{"id":23364,"date":"2023-01-17T04:45:00","date_gmt":"2023-01-16T20:45:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=23364"},"modified":"2023-01-17T06:04:06","modified_gmt":"2023-01-16T22:04:06","slug":"ann-intern-med%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e5%a5%88%e7%8e%9b%e7%89%b9%e9%9f%a6%e4%b8%8e%e5%88%a9%e6%89%98%e9%82%a3%e9%9f%a6%e6%b2%bb%e7%96%97%e6%97%a9%e6%9c%9f%e6%96%b0%e5%86%a0","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=23364","title":{"rendered":"[Ann Intern Med\u53d1\u8868\u8bba\u6587]\uff1a\u5948\u739b\u7279\u97e6\u4e0e\u5229\u6258\u90a3\u97e6\u6cbb\u7597\u65e9\u671f\u65b0\u51a0\u75c5\u6bd2\u611f\u67d3"},"content":{"rendered":"\n

Original Research13 December 2022<\/p>\n\n\n\n

Nirmatrelvir Plus Ritonavir for Early COVID-19 in a Large U.S. Health System: A Population-Based Cohort Study<\/h1>\n\n\n\n

Scott Dryden-Peterson, Andy Kim, Arthur Y. Kim, et al<\/h3>\n\n\n\n

Ann Intern Med https:\/\/doi.org\/10.7326\/M22-2141<\/a><\/h3>\n\n\n\n

Abstract<\/h2>\n\n\n\n

Background:<\/h5>\n\n\n\n

In the EPIC-HR (Evaluation of Protease Inhibition for Covid-19 in High-Risk Patients) trial, nirmatrelvir plus ritonavir led to an 89% reduction in hospitalization or death among unvaccinated outpatients with early COVID-19. The clinical impact of nirmatrelvir plus ritonavir among vaccinated populations is uncertain.<\/p>\n\n\n\n

Objective:<\/h5>\n\n\n\n

To assess whether nirmatrelvir plus ritonavir reduces risk for hospitalization or death among outpatients with early COVID-19 in the setting of prevalent SARS-CoV-2 immunity and immune-evasive SARS-CoV-2 lineages.<\/p>\n\n\n\n

Design:<\/h5>\n\n\n\n

Population-based cohort study analyzed to emulate a clinical trial using inverse probability\u2013weighted models to account for anticipated bias in treatment.<\/p>\n\n\n\n

Setting:<\/h5>\n\n\n\n

A large health care system providing care for 1.5 million patients in Massachusetts and New Hampshire during the Omicron wave (1 January to 17 July 2022).<\/p>\n\n\n\n

Patients:<\/h5>\n\n\n\n

44 551 nonhospitalized adults (90.3% with \u22653 vaccine doses) aged 50 years or older with COVID-19 and no contraindications for nirmatrelvir plus ritonavir.<\/p>\n\n\n\n

Measurements:<\/h5>\n\n\n\n

The primary outcome was a composite of hospitalization within 14 days or death within 28 days of a COVID-19 diagnosis.<\/p>\n\n\n\n

Results:<\/h5>\n\n\n\n

During the study period, 12 541 (28.1%) patients were prescribed nirmatrelvir plus ritonavir, and 32 010 (71.9%) were not. Patients prescribed nirmatrelvir plus ritonavir were more likely to be older, have more comorbidities, and be vaccinated. The composite outcome of hospitalization or death occurred in 69 (0.55%) patients who were prescribed nirmatrelvir plus ritonavir and 310 (0.97%) who were not (adjusted risk ratio, 0.56 [95% CI, 0.42 to 0.75]). Recipients of nirmatrelvir plus ritonavir had lower risk for hospitalization (adjusted risk ratio, 0.60 [CI, 0.44 to 0.81]) and death (adjusted risk ratio, 0.29 [CI, 0.12 to 0.71]).<\/p>\n\n\n\n

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Limitation:<\/h5>\n\n\n\n

Potential residual confounding due to differential access to COVID-19 vaccines, diagnostic tests, and treatment.<\/p>\n\n\n\n

Conclusion:<\/h5>\n\n\n\n

The overall risk for hospitalization or death was already low (1%) after an outpatient diagnosis of COVID-19, but nirmatrelvir plus ritonavir reduced this risk further.<\/p>\n\n\n\n

Primary Funding Source:<\/h5>\n\n\n\n

National Institutes of Health.<\/p>\n","protected":false},"excerpt":{"rendered":"

Original Research13 December 2022 Nirmatrelvir Plus Rit […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/23364"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=23364"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/23364\/revisions"}],"predecessor-version":[{"id":23366,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/23364\/revisions\/23366"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=23364"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=23364"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=23364"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}