File Download

There are no files associated with this item.

  Links for fulltext
     (May Require Subscription)

Article: Nirmatrelvir/ritonavir use in pregnant women with SARS-CoV-2 Omicron infection: a target trial emulation

TitleNirmatrelvir/ritonavir use in pregnant women with SARS-CoV-2 Omicron infection: a target trial emulation
Authors
Issue Date1-Nov-2023
PublisherNature Research
Citation
Nature Medicine, 2023, v. 30, n. 1, p. 112-116 How to Cite?
Abstract

To date, there is a lack of randomized trial data examining the use of the antiviral nirmatrelvir/ritonavir in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected pregnant persons. This target trial emulation study aimed to address this gap by evaluating the use of nirmatrelvir/ritonavir in nonhospitalized pregnant women with symptomatic SARS-CoV-2 Omicron variant infection. Among patients diagnosed between 16 March 2022 and 5 February 2023, exposure was defined as outpatient nirmatrelvir/ritonavir treatment within 5 days of symptom onset or coronavirus disease 2019 (COVID-19) diagnosis. Primary outcomes were maternal morbidity and mortality index (MMMI), all-cause maternal death and COVID-19-related hospitalization, while secondary outcomes were individual components of MMMI, preterm birth, stillbirth, neonatal death and cesarean section. One-to-ten propensity-score matching was conducted between nirmatrelvir/ritonavir users and nonusers, followed by cloning, censoring and weighting. Overall, 211 pregnant women on nirmatrelvir/ritonavir and 1,998 nonusers were included. Nirmatrelvir/ritonavir treatment was associated with reduced 28-day MMMI risk (absolute risk reduction (ARR) = 1.47%, 95% confidence interval (CI) = 0.21–2.34%) but not 28-days COVID-19-related hospitalization (ARR = −0.09%, 95% CI = −1.08% to 0.71%). Nirmatrelvir/ritonavir treatment was also associated with reduced risks of cesarean section (ARR = 1.58%, 95% CI = 0.85–2.39%) and preterm birth (ARR = 2.70%, 95% CI = 0.98–5.31%). No events of maternal or neonatal death or stillbirth were recorded. The findings suggest that nirmatrelvir/ritonavir is an effective treatment in symptomatic pregnant women with SARS-CoV-2 Omicron variant infection.


Persistent Identifierhttp://hdl.handle.net/10722/339022
ISSN
2023 Impact Factor: 58.7
2023 SCImago Journal Rankings: 19.045
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorWong, Carlos KH-
dc.contributor.authorLau, Kristy TK-
dc.contributor.authorChung, Matthew SH-
dc.contributor.authorAu, Ivan CH-
dc.contributor.authorCheung, Ka Wang-
dc.contributor.authorLau, Eric HY-
dc.contributor.authorDaoud, Yasmin-
dc.contributor.authorCowling, Benjamin J-
dc.contributor.authorLeung, Gabriel M-
dc.date.accessioned2024-03-11T10:33:16Z-
dc.date.available2024-03-11T10:33:16Z-
dc.date.issued2023-11-01-
dc.identifier.citationNature Medicine, 2023, v. 30, n. 1, p. 112-116-
dc.identifier.issn1078-8956-
dc.identifier.urihttp://hdl.handle.net/10722/339022-
dc.description.abstract<p>To date, there is a lack of randomized trial data examining the use of the antiviral nirmatrelvir/ritonavir in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected pregnant persons. This target trial emulation study aimed to address this gap by evaluating the use of nirmatrelvir/ritonavir in nonhospitalized pregnant women with symptomatic SARS-CoV-2 Omicron variant infection. Among patients diagnosed between 16 March 2022 and 5 February 2023, exposure was defined as outpatient nirmatrelvir/ritonavir treatment within 5 days of symptom onset or coronavirus disease 2019 (COVID-19) diagnosis. Primary outcomes were maternal morbidity and mortality index (MMMI), all-cause maternal death and COVID-19-related hospitalization, while secondary outcomes were individual components of MMMI, preterm birth, stillbirth, neonatal death and cesarean section. One-to-ten propensity-score matching was conducted between nirmatrelvir/ritonavir users and nonusers, followed by cloning, censoring and weighting. Overall, 211 pregnant women on nirmatrelvir/ritonavir and 1,998 nonusers were included. Nirmatrelvir/ritonavir treatment was associated with reduced 28-day MMMI risk (absolute risk reduction (ARR) = 1.47%, 95% confidence interval (CI) = 0.21–2.34%) but not 28-days COVID-19-related hospitalization (ARR = −0.09%, 95% CI = −1.08% to 0.71%). Nirmatrelvir/ritonavir treatment was also associated with reduced risks of cesarean section (ARR = 1.58%, 95% CI = 0.85–2.39%) and preterm birth (ARR = 2.70%, 95% CI = 0.98–5.31%). No events of maternal or neonatal death or stillbirth were recorded. The findings suggest that nirmatrelvir/ritonavir is an effective treatment in symptomatic pregnant women with SARS-CoV-2 Omicron variant infection.</p>-
dc.languageeng-
dc.publisherNature Research-
dc.relation.ispartofNature Medicine-
dc.titleNirmatrelvir/ritonavir use in pregnant women with SARS-CoV-2 Omicron infection: a target trial emulation-
dc.typeArticle-
dc.identifier.doi10.1038/s41591-023-02674-0-
dc.identifier.scopuseid_2-s2.0-85178470243-
dc.identifier.volume30-
dc.identifier.issue1-
dc.identifier.spage112-
dc.identifier.epage116-
dc.identifier.eissn1546-170X-
dc.identifier.isiWOS:001111987000001-
dc.identifier.issnl1078-8956-

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats