Clinical effectiveness of nirmatrelvir plus ritonavir in the treatment of COVID-19 in patients with cirrhosis

Abstract

ABSTRACT Objectives This retrospective cohort study assessed the clinical effectiveness of nirmatrelvirplus ritonavir (NMV-r) in treating COVID-19 in patients with liver cirrhosis(LC). Methods The data of non-hospitalized adult patients with LC who had COVID-19 were selected from the TriNetX platform for the period between 1 March 20201 March 2020, and 31 December 202231 December 2022. Propensity score matching was used to match patients receiving NMV-r (theNMV-r group) with those not receiving NMV-r (the control group). Hazard ratios(HRs) along with 95% confidence intervals (CIs) for the primary outcome – a composite of all-cause hospitalization or mortality during the 30-day follow-up period – were calculated and compared. Results Two cohorts of 2,369 patients each with balanced baseline characteristics were identified.During the follow-up period, the NMV-r group had a lower risk of all-cause hospitalization or mortality (HR, 0.642;95% CI, 0.503–0.819) than did the control group.NMV-r was also associated with a reduced risk of individual all-cause hospitalization (HR 0.681, 95% CI 0.530–0.876])and all-cause mortality (HR, 0.270; 95% CI,0.129–0.562). This association was consistently observed in the subgroups of age, sex, vaccination status, and LC severity. Conclusions NMV-r can reduce all-cause hospitalization and mortality among patients with LC who have COVID-19.