Association of Treatment With Nirmatrelvir and the Risk of Post–COVID-19 Condition
Nirmatrelvir is one component of Pfizer's Paxlovid antiviral. The differences observed below were weak but pervasive, suggesting some usefulness in preventing long Covid
Yan Xie et al
Key Points
Question Is treatment with nirmatrelvir in the acute phase of SARS-CoV-2 infection associated with a lower risk of post–COVID-19 condition (PCC)?
Findings In this cohort study of 281 793 people with SARS-CoV-2 infection who had at least 1 risk factor for progression to severe COVID-19 illness, compared with 246 076 who had no treatment, nirmatrelvir use in the acute phase (n = 35 717) was associated with reduced risk of PCC, including reduced risk of 10 of 13 post–acute sequelae in various organ systems, as well as reduced risk of post–acute death and post–acute hospitalization. Nirmatrelvir was associated with reduced risk of PCC in people who were unvaccinated, vaccinated, and boosted, and in people with primary SARS-CoV-2 infection and reinfection.
Meaning In people with SARS-CoV-2 infection and at least 1 risk factor for progression to severe COVID-19 illness, treatment with nirmatrelvir during the acute phase of COVID-19 was associated with reduced risk of PCC.
Abstract
Importance Post–COVID-19 condition (PCC), also known as long COVID, affects many individuals. Prevention of PCC is an urgent public health priority.
Objective To examine whether treatment with nirmatrelvir in the acute phase of COVID-19 is associated with reduced risk of PCC.
Design, Setting, and Participants This cohort study used the health care databases of the US Department of Veterans Affairs (VA) to identify patients who had a SARS-CoV-2 positive test result between January 3, 2022, and December 31, 2022, who were not hospitalized on the day of the positive test result, who had at least 1 risk factor for progression to severe COVID-19 illness, and who had survived the first 30 days after SARS-CoV-2 diagnosis. Those who were treated with oral nirmatrelvir within 5 days after the positive test (n = 35 717) and those who received no COVID-19 antiviral or antibody treatment during the acute phase of SARS-CoV-2 infection (control group, n = 246 076) were identified.
Exposures Treatment with nirmatrelvir or receipt of no COVID-19 antiviral or antibody treatment based on prescription records.
Main Outcomes and Measures Inverse probability weighted survival models were used to estimate the association of nirmatrelvir (vs control) with post–acute death, post–acute hospitalization, and a prespecified panel of 13 post–acute COVID-19 sequelae (components of PCC) and reported in relative scale as relative risk (RR) or hazard ratio (HR) and in absolute scale as absolute risk reduction in percentage at 180 days (ARR).
Results A total of 281 793 patients (mean [SD] age, 61.99 [14.96]; 242 383 [86.01%] male) who had a positive SARS-CoV-2 test result and had at least 1 risk factor for progression to severe COVID-19 illness were studied. Among them, 246 076 received no COVID-19 antiviral or antibody treatment during the acute phase of SARS-CoV-2 infection, and 35 717 received oral nirmatrelvir within 5 days after the positive SARS-CoV-2 test result. Compared with the control group, nirmatrelvir was associated with reduced risk of PCC (RR, 0.74; 95% CI, 0.72-0.77; ARR, 4.51%; 95% CI, 4.01-4.99), including reduced risk of 10 of 13 post–acute sequelae (components of PCC) in the cardiovascular system (dysrhythmia and ischemic heart disease), coagulation and hematologic disorders (pulmonary embolism and deep vein thrombosis), fatigue and malaise, acute kidney disease, muscle pain, neurologic system (neurocognitive impairment and dysautonomia), and shortness of breath. Nirmatrelvir was also associated with reduced risk of post–acute death (HR, 0.53; 95% CI, 0.46-0.61); ARR, 0.65%; 95% CI, 0.54-0.77), and post–acute hospitalization (HR, 0.76; 95% CI, 0.73-0.80; ARR, 1.72%; 95% CI, 1.42-2.01). Nirmatrelvir was associated with reduced risk of PCC in people who were unvaccinated, vaccinated, and boosted, and in people with primary SARS-CoV-2 infection and reinfection.
Conclusions and Relevance This cohort study found that in people with SARS-CoV-2 infection who had at least 1 risk factor for progression to severe disease, treatment with nirmatrelvir within 5 days of a positive SARS-CoV-2 test result was associated with reduced risk of PCC across the risk spectrum in this cohort and regardless of vaccination status and history of prior infection; the totality of findings suggests that treatment with nirmatrelvir during the acute phase of COVID-19 may reduce the risk of post–acute adverse health outcomes.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2802878
**********************************************Authors Conclude "Relatively Safe" as Dozens of Children Die After COVID-19 Vaccination
Peter A. McCullough
As an author and editor, I have always lived by a principle of medical publication that the conclusions must be supported by the data presented. Many have asked me why to do doctors still support COVID-19 vaccination with all safety data systems reporting record mortality after injection? Many cases occur on the same day or in the next few days after administration. The reason may be what doctors are concluding from the data in peer-reviewed manuscripts that does not match the information disclosed.
Villa-Zapata and coworkers published a report from VAERS on “safety” of COVID-19 vaccination in children aged 5 to 17, and in the data table there are 56 deaths! Also listed are other potentially fatal complications such as anaphylaxis and myocarditis. The authors concluded that COVID-19 vaccination in children is “relatively safe.”
Any person reading this report should be shocked and appalled with news of 56 children and adolescents losing their lives after COVID-19 vaccination.
The vast majority of reports to VAERS are made by doctors and healthcare providers who believe the vaccine was the cause of the problem reported. The CDC generates a temporary number followed by a permanent VAERS number when the event is confirmed (e.g., fatal events confirmed by death certificate or national death index). VAERS cases represent the tip of the iceberg and grossly under-represent reality. This means the number of childhood deaths could be 30-fold greater—or 1680 for 2021.
In summary, the COVID-19 pandemic has taught clinical scholars to ignore the written conclusions by the authors who may have conflicts of interest. They may have taken COVID-19 vaccines themselves and cannot psychologically recognize what is happening with catastrophic safety outcomes in populations studied.
The data must be evaluated independently and it is up to the reader to draw his or her own inferences. My conclusion is that COVID-19 vaccines are unsafe for human use and one child lost after injection is one too many. They must be pulled off the market.
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Arthritis after COVID-19 Vaccination
Good response to steroids
Peter A. McCullough
Approximately a third of COVID-19 vaccine recipients develop transient fever. It is important to recognize that a constellation of symptoms in addition to fever should prompt recognition of Still’s Disease. Adult-onset Still’s disease, also known as systemic onset juvenile idiopathic arthritis, is a systemic inflammatory disorder characterized by inflammatory polyarthritis, daily fever and a transient salmon-pink maculopapular rash. A serum ferritin level of more than 1000 ng/ml is common in this condition.
Sharabi and colleagues described two cases of adult-onset Still’s disease after the Pfizer mRNA COVID-19 vaccine. Both cases were serious, involved myopericarditis, required hospitalization and treatment with pulsed corticosteroids.
The major points for patients and doctors to pay attention to are fever and associated symptoms after mRNA vaccination. There are vaccine injury syndromes that are steroid-responsive, and complicated courses including hospitalization can potentially be avoided.
Sharabi A, Shiber S, Molad Y. Adult-onset Still's disease following mRNA COVID-19 vaccination. Clin Immunol. 2021 Dec;233:108878. doi: 10.1016/j.clim.2021.108878. Epub 2021 Nov 9. PMID: 34763089; PMCID: PMC8575550.
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Biden Signs Measure Ending COVID-19 National Emergency
President Joe Biden on April 10 signed a measure that ends the COVID-19 national emergency more than three years after it was enacted, the White House announced.
HJ Res 7 passed through the Senate on March 29 by a 68-23 margin, with 21 Democrats joining 47 Republicans to support the measure.
Four Republicans and five Democrats did not cast a vote—and 23 Democrats voted against the short resolution—which was introduced by Rep. Paul Gosar (R-Ariz.) last month and passed by the House 229-197 on Feb. 1.
Eleven Democrats voted against the House measure.
The legislation included a simple one-line description declaring that the pandemic national emergency “is hereby terminated.”
Before the Senate vote on the resolution. Sen. Roger Marshall (R-Kansas) encouraged his fellow legislators to “end this chapter and let Americans get back to their own lives.”
“I ask my colleagues to join me again in a strong bipartisan fashion in sending this resolution to the president’s desk to end the national emergency declaration for COVID-19 once and for all today,” Marshall said.
President Donald Trump enacted the COVID national emergency on March 13, 2020, after establishing the COVID public health emergency on Jan. 31, 2020.
Originally, the White House planned to end both emergencies on May 11.
In a 60 Minutes interview last September Biden said, “the pandemic is over.”
“We still have a problem with COVID. We’re still doing a lot of work on it. But the pandemic is over,” Biden said.
“If you notice, no one’s wearing masks. Everybody seems to be in pretty good shape. And so I think it’s changing.”
The Biden administration wrote a letter to Congress on Jan. 30 highlighting the reasoning behind the decision to end the COVID national emergency and public health emergency on May 11.
“At present, the administration’s plan is to extend the emergency declarations to May 11, and then end both emergencies on that date.
“This wind down would align with the administration’s previous commitments to give at least 60 days’ notice prior to termination of the PHE,” the letter read.
“To be clear, [the] continuation of these emergency declarations until May 11 does not impose any restriction at all on individual conduct with regard to COVID-19,” the letter continued.
“They do not impose mask mandates or vaccine mandates. They do not restrict school or business operations. They do not require the use of any medicines or tests in response to cases of COVID-19.”
https://www.theepochtimes.com/biden-signs-measure-ending-covid-19-national-emergency_5185150.html
****************************************************Also see my other blogs. Main ones below:
http://edwatch.blogspot.com (EDUCATION WATCH)
http://antigreen.blogspot.com (GREENIE WATCH)
http://pcwatch.blogspot.com (POLITICAL CORRECTNESS WATCH) Also here
http://australian-politics.blogspot.com (AUSTRALIAN POLITICS)
http://snorphty.blogspot.com (TONGUE-TIED)
https://immigwatch.blogspot.com (IMMIGRATION WATCH) Also here
https://awesternheart.blogspot.com (THE PSYCHOLOGIST)
http://jonjayray.com/blogall.html More blogs
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