Pfizer’s Paxlovid Reduces Risk of Post-Acute Death and Sequelae Among Hospitalised COVID-19 patients

This is a pretty good result. Anecdotally, I have heard good reports of Paxlovid

The Chinese University of Hong Kong (CUHK)’s Faculty of Medicine (CU Medicine) conducted a retrospective investigation using real-world data to examine the association of Paxlovid (also known as nirmatrelvir-ritonavir) with post-acute sequelae in hospitalised COVID-19 patients, as well as mortality.

The results showed that the risk of post-acute inpatient death (i.e. death occurring 21 days after a positive test result) in COVID-19 patients who were hospitalized and prescribed oral Paxlovid within five days after symptom onset was significantly reduced by 38% compared to those who were hospitalised and didn’t use the drug during the acute phase.

Similar effects were observed on the post-acute sequelae of cardiovascular and respiratory complications. Study results have been published in the journal The Lancet Infectious Diseases.

Importantly, while some compelling data is generated, this study was not a randomized controlled study and several limitations in the study suggest results should be interpreted with caution.

According to the CUHK team, a review of the literature suggested that the prevalence of post-COVID-19 conditions among individuals infected with SARS-CoV-2 may range from 10% to 30%. Despite authorized use of Paxlovid for treating COVID-19 in late 2021, few investigations have evaluated the association of the drug with post-acute sequelae and mortality, especially in hospitalized patients.

The Study

The current study used the real-world COVID-19 surveillance data obtained from Hong Kong Hospital Authority and Department of Health. The research team analyzed more than 50,000 hospitalized COVID-19 patients records aged 18 and over in Hong Kong between March 2022, and October 2023. Of this large group, approximately 15,000 were prescribed Paxlovid within five days of symptom onset, while those who did not take the oral drug during the acute phase were grouped as the control.

Findings

The outcomes point to the conclusion that the risk of post-acute death of hospitalized COVID-19 patients who were prescribed oral Paxlovid was 6.9%, considerably lower than the 13.5% risk of those hospitalised who did not use the drug.

This represents a 38% rate after adjusting for their demographics, clinical background, and vaccination status. Similar effects were observed on the post-acute sequelae of cardiovascular and respiratory complications.

Professor Marc Chong Ka-chun, a corresponding author of the research paper and Assistant Professor at The Jockey Club School of Public Health and Primary Care of CU Medicine, said, “Public health agencies should adequately prepare effective antivirals to manage both acute and post-acute conditions of COVID-19, particularly considering the ongoing emergence of new variants of concern of the SARS-CoV-2 virus.”

Professor Yeoh Eng-kiong, also a corresponding author of the research paper and Director at the Centre for Health Systems and Policy Research at CU Medicine’s The Jockey Club School of Public Health and Primary Care, stated, “To our knowledge, our study is the first to highlight the extended benefits of Paxlovid in patients admitted to hospital with COVID-19. This study showcases the long-term benefits of the antiviral serving as a valuable complement to COVID-19 vaccines in mitigating the global clinical burden of COVID-19 in the years ahead.”

The research team member included Ms Wang Hu-wen, a doctoral student from The Jockey Club School of Public Health and Primary Care at CU Medicine. Ms Wang was one of the awardees of the Research Grants Council’s Hong Kong PhD Fellowship Scheme 2021/22 and is the first author of the published paper.

Limitations

Numerous limitations are cited by the authors, which means that these results should be understood with caution. TrialSite summarizes key limitations which raise concern about generalization to broader populations:

The grouping of cohorts (nirmatrelvir–ritonavir group vscontrol group) relied on prescription records, which might not guarantee actual usage and could potentially lead to misgrouping.

The Hong Kong-based investigators focused on a predefined set of 13 sequelae previously identified to have an elevated risk among hospitalized patients with COVID-19 in Hong Kong. The study focused on sequelae that are typically recorded in a standardized manner using ICD codes within the electronic health system.

Here the authors focused specifically on nirmatrelvir–ritonavir rather than assessing multiple targeted antivirals for COVID-19, particularly another widely used antiviral drug, molnupiravir.

In the study, the post-acute period as starting at 21 days after the positive PCR date, following a previous local study. The authors acknowledge that other studies might use different durations, such as 28 days for post-acute or 3 months for post-COVID-19 condition, which might affect direct comparability of results.

The participants included in this study were primarily infected with omicron sublineages BA.2 and BA.5. Although the dominant sublineages in Hong Kong became XBB after April 20, 2023, case-based surveillance of COVID-19 was discontinued from Jan 30, 2023, onwards. As a result, the proportion of patients infected with XBB was relatively small compared with BA.2 and BA.5. The authors suggest caution is advised when generalizing the current findings to other variants and sublineages.

With insufficient number of events, especially in subgroup analyses, this could introduce sparse data bias.

With data availability limitations, some unmeasured confounders, such as clinical characteristics recorded during hospitalization (e.g., dyspnoea and fever), were not included in the analysis.

https://www.trialsitenews.com/a/cuhk-investigation-pfizers-paxlovid-reduces-risk-of-post-acute-death-and-sequelae-among-hospitalised-covid-19-patients-1e4c86c7

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http://edwatch.blogspot.com (EDUCATION WATCH)

http://antigreen.blogspot.com (GREENIE WATCH)

http://pcwatch.blogspot.com (POLITICAL CORRECTNESS WATCH)

http://australian-politics.blogspot.com (AUSTRALIAN POLITICS)

http://snorphty.blogspot.com (TONGUE-TIED)

https://immigwatch.blogspot.com (IMMIGRATION WATCH)

https://awesternheart.blogspot.com (THE PSYCHOLOGIST)

http://jonjayray.com/blogall.html More blogs

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