1), С. 107 - 107

Опубликована: Янв. 1, 2023

COVID-19 virus, since the detection of first case in Wuhan 2019, has caused a worldwide pandemic with significant human, economic and social costs. Fortunately, several vaccines treatments, both IV oral, are currently approved against virus. Paxlovid is an oral treatment option for patients mild-to-moderate disease, it effectively reduces disease severity high-risk patients. antiviral that consists combination nirmatrelvir ritonavi. As medication suitable outpatient treatment, cost, hospitalization mortality associated infection. The pregnant population category disease. Given their exclusion clinical trials, there limited data regarding use lactating women. Indirect evidence from ritonavir as part HAART therapy HIV shown no teratogenicity. Moreover, animal studies on do not suggest This article summarizes available during pregnancy ongoing trials. We also review recommendations major societies breastfeeding

Язык: Английский

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Efficacy and safety of paxlovid (nirmatrelvir/ritonavir) in the treatment of COVID‐19: An updated meta‐analysis and trial sequential analysis

Reviews in Medical Virology, Год журнала: 2023, Номер 33(5)

Опубликована: Июль 23, 2023

Abstract Our study is aimed to access the efficacy and safety outcomes for coronavirus disease 2019 (COVID‐19) patients treated with Paxlovid. According inclusion exclusion criteria, databases were used retrieve articles from 1 January 2020 2023. Article screening, quality evaluation data extraction completed cross‐checked. The meta‐analysis trial sequential analysis (TSA) conducted using RevMan, StataMP, TSA software. A total of 42 original included. Overall results showed that death, hospitalisation, death or emergency department (ED) visit, intensive care unit (ICU) admission, extra oxygen requirement outcomes, every odds ratio (OR) was <1 p < 0.05. For rebound outcome, OR >1 > adverse events (AEs) In conclusion, Paxlovid effectively reduced risks ED ICU requirement. There no significant statistical difference considering rebound, but people should pay attention possible AEs. However, AEs observations in certain subgroups suggested conclusions contrary overall meta‐analysis. Trial indicated these two have a risk false negative positive conclusions, so additional studies are needed further validation.

Язык: Английский

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Real-world effectiveness of Azvudine in hospitalized patients with COVID-19: a retrospective cohort study

medRxiv (Cold Spring Harbor Laboratory), Год журнала: 2023, Номер unknown

Опубликована: Янв. 23, 2023

ABSTRACT Current guidelines prioritize the use of Azvudine in coronavirus disease 2019 (COVID-19) patients. However, clinical effectiveness real-world studies was lacking, despite trials showed shorter time nucleic acid negative conversion. To evaluate following treatment hospitalized COVID-19 patients, we identified 1505 patients during study period, with a follow-up up to 29 days. After exclusions and propensity score matching, included 226 recipients matched controls. The lower crude incidence rate composite progression outcome (4.21 vs. 10.39 per 1000 person-days, P =0.041) all-cause mortality (1.57 6.00 =0.027) were observed among compared rates initiation invasive mechanical ventilation also statistically different between groups according log-rank tests ( =0.020). associated significantly risks (hazard ratio [HR]: 0.43; 95% confidence interval [CI]: 0.18 0.99) death (HR: 0.26; CI: 0.07 0.94) Subgroup analyses indicated robustness point estimates HRs (ranged from 0.14 0.84). Notably, male had stronger than female respect both death. These findings suggest that substantial benefits should be considered for this population

Язык: Английский

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Post-acute hospitalization and mortality of nirmatrelvir plus ritonavir for COVID-19 survivors

Journal of Infection, Год журнала: 2023, Номер 86(4), С. e107 - e110

Опубликована: Фев. 10, 2023

Язык: Английский

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Exploring Paxlovid Efficacy in COVID-19 Patients with MAFLD: Insights from a Single-Center Prospective Cohort Study

Viruses, Год журнала: 2024, Номер 16(1), С. 112 - 112

Опубликована: Янв. 12, 2024

This study investigates the intricate interplay between Metabolic-associated Fatty Liver Disease (MAFLD) and COVID-19, exploring impact of MAFLD on disease severity, outcomes, efficacy antiviral agent Paxlovid (nirmatrelvir/ritonavir). MAFLD, affecting a quarter global population, emerges as potential risk factor for severe yet underlying pathophysiological mechanisms remain elusive. focuses clinical significance Paxlovid, first orally bioavailable granted Emergency Use Authorization in United States. Notably, outcomes from phase II/III trials exhibit an 88% relative reduction COVID-19-associated hospitalization or mortality among high-risk patients. Despite conflicting data association COVID-19 this research strives to bridge gap by evaluating effectiveness patients with addressing scarcity relevant studies.

Язык: Английский

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ACVPred: Enhanced prediction of anti-coronavirus peptides by transfer learning combined with data augmentation

Future Generation Computer Systems, Год журнала: 2024, Номер 160, С. 305 - 315

Опубликована: Июнь 7, 2024

Язык: Английский

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

Expert Opinion on Drug Safety, Год журнала: 2025, Номер unknown, С. 1 - 8

Опубликована: Фев. 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.

Язык: Английский

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The Antiviral Effect of Nirmatrelvir/Ritonavir during COVID-19 Pandemic Real-World Data

Viruses, Год журнала: 2023, Номер 15(4), С. 976 - 976

Опубликована: Апрель 16, 2023

Vaccination against SARS-CoV-2 and the prevalence of Omicron variants have reduced risk severe clinical progress COVID-19. However, breakthrough infections has increased, early administration an effective antiviral treatment is significant in order to prevent progression COVID-19 vulnerable patients with comorbidities.Adults confirmed infection were included a matched-pair retrospective study based on age, gender, comorbidities vaccination status. They divided into two groups: group A (n = 200) consisted outpatients at increased who treated nirmatrelvir/ritonavir B non-hospitalized did not receive treatment. Demographic data, outcome (death, intubation), days hospitalization, time for recovery, adverse events compliance reported.The median age (75.24 ± 13.12 years 76.91 14.02 comparison group) proportion males (59% vs. 60.5%, respectively) similar between groups. total 6.5% 10.5% unvaccinated SARS-CoV-2. Three from (1.5%) one hundred eleven (55.5%) required hospitalization. The duration hospitalization (3 10 B, p < 0.001) needed recovery (5 9 days, was shorter group. rebound within 8-12 after diagnosis documented 8% B.Oral high-risk safe preventing pneumonia. Early agents combined full scheme avoid outcomes.

Язык: Английский

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Effectiveness of previous infection-induced and vaccine-induced protection against hospitalisation due to omicron BA subvariants in older adults: a test-negative, case-control study in Quebec, Canada

The Lancet Healthy Longevity, Год журнала: 2023, Номер 4(8), С. e409 - e420

Опубликована: Июль 14, 2023

Older adults (aged ≥60 years) were prioritised for COVID-19 booster vaccination due to severe outcome risk, but the risk this group is also affected by previous SARS-CoV-2 infection and vaccination. We estimated vaccine effectiveness against omicron-associated hospitalisation in older previously documented infection, time since last immunological event, age group.This was a population-based test-negative case-control study done Quebec, Canada, during BA.1 dominant (December, 2021, March, 2022), BA.2 (April June, BA.4/5 (July November, 2022) periods using provincial laboratory, immunisation, hospitalisation, chronic disease surveillance databases. included with symptoms associated who tested acute-care hospitals. Cases defined as patients hospitalised within 14 days after testing positive; controls negative. Analyses spanned 3-14 months dose or infection. Logistic regression models compared mRNA versus unvaccinated infection-naive participants.Between Dec 26, Nov 5, 2022, we 174 819 specimens (82 870 [47·4%] from men 91 949 [52·6%] women; 8455 cases 166 364 controls), taken 2951 48 724 period; 1897 41 702 3607 75 938 period. In participants naive, improved number, consistent shorter median dose, decreased more recent omicron subvariants. Four-dose 96% (95% CI 93-98) period, 84% (81-87) 68% (63-72) Regardless of number (two five doses) timing hybrid protection than 90%, persisted at least 6-8 months, did not decline age.Older both two doses appear be well protected prolonged period subvariants, including BA.4/5. Ensuring that are naive remain up date might reduce hospitalisations most efficiently.Ministère de la Santé et des Services Sociaux du Québec.For French translation abstract see Supplementary Materials section.

Язык: Английский

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SARS-CoV-2 Evasion of the Interferon System: Can We Restore Its Effectiveness?

International Journal of Molecular Sciences, Год журнала: 2023, Номер 24(11), С. 9353 - 9353

Опубликована: Май 27, 2023

Type I and III Interferons (IFNs) are the first lines of defense in microbial infections. They critically block early animal virus infection, replication, spread, tropism to promote adaptive immune response. IFNs induce a systemic response that impacts nearly every cell host, while type IFNs’ susceptibility is restricted anatomic barriers selected cells. Both IFN types critical cytokines for antiviral against epithelium-tropic viruses being effectors innate immunity regulators development Indeed, essential limit replication at stages thus reducing viral spread pathogenesis. However, many have evolved strategies evade The Coronaviridae with largest genome among RNA viruses. Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) caused coronavirus disease 2019 (COVID-19) pandemic. has numerous contrast system immunity. We intend describe virus-mediated evasion responses by going through main phases: First, molecular mechanisms involved; second, role genetic background production during SARS-CoV-2 infection; third, potential novel approaches pathogenesis restoring endogenous sensitivity sites infection.

Язык: Английский

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