학술논문
Early administration of nirmatrelvir/ritonavir leads to faster negative SARS-CoV-2 nasal swabs than monoclonal antibodies in COVID 19 patients at high-risk for severe disease.
Document Type
Article
Author
Colaneri, Marta; Scaglione, Giovanni; Fassio, Federico; Galli, Lucia; Lai, Alessia; Bergna, Annalisa; Gabrieli, Arianna; Tarkowski, Maciej; Ventura, Carla Della; Colombo, Valeria; Cordier, Laura; Bernasconi, Davide; Corbellino, Mario; Dedivitiis, Gianfranco; Borghetti, Silvia; Visigalli, Debora; Sollima, Salvatore; Casalini, Giacomo; Rizzardini, Giuliano; Gori, Andrea
Source
Subject
*COVID-19
*MONOCLONAL antibodies
*SARS-CoV-2
*RITONAVIR
*SARS-CoV-2 Omicron variant
*VACCINATION status
*
*
*
*
*
Language
ISSN
1743-422X
Abstract
Purpose: Besides the well-established efficacy in preventing severe COVID-19, the impact of early treatments, namely antivirals and monoclonal antibodies (mAbs), on the time length to negativization of SARS-CoV-2 nasal swabs is still unclear. The aim of this study was to compare the efficacy of different early treatments in reducing the SARS-CoV-2 viral shedding, identifying a single drug that might potentially lead to a more rapid negativization of SARS-CoV-2 nasal swab. Methods: This was a single-centre, retrospective, observational study conducted at Ospedale Luigi Sacco in Milan. Data of high-risk COVID-19 patients who received early treatments between 23 December 2021 and March 2023 were extracted. The comparison across treatments was conducted using the Kruskall-Wallis test for continuous variables. Dunn's test with Bonferroni adjustment was performed for post-hoc comparisons of days to negativization. Secondly, a negative binomial regression adjusted for age, sex, number of comorbidities, immunosuppression, and SARS-CoV-2 vaccination status was implemented. Results: Data from 428 patients receiving early treatments were collected. The majority were treated with Nirmatrelvir/Ritonavir and were affected by SARS-CoV-2 Omicron infection with BA.2 sublineage. The median length time to SARS-CoV-2 nasal swab negativization was 9 days [IQR 7–13 days]. We found that Nirmatrelvir/Ritonavir determined a significant decrease of the length time to SARS-CoV-2 nasal swab negativization compared to mAbs (p = 0.003), but not compared to Remdesivir (p = 0.147) and Molnupiravir (p = 0.156). Conclusion: Our findings highlight the importance of promptly treating high-risk COVID-19 patients with Nirmatrelvir/Ritonavir, as it also contributes to achieving a faster time to negative SARS-CoV-2 nasal swabs. [ABSTRACT FROM AUTHOR]