دورية أكاديمية
Remdesivir or Nirmatrelvir/Ritonavir Therapy for Omicron SARS-CoV-2 Infection in Hematological Patients and Cell Therapy Recipients
| العنوان: | Remdesivir or Nirmatrelvir/Ritonavir Therapy for Omicron SARS-CoV-2 Infection in Hematological Patients and Cell Therapy Recipients |
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| المؤلفون: | Piñana, José Luis, Heras, Inmaculada, Aiello, Tommaso Francesco, García-Cadenas, Irene, Vázquez, Lourdes, López Jiménez, Javier, Chorão, Pedro, Aroca, Cristina, García-Vidal, Carolina, Arroyo, Ignacio, Soler-Espejo, Eva, López-Corral, L., Avendaño, Alejandro, Arrufat, Anna, García-Gutierrez, V., Arellano, Elena, Hernández-Medina, Lorena, González-Santillana, Clara, Morell, Julia, Hernández-Rivas, José Ángel, Rodriguez-Galvez, Paula, Mico-Cerdá, Mireia, Guerreiro, Manuel, Campos, Diana, Navarro, David, Cedillo, Ángel, Martino, Rodrigo, Solano, Carlos |
| بيانات النشر: | Multidisciplinary Digital Publishing Institute |
| سنة النشر: | 2023 |
| المجموعة: | Digital.CSIC (Consejo Superior de Investigaciones Científicas / Spanish National Research Council) |
| مصطلحات موضوعية: | Remdesivir, Nirmatrelvir/ritonavir, Molnupiravir SARS-CoV-2 vaccines, Omicron, Respiratory virus, Hematological malignancies, Allogeneic stem cell transplantation, Autologous stem cell transplantation, COVID-19, mRNA vaccine, Immunocompromised patients |
| الوصف: | 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. ; Peer reviewed |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 1999-4915 |
| العلاقة: | Viruses; Publisher's version; https://doi.org/10.3390/v15102066Test; Sí; Viruses 15(10): 206 (2023); http://hdl.handle.net/10261/352643Test; 2-s2.0-85175276837; https://api.elsevier.com/content/abstract/scopus_id/85175276837Test |
| DOI: | 10.3390/v15102066 |
| الإتاحة: | https://doi.org/10.3390/v15102066Test http://hdl.handle.net/10261/352643Test https://api.elsevier.com/content/abstract/scopus_id/85175276837Test |
| حقوق: | open |
| رقم الانضمام: | edsbas.CEED6187 |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 19994915 |
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| DOI: | 10.3390/v15102066 |