Clinical efficacy of nirmatrelvir plus ritonavir in patients with COVID-19 and preexisting cardiovascular diseases

ABSTRACT

Background

This study assessed the clinical efficacy of nirmatrelvir plus ritonavir (NMV-r) in treating patients with COVID-19 who have preexisting cardiovascular diseases (CVDs).

Methods

Patients with underlying CVDs and COVID-19 were included from the TriNetX network. We employed a 1:1 propensity score matching to create two comparable cohorts: patients receiving NMV-r and those not receiving NMV-r. The primary outcome was the composite outcome of all-cause hospitalization or death within 30 days.

Results

Propensity score matching yielded two matched cohorts of 10,847 patients each. The composite outcomes of all-cause hospitalization or death within 30 days were 2.2% (239 patients) in the NMV-r cohort and 4.7% (512 patients) in the control cohort, indicating reduced risk in the NMV-r cohort (hazard ratio [HR], 0.475; 95% confidence interval [CI], 0407–0.533). The NMV-r cohort exhibited lower risks of all-cause hospitalization (HR, 0.525; 95% CI, 0.449–0.615) and mortality (HR, 0.113; 95% CI, 0.052–0.246) compared with the control group. A similar trend was observed across most of the subgroups.

Conclusions

Our findings indicate that NMV-r to treat COVID-19 could reduce all-cause hospitalization and death in patients with CVDs.

KEYWORDS:

• COVID-19
• hospitalization
• mortality
• nirmatrelvir plus ritonavir
• cardiovascular disease
• coronary artery disease
• stroke
• SARS-CoV-2

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Ethics statement

Because only de-identified data are provided by the TriNetX, the requirement for written informed consent was waived in this study. The study protocol was approved by the Institutional Review Board (No. 11202–002).

Data availability statement

Raw data were generated at TriNetX network. Derived data supporting the findings of this study are available.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14787210.2023.2284367.

Additional information

Funding

This paper was not funded.