Evidence map›Paper›PMID 41214000›Full record

ArticleNature communications2025

Greater benefits of immediate nirmatrelvir-ritonavir initiation for post-COVID outcomes: a population-based retrospective cohort study.

Ka Chun Chong, Yuchen Wei, Carlos King Ho Wong, Xi Xiong, Huwen Wang, Chi Tim Hung, Conglu Li, Carrie Ho Kwan Yam, Tsz Yu Chow, Zihao Guo and 7 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Nature communications, 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. Review
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.

Ka Chun ChongSchool of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.ORCID http://orcid.org/0000-0001-5610-1298
Yuchen WeiSchool of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
Carlos King Ho WongLaboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong Special Administrative Region, China.ORCID http://orcid.org/0000-0002-6895-6071
Xi XiongLaboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong Special Administrative Region, China.ORCID http://orcid.org/0000-0002-9418-7448
Huwen WangDuke-NUS Medical School, Singapore, Singapore.
Chi Tim HungSchool of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.ORCID http://orcid.org/0000-0003-2103-8377
Conglu LiSchool of Public Health and Primary Care, The Chinese University of 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 Special Administrative Region, China.
Tsz Yu ChowSchool of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
Zihao GuoSchool of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.ORCID http://orcid.org/0000-0001-9002-0483
Kehang LiSchool of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.ORCID http://orcid.org/0000-0002-3778-7068
Aimin YangDepartment of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
Chris Ka Pun MokSchool of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.ORCID http://orcid.org/0000-0002-0525-6772
David S C HuiS.H. Ho Research Centre for Infectious Diseases, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.ORCID http://orcid.org/0000-0003-4382-2445
Shi ZhaoSchool of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China. zhaoshi.cmsa@gmail.com.ORCID http://orcid.org/0000-0001-8722-6149
Eng Kiong YeohSchool of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China. yeoh_ek@cuhk.edu.hk.ORCID http://orcid.org/0000-0002-1721-9450
Guozhang LinSchool of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China. guozhanglin@cuhk.edu.hk.ORCID http://orcid.org/0009-0006-5996-2927

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Nirmatrelvir-ritonavir is generally recommended to be initiated within five days of COVID-19 symptom onset. This study examined the association between the timing of nirmatrelvir-ritonavir initiation and post-acute outcomes more precisely using territory-wide data in Hong Kong. We included patients aged ≥18 years who tested positive for SARS-CoV-2 between March 16, 2022, and November 9, 2023, and were hospitalized with COVID-19. Treatment groups were formed based on the time from the positive RT-PCR date to nirmatrelvir-ritonavir initiation. Among 15,978 patients who received nirmatrelvir-ritonavir, 10,028 (62.8%) patients were included in Day 0 group, 4973 (31.1%) in Day 1 group, and 977 (6.1%) in Day 2 or later group. The control group comprised 22,312 patients who did not receive nirmatrelvir-ritonavir. Compared with the control group, the risks of post-acute mortality were significantly lower in Day 0 group (hazard ratio [HR] 0.51, 95% CI 0.46-0.56; p < 0.0001) and Day 1 group (HR 0.66, CI 0.59-0.74; p < 0.0001), but not in Day 2 or later group. Meta-regression results showed that more immediate initiation was associated with lower risks of death and all-cause hospitalization. Our findings suggested that the antiviral should be prescribed immediately after COVID-19 diagnosis for achieving its greatest benefit on improving post-COVID outcomes.

Indexed as

Antiviral AgentsCOVID-19COVID-19 Drug TreatmentRitonavirAdultAgedFemaleHong KongHumansMaleMiddle AgedRetrospective StudiesSARS-CoV-2Treatment OutcomeAntiviral AgentsRitonavir

Identifiers

PMID41214000
PMCPMC12602690

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.