COVID-19 clinical rebound after treatment with nirmatrelvir/ritonavir DOI Creative Commons
Daniel M. Camp, Matthew Caputo,

Fabiola Moreno Echevarria

и другие.

Research Square (Research Square), Год журнала: 2024, Номер unknown

Опубликована: Июнь 21, 2024

Abstract Background: Nirmatrelvir/ritonavir (NM/r) is a safe and effective oral antiviral therapeutic used for treatment of mild-to-moderate COVID-19. Case reports described clinical rebound syndrome whereby individuals experience relapse symptoms shortly after completing successful treatment. There lack information on frequency COVID-19 NM/r in routine care, contributing factors, outcomes. Methods: We reviewed electronic medical records to verify diagnosis, symptoms, with from January-June 2022. defined as clear improvement followed by recurrence or worsening within 30 days five-day course NM/r. Results: studied 268 adults median age 57 (IQR 47, 68), 80% White race, 85% non-Hispanic ethnicity, 55% female, vaccinated boosted against SARS-CoV-2, 68% any co-morbidity. Sixteen (6.0%) patients were determined have rebound. The time starting was 11 9, 13). Notable demographic factors higher proportion (not statistically significant) among female sex (75% vs 54.5% no rebound), Black race (12.5% 4.9% presence at least one co-morbidity (81.3% 67.5% prior SARS-CoV-2 infection (100% 92.9% rebound). Only patient (6.25%) hospitalized Conclusions: mild favorable outcomes more common than previously reported real-world care studies.

Язык: Английский

Disparate SARS-CoV-2 infection outcomes abound, but what makes SARS-CoV-2 bound for rebound? DOI Creative Commons
Timothy P. Sheahan

The Journal of Infectious Diseases, Год журнала: 2024, Номер unknown

Опубликована: Авг. 1, 2024

The global research community attacked the COVID-19 pandemic and its causative agent, SARS-CoV-2, with intense ferocity.Over past four years, one could argue that SARS-CoV-2 was most intensely studied virus on planet dwarfing publication outputs of important pathogens such as HIV influenza virus*.In addition, prior to pandemic, coronaviruses (CoV) had been researched for decades since their discovery in 1960s (1) experienced experimental renaissances emergence SARS-CoV 2002 (2) MERS-CoV 2012 (3) (Fig. 1).Yet despite volumes research, questions about CoV biology from relatively simple complex, remain unclear.For example, what is clinical course infection?While answering this early may have garnered a straightforward answer, astronomical case numbers, enterprising scientists time collectively worked together provide insights into disease gone unnoticed otherwise, benefit studying rapid explosive infectious disease.

Язык: Английский

Процитировано

0
Kinetics of SARS-CoV-2 Shedding in Nursing Home Residents and Staff DOI
Morgan J. Katz,

Majerle Reeves,

Tiffany G. Harris

и другие.

Опубликована: Янв. 1, 2024

Язык: Английский

Процитировано

0
Independent FDA Analyses of Nirmatrelvir/Ritonavir Resistance in the Phase 2/3 Trials EPIC-HR and EPIC-SR DOI Creative Commons
Jonathan Rawson, Eric Donaldson,

Julian J. O’Rear

и другие.

Clinical Infectious Diseases, Год журнала: 2024, Номер unknown

Опубликована: Дек. 17, 2024

Abstract Background PAXLOVID consists of nirmatrelvir, an inhibitor SARS-CoV-2 main protease (Mpro), copackaged with ritonavir, a pharmacokinetic enhancer. Nirmatrelvir/ritonavir received emergency use authorization in the United States 2021 and was approved 2023. However, there is limited published information on clinical resistance to nirmatrelvir/ritonavir. Methods To investigate development nirmatrelvir/ritonavir treated patients, we analyzed baseline matching post-baseline next-generation sequencing data from 1,862 participants (912 nirmatrelvir/ritonavir, 950 placebo) EPIC-HR EPIC-SR, which were Phase 2/3, randomized, double-blind, placebo-controlled trials mild-to-moderate COVID-19. Potential resistance-associated substitutions (RAS) defined as those that enriched nirmatrelvir/ritonavir-treated or occurred at Mpro positions interest, using nonclinical data. sequence databases characterize temporal frequencies RAS circulating viruses. Results In EPIC-HR, included T21I (n=1), E166V (n=3), A173T T304I being clearest observed. no detected. not associated hospitalization death. Analyses did reveal concerning increases over time. Conclusions trials, emergence infrequent (<0.3%-1.1%). Surveillance currently indicate low frequency variants RAS. Collectively, these results provide most comprehensive analysis setting date. Viral sequences should continue be closely monitored identify potential nirmatrelvir/ritonavir-resistant variants.

Язык: Английский

Процитировано

0
Viral SARS-CoV-2 Rebound Rates in Linked Commercial Pharmacy-Based Testing and Health Care Claims DOI Creative Commons
Scott P. Kelly, Lisa M. McEwen, Magnus Isaksson

и другие.

Open Forum Infectious Diseases, Год журнала: 2024, Номер 11(6)

Опубликована: Апрель 29, 2024

Abstract Background Viral SARS-CoV-2 rebound (viral RNA rebound) is challenging to characterize in large cohorts due the logistics of collecting frequent and regular diagnostic test results. Pharmacy-based testing data provide an opportunity study phenomenon a population, also enabling subgroup analyses. The current real-world evidence approach complements approaches focused on smaller, prospective designs. Methods We linked real-time reverse transcription quantitative polymerase chain reaction from national pharmacy-based health care claims via tokenization calculate cumulative incidence viral within 28 days following positive results nirmatrelvir/ritonavir (NMV-r)–treated untreated individuals during Omicron era (December 2021–November 2022) prior (October 2020–November 2021). Results Among 30 646 patients, rate was 3.5% (95% CI, 2.0%–5.7%) NMV-r–treated infections as compared with 1.5% 1.3%–1.7%) 1.9% 1.7%–2.1%) era. patients who were vaccinated (n = 8151), high risk 4411), or older (≥65 years, n 4411) occurred at comparable rates overall cohort (range, 1.1%–4.8%). rebounds levels 8% 5% 11% infections. Rates hospitalization between (0%) (0%–1.2%). Conclusions Our findings suggest rare (< 5%), that consistent those EPIC-HR trial (Evaluation Protease Inhibition for COVID-19 High-Risk Patients). Most occurrences associated low levels, progression severe disease not observed.

Язык: Английский

Процитировано

0
COVID-19 clinical rebound after treatment with nirmatrelvir/ritonavir DOI Creative Commons
Daniel M. Camp, Matthew Caputo,

Fabiola Moreno Echevarria

и другие.

Research Square (Research Square), Год журнала: 2024, Номер unknown

Опубликована: Июнь 21, 2024

Abstract Background: Nirmatrelvir/ritonavir (NM/r) is a safe and effective oral antiviral therapeutic used for treatment of mild-to-moderate COVID-19. Case reports described clinical rebound syndrome whereby individuals experience relapse symptoms shortly after completing successful treatment. There lack information on frequency COVID-19 NM/r in routine care, contributing factors, outcomes. Methods: We reviewed electronic medical records to verify diagnosis, symptoms, with from January-June 2022. defined as clear improvement followed by recurrence or worsening within 30 days five-day course NM/r. Results: studied 268 adults median age 57 (IQR 47, 68), 80% White race, 85% non-Hispanic ethnicity, 55% female, vaccinated boosted against SARS-CoV-2, 68% any co-morbidity. Sixteen (6.0%) patients were determined have rebound. The time starting was 11 9, 13). Notable demographic factors higher proportion (not statistically significant) among female sex (75% vs 54.5% no rebound), Black race (12.5% 4.9% presence at least one co-morbidity (81.3% 67.5% prior SARS-CoV-2 infection (100% 92.9% rebound). Only patient (6.25%) hospitalized Conclusions: mild favorable outcomes more common than previously reported real-world care studies.

Язык: Английский

Процитировано

0