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...
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| Language: | English |
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Elsevier
2025-02-01
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| Series: | iScience |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589004225001671 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Guanyue Su |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-060ad06f653e4e029f124a06300366e1 |
| institution | Kabale University |
| issn | 2589-0042 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | iScience |
| spelling | doaj-art-060ad06f653e4e029f124a06300366e12025-02-08T05:00:54ZengElsevieriScience2589-00422025-02-01282111907Real-world effectiveness of azvudine versus nirmatrelvir-ritonavir in hospitalized patients with COVID-19 and pre-existing diabetesGuanyue Su0Silin Li1Donghua Zhang2Yongjian Zhou3Ling Wang4Yiqiang Yuan5Guowu Qian6Guotao Li7Na Han8Ming Cheng9Guangming Li10Shixi Zhang11Hong Luo12Mengzhao Yang13Yanyang Zhang14Zhan Song15Jiyuan Xing16Zujiang Yu17Zhigang Ren18Department of Infectious Diseases, State Key Laboratory of Antiviral Drugs, Pingyuan Laboratory, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, ChinaDepartment of Respiratory and Critical Care Medicine, Fengqiu County People’s Hospital, Xinxiang 453300, ChinaDepartment of Infectious Diseases, Anyang City Fifth People’s Hospital, Anyang 455000, ChinaDepartment of Infectious Diseases, State Key Laboratory of Antiviral Drugs, Pingyuan Laboratory, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, ChinaDepartment of Cardiovascular Medicine, Henan Provincial Chest Hospital Affiliated to Zhengzhou University, Zhengzhou 450008, ChinaDepartment of Cardiovascular Medicine, Henan Provincial Chest Hospital Affiliated to Zhengzhou University, Zhengzhou 450008, ChinaDepartment of Gastrointestinal Surgery, Nanyang Central Hospital, Nanyang 473009, ChinaDepartment of Infectious Diseases, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang 471000, ChinaDepartment of Infectious Diseases, State Key Laboratory of Antiviral Drugs, Pingyuan Laboratory, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, ChinaDepartment of Medical Information, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, ChinaDepartment of Liver Disease, the Affiliated Infectious Disease Hospital of Zhengzhou University, Zhengzhou 450052, ChinaDepartment of Infectious Diseases, Shangqiu Municipal Hospital, Shangqiu 476000, ChinaGuangshan County People’s Hospital, Guangshan County, Xinyang 465450, ChinaDepartment of Infectious Diseases, State Key Laboratory of Antiviral Drugs, Pingyuan Laboratory, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, ChinaHenan Center for Disease Control and Prevention, Zhengzhou 450016, ChinaDepartment of Gastrointestinal Surgery, Nanyang Central Hospital, Nanyang 473009, ChinaDepartment of Infectious Diseases, State Key Laboratory of Antiviral Drugs, Pingyuan Laboratory, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, ChinaDepartment of Infectious Diseases, State Key Laboratory of Antiviral Drugs, Pingyuan Laboratory, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Corresponding authorDepartment of Infectious Diseases, State Key Laboratory of Antiviral Drugs, Pingyuan Laboratory, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Corresponding authorSummary: 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.http://www.sciencedirect.com/science/article/pii/S2589004225001671Health sciencesMedicineMedical specialtyImmunologyEndocrinologyPharmacology |
| spellingShingle | 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 Real-world effectiveness of azvudine versus nirmatrelvir-ritonavir in hospitalized patients with COVID-19 and pre-existing diabetes iScience Health sciences Medicine Medical specialty Immunology Endocrinology Pharmacology |
| title | Real-world effectiveness of azvudine versus nirmatrelvir-ritonavir in hospitalized patients with COVID-19 and pre-existing diabetes |
| title_full | Real-world effectiveness of azvudine versus nirmatrelvir-ritonavir in hospitalized patients with COVID-19 and pre-existing diabetes |
| title_fullStr | Real-world effectiveness of azvudine versus nirmatrelvir-ritonavir in hospitalized patients with COVID-19 and pre-existing diabetes |
| title_full_unstemmed | Real-world effectiveness of azvudine versus nirmatrelvir-ritonavir in hospitalized patients with COVID-19 and pre-existing diabetes |
| title_short | Real-world effectiveness of azvudine versus nirmatrelvir-ritonavir in hospitalized patients with COVID-19 and pre-existing diabetes |
| title_sort | real world effectiveness of azvudine versus nirmatrelvir ritonavir in hospitalized patients with covid 19 and pre existing diabetes |
| topic | Health sciences Medicine Medical specialty Immunology Endocrinology Pharmacology |
| url | http://www.sciencedirect.com/science/article/pii/S2589004225001671 |
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