Evidence map›Paper›PMID 40022135›Full record

ArticleRespiratory research2025

Short- and long-term comparative effectiveness of nirmatrelvir/ritonavir and molnupiravir in asthma patients: a cohort study.

Guozhang Lin, Yuchen Wei, Zihao Guo, Huwen Wang, Kate Ching Ching Chan, Renee Wan Yi Chan, Chi Tim Hung, Xiaoting Jiang, Conglu Li, Carrie Ho Kwan Yam and 9 more

Abstract readComparative Study
In one paragraph

Article in Respiratory research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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

19 authors.

Guozhang Lin *School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region, China.
Yuchen Wei *School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region, China.
Zihao GuoSchool of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region, China.
Huwen WangSchool of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region, China.
Kate Ching Ching ChanDepartment of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China.
Renee Wan Yi ChanDepartment of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China.
Chi Tim HungSchool of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region, China.
Xiaoting JiangSchool of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region, China.
Conglu LiSchool of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region, China.
Carrie Ho Kwan YamSchool of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region, China.
Tsz Yu ChowSchool of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region, China.
Yawen WangDivision of Landscape Architecture, Department of Architecture, Faculty of Architecture, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China.
Shi ZhaoSchool of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region, China.
Kehang LiSchool of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region, China.
Aimin YangDepartment of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region, China.
Chris Ka Pun MokLi Ka Shing Institute of Health Sciences, Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region, China.
David S C HuiS.H. Ho Research Centre for Infectious Diseases, Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region, China.
Eng Kiong YeohSchool of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region, China.
Ka Chun ChongSchool of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region, China. marc@cuhk.edu.hk.

Funding

Health and Medical Research Fund COVID190105, COVID19F03, INF-CUHK-1, COVID1903003RGC Collaborative Research Fund C6036-21GFRGC theme-based research schemes T11-705/21-N
6 · The paper itself

Abstract

backgroundFew studies evaluated the effectiveness of COVID-19 antivirals specifically in the asthma population This study assessed short- and long-term effects of nirmatrelvir/ritonavir versus molnupiravir in asthma population.

methodsThis is a retrospective cohort study on adult asthma patients infected with COVID-19, using real-world data obtained from the health officials in Hong Kong. Key inclusion criteria were infection with COVID-19 between March 16, 2022, and Oct 30, 2023, age ≥ 18 years, previous asthma diagnosis, and prescription history of an asthma medication. Outcomes included acute and post-acute mortality, post-acute all-cause hospitalization, and cause-specific hospitalization.

results1,745 patients were eligible for this study, with a median follow-up time of 365 days (IQR: 335-365). Patients in the nirmatrelvir/ritonavir group had significantly lower risks of acute inpatient death (HR, 0·27 [95% CI, 0·12 to 0·59]; p = 0·0011), post-acute inpatient death (HR, 0·49 [95% CI, 0·28 to 0·85]; p = 0·011), all-cause hospitalization (HR, 0·72 [95% CI, 0·58 to 0·89]; p = 0·0020), and myocardial infarction (HR, 0·10 [95% CI, 0·01 to 0·92]; p = 0·042) than patients in the control group. The risk of all-cause hospitalization was significantly lower in the nirmatrelvir/ritonavir group compared to the molnupiravir group (HR, 0·65 [95% CI, 0·52 to 0·81]; p = 0·00012). Among patients who were prescribed medium-/ high-dose inhaled corticosteroids, the nirmatrelvir/ritonavir group had a lower hazard of asthma exacerbation than the molnupiravir group (HR, 0·58 [95% CI, 0·35 to 0·95]; p = 0.030).

conclusionCompared with molnupiravir, nirmatrelvir/ritonavir may offer more benefits in reducing the risk of post-acute sequelae of COVID-19 among asthma patients. In addition, the post-acute benefits of the antivirals were also demonstrated in patients with mild asthma, which have not been generally recommended in existing clinical management guidelines.

Indexed as

Antiviral AgentsAsthmaCOVID-19 Drug TreatmentCytidineHydroxylaminesProlineRitonavirAdultAgedCohort StudiesCOVID-19Drug CombinationsFemaleFollow-Up StudiesHong KongHospitalizationAntiviral AgentsCytidineDrug CombinationsHydroxylaminesmolnupiravirProlineRitonavirAsthmaCOVID-19EffectivenessMolnupiravirNirmatrelvir/ritonavir

Identifiers

PMID40022135
PMCPMC11871785

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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.