ArticleThe Lancet regional health. Western Pacific2023
Efficacy and safety of Paxlovid in severe adult patients with SARS-Cov-2 infection: a multicenter randomized controlled study.
Article in The Lancet regional health. Western Pacific, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 67 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
67 citing papers in PubMed, 5 syntheses or guidelines pooled it, 110 citations in OpenAlex.
- Drug treatments for mild or moderate covid-19: systematic review and network meta-analysis.BMJ (Clinical research ed.) · 2025Pooled it
- Nirmatrelvir combined with ritonavir for preventing and treating COVID-19.The Cochrane database of systematic reviews · 2023Pooled it
- Pooled it
- Combination of Evans syndrome and COVID-19: a systematic review of reported cases.Blood transfusion = Trasfusione del sanguePooled it
- Nirmatrelvir/Ritonavir Regimen for Mild/Moderately Severe COVID-19: A Rapid Review With Meta-Analysis and Trial Sequential Analysis.Annals of family medicinePooled it
- Molnupiravir or nirmatrelvir-ritonavir plus usual care versus usual care alone in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial.The Lancet. Infectious diseases · 2025Trial
- Antiviral and immunomodulatory effect of zapnometinib in animal models and hospitalized COVID-19 patients.Frontiers in immunology · 2025Trial
- A Systematic Review of Nirmatrelvir/Ritonavir and Molnupiravir for the Treatment of Coronavirus Disease 2019.Open forum infectious diseases · 2024Trial
- Design, synthesis, and X-ray structural studies of potent SARS-CoV-2 Mpro inhibitors containing tetrahydroisoquinoline-3-carboxamides as P2 ligands.RSC medicinal chemistry · 2026Article
- Still Treating Yesterday's Risk? Reconsidering Antiviral Use for Mild-to-Moderate COVID-19 Cases in a Broadly Immune Population.The Medical journal of Australia · 2026Article
- Evaluating the Effectiveness of Antivirals for COVID-19 in the Post-vaccine, Omicron Era: A Systematic Review and Meta-analysis.Open forum infectious diseases · 2026Article
- Distinct CD8iScience · 2026Article
- Targeting SARS-CoV-2 Structural and Accessory Proteins: Emerging Opportunities for Small-Molecule Coronavirus Antivirals.Pharmaceutics · 2026Review
- Targeting SARS-CoV-2 Non-Structural Proteins: A Blueprint for Next-Generation Small-Molecule Coronavirus Antivirals.Pharmaceutics · 2026Review
- Corticosteroids with or without antiviral therapy in elderly patients hospitalized with COVID-19 during the Omicron era: A multicenter real-world study.Journal of virus eradication · 2026Article
- Cu(I)-N-Heterocyclic carbenes as potent inhibitors of SARS-CoV-2 replication.Biometals : an international journal on the role of metal ions in biology, biochemistry, and medicine · 2026Article
- Nirmatrelvir/Ritonavir Efficacy in Immunocompetent Patients with Confirmed Omicron Variant of Severe Acute Respiratory Syndrome Coronavirus 2: An Updated Systematic Review and Meta-analysis.Journal of research in pharmacy practice · 2026Review
- Cardiovascular Outcomes in COVID-19 Patients Treated with Paxlovid: A Multicenter Retrospective Study.Acta Cardiologica Sinica · 2026Article
- Association of Nirmatrelvir-ritonavir with intubation or mortality risks in severe COVID-19 patients: a comparative study.BMC infectious diseases · 2025Article
- Developing New Drugs for the COVID-19 Emergency: Anatomy of the U.S. Response.Pharmacotherapy · 2025Review
7 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
34 authors at 10 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Nirmatrelvir plus ritonavir (Paxlovid) reduced the risk of hospitalization or death by 89% in high-risk, ambulatory adults with COVID-19. We aimed at studying the efficacy and safety of Paxlovid in hospitalized adult patients with SARS-Cov-2 (Omicron BA.2.2 variant) infection and severe comorbidities. Methods: We conducted an open-label, multicenter, randomized controlled trial in which hospitalized adult patients with severe comorbidities were eligible and assigned in a 1:1 ratio to receive either 300 mg of nirmatrelvir plus 100 mg of ritonavir every 12 h for 5 days with standard treatment or only standard treatment. All-cause mortality on day 28, the duration of SARS-CoV-2 RNA clearance, and safety were evaluated. Findings: 264 patients (mean age, 70.35 years; 122 [46.21%] female) who met the criteria were enrolled at 5 sites in Shanghai from April 10 to May 19 in 2022. After randomization, a total of 132 patients were assigned to receive Paxlovid treatment plus standard treatment, and 132 patients were assigned to receive only standard treatment. The overall 28-day mortality was 4.92%, 8 patients died in the standard treatment group and 5 died in the Paxlovid plus standard treatment group. There was no significant difference in mortality from any cause at 28 days between the Paxlovid plus standard treatment group and the standard treatment group (absolute risk difference [ARD], 2.27; 95% CI -2.94 to 7.49, P = 0.39). There was no significant difference in the duration of SARS-CoV-2 RNA clearance among the two groups (mean days, 10 in Paxlovid plus standard treatment group and 10.50 in the standard treatment group; ARD, -0.62; 95% CI -2.29 to 1.05, P = 0.42). The incidence of adverse events that occurred during the treatment period was similar in the two groups (any adverse event, 10.61% with Paxlovid plus standard treatment vs. 7.58% with the standard, P = 0.39; serious adverse events, 4.55% vs. 3.788%, P = 0.76). Interpretation: Paxlovid showed no significant reduction in the risk of all-cause mortality on day 28 and the duration of SARS-CoV-2 RNA clearance in hospitalized adult COVID-19 patients with severe comorbidities. Funding: National Natural Science Foundation of China (grant number: 82172152, 81873944).
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.