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Short-Term Effectiveness of Oral Nirmatrelvir/Ritonavir Against the SARS-CoV-2 Omicron Variant and Culture-Positive Viral Shedding
Authors:Eunyoung Lee  Sehee Park  Jae-Phil Choi  Min-Kyung Kim  Eunmi Yang  Sin Young Ham  Seungjae Lee  Bora Lee  Jeong-Sun Yang  Byoung Kwon Park  Da Sol Kim  So-Young Lee  Joo-Yeon Lee  Hee-Chang Jang  Jaehyun Jeon  Sang-Won Park
Abstract:BackgroundInformation on the effectiveness of nirmatrelvir/ritonavir against the omicron is limited. The clinical response and viral kinetics to therapy in the real world need to be evaluated.MethodsMild to moderate coronavirus disease 2019 (COVID-19) patients with risk factors for severe illness were prospectively enrolled as a treatment group with nirmatrelvir/ritonavir therapy versus a control group with supportive care. Serial viral load and culture from the upper respiratory tract were evaluated for seven days, and clinical responses and adverse reactions were evaluated for 28 days.ResultsA total of 51 patients were analyzed including 40 in the treatment group and 11 in the control group. Faster symptom resolution during hospitalization (P = 0.048) was observed in the treatment group. Only minor adverse reactions were reported in 27.5% of patients. The viral load on Day 7 was lower in the treatment group (P = 0.002). The viral culture showed a positivity of 67.6% (25/37) vs. 100% (6/6) on Day 1, 0% (0/37) vs. 16.7 (1/6) on Day 5, and 0% (0/16) vs. 50.0% (2/4) on Day 7 in the treatment and control groups, respectively.ConclusionsNirmatrelvir/ritonavir against the omicron was safe and resulted in negative viral culture conversion after Day 5 of treatment with better symptomatic resolution.
Keywords:Viral Load   Culture   Omicron   COVID-19   Nirmatrelvir/Ritonavir
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