PMID- 37322616
OWN - NLM
STAT- MEDLINE
DCOM- 20230619
LR  - 20231122
IS  - 1096-9071 (Electronic)
IS  - 0146-6615 (Linking)
VI  - 95
IP  - 6
DP  - 2023 Jun
TI  - Clinical effectiveness of oral antiviral agents in older patients with COVID-19 
      based on real-world data.
PG  - e28869
LID - 10.1002/jmv.28869 [doi]
AB  - Several randomized controlled trials and real-world cohort studies have 
      demonstrated the efficacies of nirmatrelvir plus ritonavir (NMV-r) and 
      molnupiravir (MOV) in at-risk patients with COVID-19; however, the effectiveness 
      of antisevere acute respiratory syndrome-coronavirus 2 treatments on older 
      patients (>/=65 years) remains unclear. This retrospective cohort study aimed to 
      assess the clinical effectiveness of the oral antiviral agents, MOV and NMV-r, in 
      older patients (>/=65 years) infected with severe acute respiratory 
      syndrome-coronavirus 2. Nonhospitalized older patients with COVID-19 between 
      January 1, 2022, and December 31, 2022, were recruited from the TriNetX Research 
      Network. Propensity score matching (PSM) was used to match patients who received 
      either NMV-r or MOV treatment with those who did not receive any oral antiviral 
      agents. Hazard ratios (HRs) for composite all-cause hospitalization or death 
      during the 30-day follow-up period were calculated. PSM revealed two cohorts with 
      28 824 patients each having balanced baseline characteristics. The antiviral 
      group was associated with significantly lower risk of the primary composite 
      outcome of all-cause hospitalization or death than the control group (241 vs. 
      801; HR, 0.307; 95% confidence interval (CI), 0.27-0.36) during the follow-up 
      period. For the secondary outcome, the antiviral group had a significantly lower 
      risk of all-cause hospitalization (288 vs. 725; HR, 0.322; 95% CI, 0.28-0.37) and 
      mortality (16 vs. 94; HR, 0.176; 95% CI, 0.10-0.30) than the control group. 
      Moreover, the reduced risk of all-cause hospitalization or death remained 
      consistent in patients receiving NMV-r (HR, 0.279; 95% CI, 0.24-0.33) and MOV 
      (HR, 0.279; 95% CI, 0.21-0.38). Our results revealed that NMV-r and MOV decreased 
      the all-cause hospitalization and death rates among older patients with COVID-19, 
      supporting the use of antivirals in this vulnerable population.
CI  - (c) 2023 Wiley Periodicals LLC.
FAU - Tsai, Ya-Wen
AU  - Tsai YW
AUID- ORCID: 0000-0003-4630-3923
AD  - Center for Integrative Medicine, Chi Mei Medical Center, Tainan City, Taiwan.
AD  - Department of Medical Laboratory Sciences and Biotechnology, Fooyin University, 
      Kaohsiung, Taiwan.
AD  - Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, 
      Taiwan.
FAU - Wu, Jheng-Yan
AU  - Wu JY
AUID- ORCID: 0000-0002-3290-1909
AD  - Department of Nutrition, Chi Mei Medical Center, Tainan, Taiwan.
AD  - Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical 
      University, Kaohsiung, Taiwan.
FAU - Liu, Ting-Hui
AU  - Liu TH
AD  - Department of Psychiatry, Chi Mei Medical Center, Tainan, Taiwan.
FAU - Chuang, Min-Hsiang
AU  - Chuang MH
AD  - Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
FAU - Hsu, Wan-Hsuan
AU  - Hsu WH
AD  - Department of General Medicine, Chi Mei Medical Center, Tainan, Taiwan.
FAU - Huang, Po-Yu
AU  - Huang PY
AUID- ORCID: 0000-0002-8682-1322
AD  - Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
FAU - Lai, Chih-Cheng
AU  - Lai CC
AD  - Division of Hospital Medicine, Department of Internal Medicine, Chi Mei Medical 
      Center, Tainan, Taiwan.
AD  - School of Medicine, College of Medicine, National Sun Yat-sen University, 
      Kaohsiung, Taiwan.
FAU - Tsai, Kang-Ting
AU  - Tsai KT
AD  - Division of Geriatrics and Gerontology, Department of Internal Medicine, Chi Mei 
      Medical Center, Tainan, Taiwan.
AD  - Department of Senior Welfare and Services, Southern Taiwan University of Science 
      and Technology, Tainan, Taiwan.
FAU - Shiue, Yow-Ling
AU  - Shiue YL
AD  - Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, 
      Taiwan.
AD  - Institute of Precision Medicine, National Sun-Yat-Sen University, Kaohsiung, 
      Taiwan.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Med Virol
JT  - Journal of medical virology
JID - 7705876
RN  - YA84KI1VEW (molnupiravir)
RN  - 0 (Antiviral Agents)
RN  - O3J8G9O825 (Ritonavir)
SB  - IM
CIN - J Med Virol. 2023 Sep;95(9):e29086. PMID: 37695099
CIN - J Med Virol. 2023 Sep;95(9):e29085. PMID: 37721355
MH  - Humans
MH  - Aged
MH  - *COVID-19
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - SARS-CoV-2
MH  - Antiviral Agents/therapeutic use
MH  - Ritonavir/therapeutic use
OTO - NOTNLM
OT  - COVID-19
OT  - molnupiravir
OT  - nirmatrelvir and ritonavir
EDAT- 2023/06/16 06:42
MHDA- 2023/06/19 13:08
CRDT- 2023/06/16 00:23
PHST- 2023/05/08 00:00 [revised]
PHST- 2023/03/27 00:00 [received]
PHST- 2023/06/02 00:00 [accepted]
PHST- 2023/06/19 13:08 [medline]
PHST- 2023/06/16 06:42 [pubmed]
PHST- 2023/06/16 00:23 [entrez]
AID - 10.1002/jmv.28869 [doi]
PST - ppublish
SO  - J Med Virol. 2023 Jun;95(6):e28869. doi: 10.1002/jmv.28869.