ArticleNature communications2025
Effectiveness of nirmatrelvir/ritonavir and molnupiravir in reducing the risk of short-term and long-term cardiovascular complications of COVID-19: a target trial emulation study.
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.
What it found
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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.
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Who cites it
1 citing paper in PubMed.
Corrections and comments
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Authors and funding
17 authors.
Funding
Abstract
While treatment with nirmatrelvir/ritonavir or molnupiravir is effective in lowering the rate of severe COVID-19, the effectiveness of these antivirals in reducing the risk of cardiovascular outcomes, especially among the hospitalized population, remains largely unknown. In this study, we assessed the real-world effectiveness of nirmatrelvir/ritonavir and molnupiravir on short- and long-term cardiovascular complications of COVID-19 using a target trial emulation design. Two target trials of COVID-19 antivirals were emulated by using a territory-wide, population-based, retrospective cohort of hospitalized patients in Hong Kong. Nine cardiovascular outcomes were evaluated in both short-term (day 0-21) and long-term (day 22-365) post-SARS-CoV-2 infection. Compared with the control group, the use of nirmatrelvir/ritonavir was associated with a significantly lower one-year risk of cardiovascular mortality, composite cardiovascular complications, major adverse cardiac events, cerebrovascular disorders, dysrhythmia, ischemic heart disease, and other cardiac disorders following infection. Molnupiravir use was associated with a short-term risk reduction in cardiovascular complications, but only a marginal risk reduction in long-term cardiovascular mortality among other complications. This study demonstrated the effectiveness of nirmatrelvir/ritonavir in reducing the risks of short- and long-term cardiovascular complications following a SARS-CoV-2 infection among the hospitalized population. Our findings suggested health-related benefits of prescribing nirmatrelvir/ritonavir over molnupiravir against severe cardiovascular post-acute sequelae of COVID-19 in the long term.
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