PMID- 37436873
OWN - NLM
STAT- MEDLINE
DCOM- 20230714
LR  - 20230718
IS  - 1096-9071 (Electronic)
IS  - 0146-6615 (Linking)
VI  - 95
IP  - 7
DP  - 2023 Jul
TI  - The effect of nirmatrelvir-ritonavir on the long-term risk of neuropsychiatric 
      sequelae following COVID-19.
PG  - e28951
LID - 10.1002/jmv.28951 [doi]
AB  - The retrospective cohort was conducted to assess the effect of 
      nirmatrelvir-ritonavir (NMV-r) on the long-term risk of neuropsychiatric sequela 
      following COVID-19. TriNetX research network was used to identify nonhospitalized 
      adult patients who tested positive for severe acute respiratory syndrome 
      coronavirus 2 infection or were diagnosed with COVID-19 between March 1, 2020 and 
      July 1, 2022. Further propensity score matching method was used to create two 
      matched cohorts with and without receiving NMV-r. The primary outcome was the 
      incidence of neuropsychiatric sequela within a 90-day to 1-year period following 
      a diagnosis of COVID-19. After screening 119 494 527 electronic health records, 
      two matched cohorts of each 27 194 patients were identified. During the follow-up 
      period, the NMV-r group demonstrated a reduced risk of any neuropsychiatric 
      sequelae compared to the control group (odds ratio [OR], 0.634; 95% confidence 
      interval [CI], 0.604-0.667). In comparison with the control group, the patient 
      treated with NMV-r exhibited a markedly diminished risk of developing 
      neurocognitive sequela (OR, 0.377; 95% CI, 0.325-0.439) and psychiatric sequela 
      (OR, 0.629; 95% CI, 0.593-0.666). In addition, patients treated with NMV-r had a 
      significantly reduced risk of developing dementia (OR, 0.365; 95% CI, 
      0.255-0.522), depression (OR, 0.555; 95% CI, 0.503-0.612), insomnia (OR, 0.582; 
      95% CI, 0.508-0.668) and anxiety disorder (OR, 0.645 95% CI, 0.600-0.692). 
      Moreover, the beneficial effect of NMV-r on the neuropsychiatric sequelae was 
      observed across further subgroup analyses. Among nonhospitalized COVID-19 
      patients, who at risk of disease progression, the use of NMV-r is associated with 
      a reduction in the long-term risk of neuropsychiatric sequela, including 
      dementia, depression, insomnia and anxiety disorder. It may be necessary to 
      re-evaluate the use of NMV-r, as a preventive measure to reduce the risk of 
      severe acute disease and post-acute adverse mental health outcomes.
CI  - (c) 2023 Wiley Periodicals LLC.
FAU - Liu, Ting-Hui
AU  - Liu TH
AD  - Department of Psychiatry, Chi Mei Medical Center, Tainan, Taiwan.
FAU - Wu, Jheng-Yan
AU  - Wu JY
AUID- ORCID: 0000-0002-3290-1909
AD  - Department of Nutrition, 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 - Tsai, Ya-Wen
AU  - Tsai YW
AUID- ORCID: 0000-0003-4630-3923
AD  - Center of Integrative Medicine, Chi Mei Medical Center, Tainan, Taiwan.
FAU - Lai, Chih-Cheng
AU  - Lai CC
AUID- ORCID: 0000-0002-6334-2388
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.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Med Virol
JT  - Journal of medical virology
JID - 7705876
RN  - 7R9A5P7H32 (nirmatrelvir)
RN  - O3J8G9O825 (Ritonavir)
RN  - 0 (Antiviral Agents)
SB  - IM
MH  - Adult
MH  - Humans
MH  - *COVID-19/complications
MH  - COVID-19 Drug Treatment
MH  - Retrospective Studies
MH  - Ritonavir/adverse effects
MH  - *Sleep Initiation and Maintenance Disorders
MH  - Disease Progression
MH  - *Dementia
MH  - Antiviral Agents/therapeutic use
OTO - NOTNLM
OT  - COVID-19
OT  - SARS-CoV-2
OT  - neurologic
OT  - nirmatrelvir-ritonavir
OT  - psychiatric
EDAT- 2023/07/12 19:07
MHDA- 2023/07/14 13:07
CRDT- 2023/07/12 12:33
PHST- 2023/05/12 00:00 [revised]
PHST- 2023/01/17 00:00 [received]
PHST- 2023/06/30 00:00 [accepted]
PHST- 2023/07/14 13:07 [medline]
PHST- 2023/07/12 19:07 [pubmed]
PHST- 2023/07/12 12:33 [entrez]
AID - 10.1002/jmv.28951 [doi]
PST - ppublish
SO  - J Med Virol. 2023 Jul;95(7):e28951. doi: 10.1002/jmv.28951.