Evidence map›Paper›PMID 38481216›Full record

ArticleBMC medicine2024

Paxlovid use is associated with lower risk of cardiovascular diseases in COVID-19 patients with autoimmune rheumatic diseases: a retrospective cohort study.

Weijie Wang, Yu-Hsun Wang, Ching-Hua Huang, Tsung-Hsueh Hsieh, Gema Hernández Ibarburu, James Cheng-Chung Wei

Open access · goldAbstract read
In one paragraph

Article in BMC medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
3.5field-weighted citation impact, top 7% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 9 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 3 countries.

Weijie WangDepartment of Rheumatology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
Yu-Hsun WangDepartment of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan.
Ching-Hua HuangDepartment of Allergy, Immunology & Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan. cshd109@gmail.com.
Tsung-Hsueh HsiehInstitute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
Gema Hernández IbarburuSenior TriNetX Healthcare Partnership Manager EMEA, TriNetX, Cambridge, USA.
James Cheng-Chung WeiDepartment of Allergy, Immunology & Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan. jccwei@gmail.com.
Chung Shan Medical University · TWChung Shan Medical University Hospital · TWTriNetX (United States) · USZhejiang Chinese Medical University · CN

Funding

National Natural Science Foundation of China 82004238
6 · The paper itself

Abstract

backgroundPaxlovid has been shown to be effective in reducing mortality and hospitalization rates in patients with coronavirus disease 2019 (COVID-19). It is not known whether Paxlovid can reduce the risk of cardiovascular diseases (CVD) in COVID-19-surviving patients with autoimmune rheumatic diseases (AIRDs).

methodsTriNetX data from the US Collaborative Network were used in this study. A total of 5,671,395 patients with AIRDs were enrolled between January 1, 2010, and December 31, 2021. People diagnosed with COVID-19 were included in the cohort (n = 238,142) from January 1, 2022, to December 31, 2022. The Study population was divided into two groups based on Paxlovid use. Propensity score matching was used to generate groups with matched baseline characteristics. The hazard ratios (HRs) and 95% confidence intervals of cardiovascular outcomes, admission rate, mortality rate, and intensive care unit (ICU) admission rate were calculated between Paxlovid and non-Paxlovid groups. Subgroup analyses on sex, age, race, autoimmune diseases group, and sensitivity analyses for Paxlovid use within the first day or within 2-5 days of COVID-19 diagnosis were performed.

resultsPaxlovid use was associated with lower risks of cerebrovascular complications (HR = 0.65 [0.47-0.88]), arrhythmia outcomes (HR = 0.81 [0.68-0.94]), ischemic heart disease, other cardiac disorders (HR = 0.51 [0.35-0.74]) naming heart failure (HR = 0.41 [0.26-0.63]) and deep vein thrombosis (HR = 0.46 [0.24-0.87]) belonging to thrombotic disorders in AIRD patients with COVID-19. Compared with the Non-Paxlovid group, risks of major adverse cardiac events (HR = 0.56 [0.44-0.70]) and any cardiovascular outcome mentioned above (HR = 0.76 [0.66-0.86]) were lower in the Paxlovid group. Moreover, the mortality (HR = 0.21 [0.11-0.40]), admission (HR = 0.68 [0.60-0.76]), and ICU admission rates (HR = 0.52 [0.33-0.80]) were significantly lower in the Paxlovid group than in the non-Paxlovid group. Paxlovid appears to be more effective in male, older, and Black patients with AIRD. The risks of cardiovascular outcomes and severe conditions were reduced significantly with Paxlovid prescribed within the first day of COVID-19 diagnosis.

conclusionsPaxlovid use is associated with a lower risk of CVDs and severe conditions in COVID-19-surviving patients with AIRD.

Indexed as

Autoimmune DiseasesCardiovascular DiseasesCOVID-19LactamsLeucineNitrilesProlineRheumatic DiseasesRitonavirCOVID-19 TestingDrug CombinationsHumansInfant, NewbornMaleRetrospective StudiesRisk FactorsDrug CombinationsLactamsLeucinenirmatrelvir and ritonavir drug combinationNitrilesProlineRitonavirAutoimmune rheumatic diseasesCardiovascular outcomesCOVID-19PaxlovidTriNetX

Identifiers

PMID38481216
PMCPMC10938827
OpenAlexW4392749037

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LicenceCC BY
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Registered trials

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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.