2023
DOI: 10.1016/j.lanwpc.2023.100694
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Efficacy and safety of Paxlovid in severe adult patients with SARS-Cov-2 infection: a multicenter randomized controlled study

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Cited by 61 publications
(65 citation statements)
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“…Hence, we think it would be useful to conduct and improve randomized trials involving vaccinated patients infected by Omicron variant [35]. This is of particular relevance since a newly published multicenter randomized controlled study that aimed at evaluating the efficacy and safety of Paxlovid in hospitalized adult patients with Omicron variant infection showed no significant reduction in the risk of all-cause mortality on day 28 and the duration of SARS-CoV-2 RNA clearance in hospitalized adult COVID-19 patients with severe comorbidities, in discordance with the results obtained previously [36]. Paxlovid consists of two active principles: nirmatrelvir, which is an inhibitor of the SARS-CoV-2 3-chymotrypsin-like cysteine protease enzyme, and ritonavir, a protease inhibitor.…”
Section: Discussionsupporting
confidence: 49%
“…Hence, we think it would be useful to conduct and improve randomized trials involving vaccinated patients infected by Omicron variant [35]. This is of particular relevance since a newly published multicenter randomized controlled study that aimed at evaluating the efficacy and safety of Paxlovid in hospitalized adult patients with Omicron variant infection showed no significant reduction in the risk of all-cause mortality on day 28 and the duration of SARS-CoV-2 RNA clearance in hospitalized adult COVID-19 patients with severe comorbidities, in discordance with the results obtained previously [36]. Paxlovid consists of two active principles: nirmatrelvir, which is an inhibitor of the SARS-CoV-2 3-chymotrypsin-like cysteine protease enzyme, and ritonavir, a protease inhibitor.…”
Section: Discussionsupporting
confidence: 49%
“… 15 Interestingly, we found that Azvudine had a stronger protective effect on severe patients with COVID-19 who were not recommended for the use of Paxlovid and molnupiravir. 20 , 21 A previous single arm clinical trial reported that all patients with severe COVID-19 were recovered after oral Azvudine. 13 Azvudine could concentrate in the thymus with its active form after oral administration, effectively inhibit the replication of SARS-CoV-2 in vivo, and protect the immune function of the thymus.…”
Section: Discussionmentioning
confidence: 99%
“…This contrasts with severe cases, where the primary cause of illness is an inflammatory response (4143). Furthermore, a randomized clinical trial conducted by Liu et al in 2023, which evaluated the efficacy of nirmatrelvir-ritonavir in adult patients hospitalized with SARS-Cov-2 (Omicron BA.2.2 variant) infection and severe comorbidities, did not show any additional benefits in terms of all-cause mortality up to day 28 when compared to standard treatment (39).…”
Section: Discussionmentioning
confidence: 99%
“…Moreover, the Omicron variant of COVID-19 has been demonstrated to have lower rates of hospitalization and mortality compared to previous variants. These factors can affect the effect of treatment with Nirmatrelvir-ritonavir (38,39). Additionally, the efficacy of nirmatrelvir-ritonavir use within the context of the availability of bivalent COVID-19 vaccines requires further consideration and evaluation.…”
Section: Discussionmentioning
confidence: 99%