ArticleLancet regional health. Americas2024
Real-world use of nirmatrelvir-ritonavir in COVID-19 outpatients during BQ.1, BQ.1.1., and XBB.1.5 predominant omicron variants in three U.S. health systems: a retrospective cohort study.
Article in Lancet regional health. Americas, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.
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Who cites it
8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 8 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
- Severity of COVID-19 Omicron Variants: A Global Systematic Review.Infectious diseases and therapy · 2026Pooled it
- Characteristics of outpatient nirmatrelvir/ritonavir recipients during the 2022/2023 era in Alberta, Canada: A retrospective observational population-based study.Canada communicable disease report = Releve des maladies transmissibles au Canada · 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
- Clinical effectiveness of oral antiviral treatment for non-hospitalized high-risk patients with COVID-19 during Omicron JN.1 subvariant wave: a US-based propensity-matched cohort study.Pneumonia (Nathan Qld.) · 2025Article
- Comparative Analysis of Neuropsychiatric Adverse Reactions Associated with Remdesivir and Nirmatrelvir/Ritonavir in COVID-19 Treatment: Insights from EudraVigilance Data.Journal of clinical medicine · 2025Article
- Efficacy of Nirmatrelvir/ritonavir in reducing the risk of severe outcome in patients with SARS-CoV-2 infection: a real-life full-matched case-control study (SAVALO Study).BMC infectious diseases · 2024Article
- Review
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Authors and funding
16 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Ritonavir-boosted Nirmatrelvir (NMV-r), a protease inhibitor with Methods: We conducted a retrospective observational cohort study of non-hospitalised adult patients with SARS-CoV-2 infection using real-world data from three health systems in Colorado and Utah, and compared hospitalisation rates in NMV-r-treated patients in a BA.2/BA.2.12.1/BA.4/BA.5 variant-predominant (first) phase (April 3, 2022-November 12, 2022), with a BQ.1/BQ.1.1/XBB.1.5 variant-predominant (second) phase (November 13, 2022-March 7, 2023). In the primary analysis, we used Firth logistic regression with a two-segment (phase) linear time model, and pre-specified non-inferiority bounds for the mean change between segments. In a pre-specified secondary analysis, we inferred NMV-r effectiveness in a cohort of treated and untreated patients infected during the second phase. For both analyses, the primary outcome was 28-day all-cause hospitalisation. Subgroup analyses assessed treatment effect heterogeneity. Findings: In the primary analysis, 28-day all-cause hospitalisation rates in NMV-r treated patients in the second phase (n = 12,061) were non-inferior compared to the first phase (n = 25,075) (198 [1.6%] vs. 345 [1.4%], adjusted odds ratio (aOR): 0.76 [95% CI 0.54-1.06]), with consistent results among secondary endpoints and key subgroups. Secondary cohort analyses revealed additional evidence for NMV-r effectiveness, with reduced 28-day hospitalisation rates among treated patients compared to untreated patients during a BQ.1/BQ.1.1/XBB.1.5 predominant phase (198/12,061 [1.6%] vs. 376/10,031 [3.7%], aOR 0.34 [95% CI 0.30-0.38), findings robust to additional sensitivity analyses. Interpretation: Real-world evidence from major US healthcare systems suggests ongoing NMV-r effectiveness in preventing hospitalisation during a BQ.1/BQ.1.1/XBB.1.5-predominant phase in the U.S, supporting its continued use in similar patient populations. Funding: U.S. National Institutes of Health.
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Registered trials
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