Real-world effectiveness of azvudine versus nirmatrelvir-ritonavir in hospitalized patients with COVID-19 and pre-existing diabetes

Summary: Azvudine and nirmatrelvir-ritonavir are prioritized treatments for SARS-CoV-2 infection in China, but their effectiveness and safety in hospitalized patients with COVID-19 and pre-existing diabetes remains unknown. In this retrospective cohort study, we collected 32,864 hospitalized COVID-1...

Full description

Saved in:
Bibliographic Details
Main Authors: Guanyue Su, Silin Li, Donghua Zhang, Yongjian Zhou, Ling Wang, Yiqiang Yuan, Guowu Qian, Guotao Li, Na Han, Ming Cheng, Guangming Li, Shixi Zhang, Hong Luo, Mengzhao Yang, Yanyang Zhang, Zhan Song, Jiyuan Xing, Zujiang Yu, Zhigang Ren
Format: Article
Language:English
Published: Elsevier 2025-02-01
Series:iScience
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2589004225001671
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Summary: Azvudine and nirmatrelvir-ritonavir are prioritized treatments for SARS-CoV-2 infection in China, but their effectiveness and safety in hospitalized patients with COVID-19 and pre-existing diabetes remains unknown. In this retrospective cohort study, we collected 32,864 hospitalized COVID-19 patients from nine hospitals, among which 636 azvudine recipients and 318 nirmatrelvir-ritonavir recipients were enrolled for final analysis after exclusion and propensity score matching. Kaplan-Meier and multivariate Cox regression analysis results showed that azvudine had a lower risk of all-cause death compared with nirmatrelvir-ritonavir for the treatment of patients with COVID-19 and pre-existing diabetes (log rank: p = 0.044; HR: 0.63; 95% CI: 0.431–0.934). No significant difference was found in composite disease progression between the two groups. Five sensitivity analyses verified the robustness of the results. Overall, azvudine may be comparable to nirmatrelvir-ritonavir in terms of both all-cause death and composite disease progression among hospitalized patients with COVID-19 and pre-existing diabetes, with acceptable adverse events.
ISSN:2589-0042