Evidence map›Paper›PMID 40597719›Full record

ArticleBMC infectious diseases2025

Real-world effectiveness of simnotrelvir-ritonavir versus nirmatrelvir-ritonavir in hospitalized patients with COVID-19 during the omicron wave in China: a retrospective cohort study.

Chuntao Li, Qingzhao Cheng, Ying Chen, Ling Liu, Dajin Liu, Jiaqiang Zhang, Zehua Liao, Yaling Xiang, Jinbiao Zhou, Keke Liao and 7 more

Abstract readComparative Study
In one paragraph

Article in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Review
  2. 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

17 authors.

Chuntao Li *Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Kunming Medical University, Kunming, China.
Qingzhao Cheng *Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Kunming Medical University, Kunming, China.
Ying ChenDepartment of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, China.
Ling LiuDepartment of Respiratory and Critical Care Medicine, First Affiliated Hospital of Kunming Medical University, Kunming, China.
Dajin LiuMedical Record Department, First Affiliated Hospital of Kunming Medical University, Kunming, China.
Jiaqiang ZhangDepartment of Respiratory and Critical Care Medicine, First Affiliated Hospital of Kunming Medical University, Kunming, China.
Zehua LiaoDepartment of Respiratory and Critical Care Medicine, First Affiliated Hospital of Kunming Medical University, Kunming, China.
Yaling XiangDepartment of Respiratory and Critical Care Medicine, First Affiliated Hospital of Kunming Medical University, Kunming, China.
Jinbiao ZhouDepartment of Respiratory and Critical Care Medicine, First Affiliated Hospital of Kunming Medical University, Kunming, China.
Keke LiaoDepartment of Respiratory and Critical Care Medicine, First Affiliated Hospital of Kunming Medical University, Kunming, China.
Yandi SuDepartment of Respiratory and Critical Care Medicine, First Affiliated Hospital of Kunming Medical University, Kunming, China.
Xuemei ZhangDepartment of Respiratory and Critical Care Medicine, First Affiliated Hospital of Kunming Medical University, Kunming, China.
Jiashu LiDepartment of Respiratory and Critical Care Medicine, First Affiliated Hospital of Kunming Medical University, Kunming, China.
Yuping ZhaoDepartment of Respiratory and Critical Care Medicine, First Affiliated Hospital of Kunming Medical University, Kunming, China.
Yue YangDepartment of Respiratory and Critical Care Medicine, First Affiliated Hospital of Kunming Medical University, Kunming, China.
Jianqing ZhangDepartment of Respiratory and Critical Care Medicine, First Affiliated Hospital of Kunming Medical University, Kunming, China. ydyyzjq@163.com.
Long YangDepartment of Pharmacy, First Affiliated Hospital of Kunming Medical University, Kunming, China. haopot@163.com.

Funding

2024 Yunnan Provincial Science and Technology Department-Kunming Medical University Joint Basic Research Program, China no. 202401AYO70001-239Medical Leaders Training Program of Yunnan Provincial Health Commission no. L2019007
6 · The paper itself

Abstract

objectiveThis study aims to assess the comparative clinical effectiveness of the 3-chymotrypsin-like protease (3CLpro) inhibitors simnotrelvir-ritonavir and nirmatrelvir-ritonavir in hospitalized patients with COVID-19 during the omicron wave in China.

methodsThe retrospective analysis of data from adult hospitalized patients with COVID-19 treated with either simnotrelvir-ritonavir or nirmatrelvir-ritonavir as antiviral treatment strategies will be conducted to determine any differences in clinical outcomes between the two drugs.

resultsThis study involved a total of 585 participants, with 264 in the simnotrelvir group and 321 in the nirmatrelvir group. Following propensity score matching, there were 186 individuals in each group. There was no statistically significant difference in the cumulative risk of the composite disease progression, all-cause death, and respiratory support at 28 days following initiation of drug exposure between the two groups (p > 0.05). However, the simnotrelvir group exhibited more cases of clinical improvement compared to the nirmatrelvir group (33.602 events per 1000 person-days vs. 30.913 events per 1000 person-days), with a better cumulative incidence in the simnotrelvir group (p < 0.05). The multivariate Cox regression analysis revealed that non-severe COVID-19 (HR 0.630, 95% CI 0.496-0.801; p < 0.001), lower C-reactive protein (CRP) levels (HR 0.993, 95% CI 0.990-0.997; p < 0.001), and treatment with simnotrelvir-ritonavir (HR 1.395, 95% CI 1.118-1.741; p = 0.003) were independently associated with a higher likelihood of clinical improvement.

conclusionThis study illustrated that both simnotrelvir-ritonavir and nirmatrelvir-ritonavir exhibited similar effectiveness in reducing the incidence of composite disease progression, all-cause death, and the need for respiratory support amidst the real-world outbreak of the omicron VOC in China. Furthermore, simnotrelvir-ritonavir was found to be more favorable in enhancing the rate of clinical improvement in COVID-19 hospitalized patients, suggesting its potential clinical effectiveness against the disease.

Indexed as

Antiviral AgentsCOVID-19 Drug TreatmentIndolesOxadiazolesRitonavirAdultAgedChinaCOVID-19Drug Therapy, CombinationFemaleHospitalizationHumansLactamsLeucineMaleAntiviral AgentsIndolesLactamsLeucinenirmatrelvirNitrilesOrganic ChemicalsOxadiazolesProlineRitonavirSIM0417All-cause deathClinical improvementComposite disease progressionCOVID‐19Nirmatrelvir-ritonavirSimnotrelvir-ritonavir

Identifiers

PMID40597719
PMCPMC12211424

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.