Azvudine therapy of common COVID‐19 in hemodialysis patients

Shang, Shunlai; Fu, Bo; Geng, Yi; Zhang, Jian; Zhang, Dawei; Xiao, Fenglin; Sheng, Zhaojun; Zhai, Jingbo; Li, Wenge; Chen, Xiangmei; Zheng, Chunfu; Li, Qinggang

doi:10.1002/jmv.29007

Cited by 12 publications

(3 citation statements)

References 28 publications

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“…Similarly, Toussi et al. ( 26 ) demonstrated that the safety of nirmatrelvir/ritonavir in patients with renal impairment was similar to that of azvudine ( 27 ). Adverse reactions during COVID-19 treatment require further exploration in future studies.…”

Section: Discussionmentioning

confidence: 93%

Allograft function predicts mortality in kidney transplant recipients with severe COVID-19: a paradoxical risk factor

Luo,

Wen,

Yang

et al. 2024

Front. Immunol.

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IntroductionKidney transplant recipients (KTRs) are at a higher risk of severe coronavirus disease (COVID-19) because of their immunocompromised status. However, the effect of allograft function on the prognosis of severe COVID-19 in KTRs is unclear. In this study, we aimed to analyze the correlation between pre-infection allograft function and the prognosis of severe COVID-19 in KTRs.MethodsThis retrospective cohort study included 82 patients who underwent kidney transplantation at the Sichuan Provincial Peoples Hospital between October 1, 2014 and December 1, 2022 and were diagnosed with severe COVID-19. The patients were divided into decreased eGFR and normal eGFR groups based on the allograft function before COVID-19 diagnosis (n=32 [decreased eGFR group], mean age: 43.00 years; n=50 [normal eGFR group, mean age: 41.88 years). We performed logistic regression analysis to identify risk factors for death in patients with severe COVID-19. The nomogram was used to visualize the logistic regression model results.ResultsThe mortality rate of KTRs with pre-infection allograft function insufficiency in the decreased eGFR group was significantly higher than that of KTRs in the normal eGFR group (31.25% [10/32] vs. 8.00% [4/50], P=0.006). Pre-infection allograft function insufficiency (OR=6.96, 95% CI: 1.4633.18, P=0.015) and maintenance of a mycophenolic acid dose >1500 mg/day before infection (OR=7.59, 95% CI: 1.0853.20, P=0.041) were independent risk factors, and the use of nirmatrelvir/ritonavir before severe COVID-19 (OR=0.15, 95% CI: 0.030.72, P=0.018) was a protective factor against death in severe COVID-19.ConclusionsPre-infection allograft function is a good predictor of death in patients with severe COVID-19. Allograft function was improved after treatment for severe COVID-19, which was not observed in patients with non-severe COVID-19.

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Section: Discussionmentioning

confidence: 93%

Allograft function predicts mortality in kidney transplant recipients with severe COVID-19: a paradoxical risk factor

Luo,

Wen,

Yang

et al. 2024

Front. Immunol.

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“…Seven studies [ 8 , 13 , 26 – 28 , 31 , 33 ] involving 2742 patients reported the incidence of adverse events in patients taking azvudine and SOC/PBO. The pooled estimate of the included studies revealed no significant difference between the two groups in terms of adverse events (RR = 1.03, 95% CI: 0.64 to 1.67, P = 0.87, I 2 = 87%, GRADE certainty: low) ( Fig 8 ).…”

Section: Resultsmentioning

confidence: 99%

Effectiveness and safety of azvudine in COVID-19: A systematic review and meta-analysis

Amani,

Amani

2024

PLoS ONE

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Objective The aim of this study was to assess the effectiveness and safety of azvudine in treating coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-COV-2). Methods A search was carried out in PubMed, Cochrane Library, Web of Science, medRxiv, and Google Scholar until October 20, 2023. The Cochrane risk of bias tools were used to assess the quality of included studies. Comprehensive Meta-Analysis software was used to analyze data. Results Twenty-one studies including 10,011 patients were examined. The meta-analysis results showed that azvudine and standard of care/placebo (SOC/PBO) were significantly different concerning mortality rate (risk ratio [RR] = 0.48, 95% confidence interval [CI]: 0.40 to 0.57) and negative polymerase chain reaction (PCR) conversion time (standard mean difference = - 0.75, 95% CI: -1.29 to—0.21). However, the two groups did not show significant differences concerning hospital stay, intensive care unit (ICU) admission, and need for mechanical ventilation (P > 0.05). On the other hand, azvudine and nirmatrelvir-ritonavir were significantly different in mortality rate (RR = 0.73, 95% CI: 0.58 to 0.92), ICU admission (RR = 0.41, 95% CI: 0.21 to 0.78), and need for mechanical ventilation (RR = 0.67, 95% CI: 0.51 to 0.89), but the two treatments were not significantly different in negative PCR conversion time, and hospital stay (P > 0.05). The incidence of adverse events between groups was not significant (P > 0.05). The certainty of evidence was rated as low or moderate. Conclusions The antiviral effectiveness of azvudine against SARS-COV-2 is questionable with regard to the certainty of evidence. Further research should be conducted to establish the effectiveness and safety of azvudine in COVID-19.

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“…Our findings showed elevated risk for ALI in people receiving nirmatrelvir-ritonavir, but azvudine showed no additional adverse event rates compared to the control, the findings of which are consistent with previous reports. 30,31 This presents one more option for vulnerable populations, improving their prognosis, especially in low and middle-income countries.…”

Section: Safety Outcomesmentioning

confidence: 99%

Azvudine and nirmatrelvir–ritonavir in hospitalized patients with moderate‐to‐severe COVID‐19: Emulation of a randomized target trial

Zhou,

Liu,

Jiang

et al. 2023

Journal of Medical Virology

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To examine the effectiveness of azvudine and nirmatrelvir–ritonavir in treating hospitalized patients with moderate‐to‐severe COVID‐19. We emulated a target trial with a multicenter retrospective cohort of hospitalized adults with moderate‐to‐severe COVID‐19 without contraindications for azvudine or nirmatrelvir–ritonavir between December 01, 2022 and January 19, 2023 (during the Omicron BA.5.2 variant wave). Exposures included treatment with azvudine or nirmatrelvir–ritonavir for 5 days versus no antiviral treatment during hospitalization. Primary composite outcome (all‐cause death and initiation of invasive mechanical ventilation), and their separate events were evaluated. Of the 1154 patients, 27.2% were severe cases. In the intent‐to‐treat analyses, azvudine reduced all‐cause death (Hazard ratio [HR]: 0.31; 95% CI: 0.12–0.78), and its composite with invasive mechanical ventilation (HR: 0.47; 95% CI: 0.24–0.92). Nirmatrelvir–ritonavir reduced invasive mechanical ventilation (HR: 0.42; 95% CI: 0.17–1.05), and its composite with all‐cause death (HR: 0.38; 95% CI: 0.18–0.81). The study did not identify credible subgroup effects. The per–protocol analyses and all sensitivity analyses confirmed the robustness of the findings. Both azvudine and nirmatrelvir–ritonavir improved the prognosis of hospitalized adults with moderate‐to‐severe COVID‐19

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Azvudine therapy of common COVID‐19 in hemodialysis patients

Cited by 12 publications

References 28 publications

Allograft function predicts mortality in kidney transplant recipients with severe COVID-19: a paradoxical risk factor

Allograft function predicts mortality in kidney transplant recipients with severe COVID-19: a paradoxical risk factor

Effectiveness and safety of azvudine in COVID-19: A systematic review and meta-analysis

Azvudine and nirmatrelvir–ritonavir in hospitalized patients with moderate‐to‐severe COVID‐19: Emulation of a randomized target trial

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