Nirmatrelvir-Ritonavir for Acute COVID-19 in Patients With Cardiovascular Disease and Postacute Sequelae of SARS-CoV-2 Infection

被引：0

作者：

Patel, Rushin ^{[1
]}

Dani, Sourbha S. ^{[2
]}

Khadke, Sumanth ^{[2
]}

Kumar, Ashish ^{[3
]}

Ahmad, Javaria ^{[2
]}

Saji, Anu Mariam ^{[4
]}

Shah, Jui ^{[1
]}

Mehta, Neev ^{[1
]}

Wener, Kenneth ^{[5
]}

Mcquillen, Daniel P. ^{[5
]}

Abraham, George ^{[6
]}

Faust, Jeremy ^{[7
]}

Maley, Jason ^{[8
]}

Patel, Smita ^{[9
]}

Mullington, Janet ^{[8
]}

Wachter, Robert M. ^{[10
]}

Mosenthal, Anne ^{[11
]}

Sax, Paul E. ^{[12
,13
]}

Ganatra, Sarju ^{[2
]}

机构：

[1] Beth Israel Lahey Hlth, Lahey Hosp & Med Ctr, Dept Internal Med, Burlington, MA USA

[2] Beth Israel Lahey Hlth, Lahey Hosp & Med Ctr, Dept Cardiovasc Med, Burlington, MA USA

[3] Cleveland Clin Akron Gen, Dept Internal Med, Akron, OH USA

[4] St Vincent Hosp, Dept Internal Med, Worcester, MA USA

[5] Beth Israel Lahey Hlth, Lahey Hosp & Med Ctr, Dept Infect Dis, Burlington, MA USA

[6] St Vincent Hosp, Dept Med, Div Infect Dis, Worcester, MA USA

[7] Brigham & Womens Hosp, Dept Emergency Med, Boston, MA USA

[8] Beth Israel Deaconess Med Ctr, Dept Neurol, Boston, MA USA

[9] Beth Israel Lahey Hlth, Lahey Hosp & Med Ctr, Dept Gastroenterol, Burlington, MA USA

[10] Univ Calif San Francisco, Dept Med, San Francisco, CA USA

[11] Tufts Univ, Sch Med, Lahey Hosp & Med Ctr, Dept Acad Affairs, Burlington, MA USA

[12] Brigham & Womens Hosp, Dept Med, Div Infect Dis, Boston, MA USA

[13] Harvard Med Sch, Boston, MA USA

来源：

JACC-ADVANCES | 2024年 / 3卷 / 06期

关键词：

cardiovascular disease; health care utilization; nirmatrelvir-ritonavir; postacute sequelae of SARS-CoV-2 infection; long COVID;

D O I：

10.1016/j.jacadv.2024.100961

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND There is limited evidence of association of nirmatrelvir-ritonavir (NMV-r) and incidence of postacute sequelae of SARS-CoV-2 infection (PASC) in patients with pre-existing cardiovascular disease (CVD). OBJECTIVES The objective of this study was to assess the association of NMV-r in nonhospitalized, vaccinated patients with pre-existing CVD and occurrence of PASC. METHODS We conducted a retrospective cohort study utilizing the TriNetX research network, including vaccinated patients with pre-existing CVD who developed COVID-19 between December 2021 and December 2022. Two cohorts were created based on NMV-r administration within 5 days of diagnosis: NMV-r and non-NMV-r cohort. The main outcome was presence of PASC, assessed between 30 to 90 days and 90 to 180 days after index COVID-19 infection. After propensity score matching, both cohorts were compared using t-test and chi-square test for continuous and categorical variables, respectively. RESULTS A total of 26,953 patients remained in each cohort after propensity score matching. Broadly defined PASC occurred in 6,925 patients (26%) in the NMV-r cohort vs 8,150 patients (30.6%) in the non-NMV-r cohort (OR: 0.80; 95% CI: 0.76-0.82; P < 0.001) from 30 to 90 days and in 6,692 patients (25.1%) as compared to 8,910 patients (33.5%) (OR: 0.25, 95% CI: 0.23-0.29; P < 0.001) from 90 to 180 days. Similarly, narrowly defined PASC occurred in 5,335 patients (20%) in the NMV-r cohort vs 6,271 patients (23.6%) in the non-NMV-r cohort between 30 and 90 days (OR: 0.81, 95% CI: 0.78-0.84, P < 0.001) and in 5,121 patients (19.2%) as compared to 6,964 patients (26.1%) (OR: 0.67, 95% CI: 0.64-0.70, P < 0.001) between 90 and 180 days. CONCLUSIONS NMV-r in nonhospitalized vaccinated patients with pre-existing CVD with COVID-19 was associated with a reduction in PASC and health care utilization. (JACC Adv 2024;3:100961) (c) 2024 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

引用

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