Author:
Rinaldi Matteo,Campoli Caterina,Gallo Mena,Marzolla Domenico,Zuppiroli Alberto,Riccardi Riccardo,Casarini Martina,Riccucci Daniele,Malosso Marta,Bonazzetti Cecilia,Pascale Renato,Tazza Beatrice,Pasquini Zeno,Marconi Lorenzo,Curti Stefania,Giannella Maddalena,Viale Pierluigi
Abstract
AbstractPurposeTo investigate the clinical impact of three available antivirals for early COVID-19 treatment in a large real-life cohort.MethodsBetween January and October 2022 all outpatients tested positive for SARS-CoV-2 referring to IRCCS S. Orsola hospital treated with an early antiviral therapy were enrolled. A comparison between patients treated with nirmatrelvir/ritonavir (NTV/r), molnupiravir (MPV) and remdesivir (RDV) was conducted in term of indications and outcome. To account for differences between treatment groups a propensity score analysis was performed. After estimating the weights, we fitted a survey-weighted Cox regression model with inverse-probability weighting with hospital admission/death versus clinical recovery as the primary outcome.ResultsOverall 1342 patients were enrolled, 775 (57.8%), 360 (26.8%) and 207 (15.4%) in MPV, NTV/r and RDV group, respectively. Median age was 73 (59–82) years, male sex was 53.4%. Primary indication was immunosuppression (438, 32.6%), the median time from symptom onset to drug administration was 3 [2–4] days. Overall, clinical recovery was reached in 96.9% of patients, with hospital admission rate of 2.6%. No significant differences were found in clinical recovery nor hospitalization. Cox regression showed a decreased probability of hospital admission/ death among prior vaccinated patients compared with unvaccinated (HR 0.31 [95%CI 0.14–0.70], p = 0.005]). No difference in hospitalization rates in early treatment compared to late treatment were found.ConclusionsNo differences among MPV, NTV/r and RDV in terms of clinical recovery or hospitalization were found. Patients not vaccinated had a significant increased risk of hospitalization.
Publisher
Springer Science and Business Media LLC