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Paxlovid Reduces COVID-19 Hospitalization Risk by 39%, Study Finds

A comprehensive study utilizing the National COVID Cohort Collaborative (N3C) database reveals that Paxlovid treatment within 5 days of COVID-19 diagnosis significantly reduces the risk of hospitalization by 39% and death by 61%. The study highlights the drug's effectiveness across different age groups and vaccination statuses, while also pointing out persistent racial and social disparities in treatment access.

Introduction

The COVID-19 pandemic has necessitated rapid advancements in treatment options to mitigate severe outcomes. Paxlovid, a combination of nirmatrelvir and ritonavir, has emerged as a significant therapeutic option following its Emergency Use Authorization by the FDA in December 2021. This study leverages the N3C database to assess Paxlovid's real-world effectiveness against COVID-19, particularly focusing on hospitalization and death rates among treated patients.

Key Findings

  • Overall Effectiveness: Paxlovid treatment within 5 days of COVID-19 diagnosis reduces the risk of hospitalization by 39% and death by 61%.
  • Vaccination Status: The drug provides a consistent absolute risk reduction in hospitalization, regardless of the patient's vaccination status, with a number needed to treat (NNT) of 143.
  • Age Stratification: Patients aged 65 and older experience the greatest absolute risk reduction (1.3 percentage points), suggesting they benefit the most from Paxlovid treatment.
  • Disparities in Treatment: Significant disparities in Paxlovid prescription rates were observed, with Black and Hispanic/Latino patients, as well as those from communities with higher social vulnerability, being less likely to receive the treatment.

Methodology

The study employed a target trial emulation framework, analyzing data from April 2022 to August 2023. It included patients aged 18 and older with a documented COVID-19 diagnosis or positive test result, who were at risk for severe outcomes. The analysis focused on the causal effect of Paxlovid on hospitalization and death, adjusting for various confounders including age, race, ethnicity, and vaccination status.

Discussion

The findings underscore Paxlovid's role in reducing severe COVID-19 outcomes, albeit with a noted discrepancy between its effectiveness in real-world settings versus clinical trials. The study also highlights the urgent need to address disparities in treatment access to ensure equitable health outcomes. Despite limitations, such as potential unmeasured confounders and missing data, the research provides valuable insights into Paxlovid's real-world impact and the importance of targeted treatment strategies.

Conclusion

Paxlovid remains a critical tool in the fight against COVID-19, offering significant protection against severe outcomes. However, efforts must be intensified to overcome barriers to treatment access, particularly among vulnerable populations, to fully realize the drug's potential in mitigating the pandemic's impact.
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Reference News

[1]
Effect of nirmatrelvir/ritonavir (Paxlovid) on hospitalization among adults with COVID-19
journals.plos.org · Jan 18, 2025

Paxlovid, a COVID-19 treatment, reduces hospitalization risk by 39% and death by 61% when administered within 5 days of ...

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