Evidence map›Paper›PMID 38599779›Full record

ArticleBMJ open respiratory research2024

Effectiveness of nirmatrelvir-ritonavir versus azvudine for adult inpatients with severe or critical COVID-19.

Huan Zhang, Tan Xiaojiao, Junjun Chen, Zheng Zhang, Chenxi Wang, Haiqing Shi, Yao Li, Jianbo Li, Yan Kang, Xiaodong Jin and 1 more

Open access · goldAbstract readComparative StudyMulticenter Study
In one paragraph

Article in BMJ open respiratory research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.9field-weighted citation impact, top 15% 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

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
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

11 authors at 1 institution in 1 country.

Huan ZhangDepartment of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, People's Republic of China.ORCID http://orcid.org/0000-0002-9077-9331
Tan XiaojiaoDepartment of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, People's Republic of China.
Junjun ChenDepartment of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, People's Republic of China.
Zheng ZhangDepartment of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, People's Republic of China.
Chenxi WangDepartment of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, People's Republic of China.
Haiqing ShiDepartment of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, People's Republic of China.
Yao LiDepartment of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, People's Republic of China.
Jianbo LiDepartment of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, People's Republic of China.
Yan KangDepartment of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, People's Republic of China.
Xiaodong JinDepartment of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, People's Republic of China.
Xuelian LiaoDepartment of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, People's Republic of China liaoxuelian@scu.edu.cn.
Sichuan University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn China, both nirmatrelvir-ritonavir (Paxlovid) and azvudine have been granted approval to treat adult SARS-CoV-2-infected patients with moderate symptoms. Information about the clinical effect of the two available agents among inpatients with severe or critical COVID-19 is scarce. PURPOSE: To compare the clinical outcomes of Paxlovid and azvudine among adult inpatients with severe or critical COVID-19.

methodWe conducted a retrospective cohort study in two large medical centres after the epidemic control measures were lifted in China. A new propensity score matched-inverse probability of treatment weighting cohort was constructed to evaluate the in-hospital all-cause mortality, hospital length of stay, Sequential Organ Failure Assessment (SOFA) score and safety.

resultsA total of 955 individuals were in the cohort. The antiviral therapy strategies were decided by the senior physician and the supplies of the pharmacy. A total of 451 patients were in the Paxlovid group, and 504 patients were in the azvudine group. Compared with Paxlovid, the effects of azvudine on in-hospital all-cause mortality were not significantly different, and the OR (95% CI) was 1.084 (0.822 to 1.430), and the average hospital length of stay of patients discharged alive was also similar in the azvudine group, and the difference (day) and (95% CI) was 0.530 (-0.334 to 1.393). After 7 days of therapy, the degree of decline in the SOFA score was greater in the Paxlovid group than in the azvudine group (p<0.001). The change in glomerular filtration rate was not significantly different (p=0.824).

conclusionPaxlovid and azvudine had similar effectiveness on in-hospital all-cause mortality and hospital length of stay. Compared with the azvudine group, after 7 days of therapy, the degree of decline in SOFA score was significantly higher in the Paxlovid group. These findings need to be verified in larger prospective studies or randomised controlled trials.

Indexed as

Antiviral AgentsCOVID-19 Drug TreatmentRitonavirSARS-CoV-2AdultAgedChinaCOVID-19FemaleHospital MortalityHumansLength of StayMaleMiddle AgedRetrospective StudiesSeverity of Illness IndexAntiviral AgentsRitonavirCOVID-19Critical CareInfection ControlViral infection

Identifiers

PMID38599779
PMCPMC11015288
OpenAlexW4394690108

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.