SynthesisPloS one2023
Effectiveness of nirmatrelvir-ritonavir for the treatment of patients with mild to moderate COVID-19 and at high risk of hospitalization: Systematic review and meta-analyses of observational studies.
Synthesis in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
17 citing papers in PubMed, 6 syntheses or guidelines pooled it, 19 citations in OpenAlex.
- Effectiveness of Nirmatrelvir/Ritonavir for Outpatients in the Era of Omicron, Vaccination, and Previous Infection: A Meta-analysis.Journal of general internal medicine · 2026Pooled it
- Comparing the Effectiveness and Safety of Remdesivir and Molnupiravir in COVID-19: A Systematic Review and Meta-Analysis.Immunity, inflammation and disease · 2025Pooled it
- Effectiveness of nirmatrelvir/ritonavir and molnupiravir in non-hospitalized adults with COVID-19: systematic review and meta-analysis of observational studies.The Journal of antimicrobial chemotherapy · 2024Pooled it
- Effectiveness and safety of azvudine in COVID-19: A systematic review and meta-analysis.PloS one · 2024Pooled 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
- Effectiveness of Nirmatrelvir-Ritonavir for the Prevention of COVID-19-Related Hospitalization and Mortality: A Systematic Literature Review.American journal of therapeuticsPooled it
- A Phase III Randomized Controlled Trial of Plitidepsin, a Marine-Derived Compound, in Hospitalized Adults With Moderate COVID-19.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Trial
- 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
- In Vitro Validation of Size-Dependent Antiviral Activity ofMarine drugs · 2026Article
- Antiviral Activity of Pyrazolopyrimidine and Triazolopyrimidine Derivatives Against SARS-CoV-2 In Vitro: Identifying PZP25 as a Promising Scaffold.Pathogens (Basel, Switzerland) · 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
- A Retrospective Observational Study on COVID-19 Patients Receiving Treatment with Nirmatrelvir/Ritonavir (PAXLOVID).Pulmonary therapy · 2025Article
- Cost-effectiveness of nirmatrelvir/ritonavir in COVID-19 patient groups at high risk for progression to severe COVID-19 in the Netherlands.Cost effectiveness and resource allocation : C/E · 2025Article
- Open Innovation or Traditional Patenting Strategies to Efficiently Address Health Emergencies: How Patent Information was used Towards Effective Treatments for COVID-19.Recent patents on biotechnology · 2025Article
- Patient Experiences With Nirmatrelvir/Ritonavir for COVID-19 in a Collaborative Care Model: A Cross-Sectional Study on Self-Management, Information, and Medication Impact.Journal of patient experience · 2025Article
- Nationwide Target Trial Emulation Evaluating the Clinical Effectiveness of Oral Antivirals for COVID-19 in Korea.Journal of Korean medical science · 2024Article
- Cardiovascular Drug Interactions with Nirmatrelvir/Ritonavir for COVID-19: Considerations for Daily Practice.European cardiology · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess the effectiveness of nirmatrelvir-ritonavir in the treatment of outpatients with mild to moderate COVID-19 who are at higher risk of developing severe illness, through a systematic review with meta-analyses of observational studies.
methodsA systematic search was performed, in accordance with the Cochrane search methods, to identify observational studies that met the inclusion criteria. The outcomes of mortality and hospitalization were analyzed. Search was conducted on PubMed, EMBASE, and The Cochrane Library. Two reviewers independently screened references, selected the studies, extracted the data, assessed the risk of bias using ROBINS-I tool and evaluated the quality of evidence using the GRADE tool. This study followed the PRISMA reporting guideline.
resultsA total of 16 observational studies were finally included. The results of the meta-analysis showed that in comparison to standard treatment without antivirals, nirmatrelvir-ritonavir reduced the risk of death by 59% (OR = 0.41; 95% CI: 0.35-0.52; moderate certainty of evidence). In addition, a 53% reduction in the risk of hospital admission was observed (OR = 0.47; 95% CI: 0.36-0.60, with very low certainty of evidence). For the composite outcome of hospitalization and/or mortality, there was a 56% risk reduction (OR = 0.44; 95% CI: 0.31-0.64, moderate certainty of evidence).
conclusionThe results suggest that nirmatrelvir-ritonavir could be effective in reducing mortality and hospitalization. The results were valid in vaccinated or unvaccinated high-risk individuals with COVID-19. Data from ongoing and future trials may further advance our understanding of the effectiveness and safety of nirmatrelvir-ritonavir and help improve treatment guidelines for COVID-19.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.