التفاصيل البيبلوغرافية
| العنوان: |
Remdesivir or Nirmatrelvir/Ritonavir Therapy for Omicron SARS-CoV-2 Infection in Hematological Patients and Cell Therapy Recipients. |
| المؤلفون: |
Piñana, José Luis, Heras, Inmaculada, Aiello, Tommaso Francesco, García-Cadenas, Irene, Vazquez, Lourdes, Lopez-Jimenez, Javier, Chorão, Pedro, Aroca, Cristina, García-Vidal, Carolina, Arroyo, Ignacio, Soler-Espejo, Eva, López-Corral, Lucia, Avendaño-Pita, Alejandro, Arrufat, Anna, Garcia-Gutierrez, Valentín, Arellano, Elena, Hernández-Medina, Lorena, González-Santillana, Clara, Morell, Julia, Hernández-Rivas, José Ángel |
| المصدر: |
Viruses (1999-4915); Oct2023, Vol. 15 Issue 10, p2066, 17p |
| مصطلحات موضوعية: |
SARS-CoV-2 Omicron variant, HEMATOPOIETIC stem cell transplantation, CELLULAR therapy, REMDESIVIR, RITONAVIR |
| مستخلص: |
Background: Scarce data exist that analyze the outcomes of hematological patients with SARS-CoV-2 infection during the Omicron variant period who received treatment with remdesivir or nirmatrelvir/ritonavir. Methods: This study aims to address this issue by using a retrospective observational registry, created by the Spanish Hematopoietic Stem Cell Transplantation and Cell Therapy Group, spanning from 27 December 2021 to 30 April 2023. Results: This study included 466 patients, 243 (52%) who were treated with remdesivir and 223 (48%) with nirmatrelvir/ritonavir. Nirmatrelvir/ritonavir was primarily used for mild cases, resulting in a lower COVID-19-related mortality rate (1.3%), while remdesivir was preferred for moderate to severe cases (40%), exhibiting a higher mortality rate (9%). A multivariate analysis in the remdesivir cohort showed that male gender (odds ratio (OR) 0.35, p = 0.042) correlated with a lower mortality risk, while corticosteroid use (OR 9.4, p < 0.001) and co-infection (OR 2.8, p = 0.047) were linked to a higher mortality risk. Prolonged virus shedding was common, with 52% of patients shedding the virus for more than 25 days. In patients treated with remdesivir, factors associated with prolonged shedding included B-cell malignancy as well as underlying disease, severe disease, a later onset of and shorter duration of remdesivir treatment and a higher baseline viral load. Nirmatrelvir/ritonavir demonstrated a comparable safety profile to remdesivir, despite a higher risk of drug interactions. Conclusions: Nirmatrelvir/ritonavir proved to be a safe and effective option for treating mild cases in the outpatient setting, while remdesivir was preferred for severe cases, where corticosteroids and co-infection significantly predicted worse outcomes. Despite antiviral therapy, prolonged shedding remains a matter of concern. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
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