Efficacy of nirmatrelvir and ritonavir for post‐acute COVID‐19 sequelae beyond 3 months of SARS‐CoV‐2 infection.

The effect of nirmatrelvir plus ritonavir (NMV‐r) on post‐acute COVID‐19 sequelae beyond 3 months of SARS‐CoV‐2 infection remains unknown. This retrospective cohort study utilized data from the TriNetX Research Network. We identified nonhospitalized adult patients with COVID‐19 receiving a diagnosis between January 1 and July 31, 2022. Propensity score matching (PSM) was used to create two matched cohorts: NMV‐r and non‐NMV‐r groups, respectively. We measured the primary outcomes using a composite of all‐cause emergency room (ER) visits or hospitalization and a composite of post‐COVID‐19 symptoms according to the WHO Delphi consensus, which also stated that post COVID‐19 condition occurs usually 3 months from the onset of COVID‐19, during the follow‐up period between 90 days after the index diagnosis of COVID‐19 and the end of follow‐up (180 days). Initially, we identified 12 247 patients that received NMV‐r within 5 days of diagnosis and 465 135 that did not. After PSM, 12 245 patients remained in each group. During the follow‐up period, patients treated with NMV‐r had a lower risk of all‐cause hospitalization and ER visits compared with untreated patients (659 vs. 955; odds ratio [OR], 0.672; 95% confidence interval [CI], 0.607–0.745; p < 0.0001). However, the overall risk of post‐acute COVID‐19 symptoms did not significantly differ between the two groups (2265 vs. 2187; OR, 1.043; 95% CI, 0.978–1.114; p = 0.2021). The reduced risk of all‐cause ER visits or hospitalization in the NMV‐r group and the similarities in the risk of post‐acute COVID‐19 symptoms between the two groups were consistent in the subgroups stratified by sex, age, and vaccination status. Early NMV‐r treatment of nonhospitalized patients with COVID‐19 was associated with reduced risk of hospitalization and ER visits during the period of 90–180 days after diagnosis compared with no NMV‐r treatment; however, post‐acute COVID‐19 symptoms and mortality risk did not differ significantly between the groups. [ABSTRACT FROM AUTHOR]