ArticleFrontiers in pharmacology2025
Composite outcome of oral azvudine vs. nirmatrelvir-ritonavir in COVID-19 patients: a retrospective cohort study.
Article in Frontiers in pharmacology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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
1 citing paper in PubMed.
- Mechanism and spectrum of inhibition of viral polymerases by 2'-deoxy-2'-β-fluoro-4'-azidocytidine or azvudine.NAR molecular medicine · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: To explore the effectiveness and safety of azvudine and nirmatrelvir-ritonavir in a real-world setting. Methods: This retrospective cohort study included adult patients with confirmed COVID-19 who received azvudine or nirmatrelvir-ritonavir treatment at Shanghai Changhai Hospital between 1 November 2022, and 30 March 2023. Data were collected from the hospital's electronic medical record system using a standardized data extraction form. Propensity score matching (PSM) was used to control for potential confounding factors. The primary outcome was the incidence of composite disease progression, defined as the occurrence of death, ICU admission, invasive respiratory support, or high-flow oxygen therapy. Multivariable Cox regression analysis was performed to identify the factors independently associated with the composite progression outcomes. Results: This study included 476 patients: 296 treated with azvudine and 180 treated with nirmatrelvir-ritonavir. After PSM, 139 patients were included in each group. There were no statistically significant differences between the two groups regarding the composite outcome (log-rank: P = 0.475; HR: 0.82, 95%CI: 0.46-1.43, P = 0.478), death (log-rank: P = 0.526; HR: 0.82, 95%CI: 0.44-1.52, P = 0.528), ICU admission (log-rank: P = 0.525; HR: 0.69, 95%CI: 0.22-2.18, P = 0.526), invasive ventilation (log-rank: P = 0.814; HR: 1.20, 95%CI: 0.27-5.39, P = 0.814), or oxygen use (log-rank: P = 0.370; HR: 1.44, 95%CI: 0.65-3.18, P = 0.372). The multivariable analysis showed that the antiviral drug (HR = 0.861, 95%CI: 0.486-1.524, P = 0.607) was not independently associated with the composite outcome. Only severe COVID-19 was independently associated with the composite outcome (HR = 3.322, 95%CI: 1.569-7.031, P = 0.002). The safety outcomes were similar between the two groups. Conclusion: This real-world study demonstrates comparable efficacy and safety profiles between azvudine and nirmatrelvir-ritonavir in treating COVID-19 patients, regardless of disease severity or baseline characteristics. The findings support azvudine as a practical alternative for treatment selection, particularly in resource-constrained settings or for patients with contraindications to specific therapies. Clinical decisions should prioritize patient-specific needs, accessibility, and cost-effectiveness. Further large-scale prospective studies are needed to validate these observations and refine subgroup-specific treatment strategies.
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.