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- Title
Nirmatrelvir-ritonavir use among adults hospitalized with COVID-19 during the Omicron phase of the COVID-19 pandemic, Canadian Nosocomial Infection Surveillance Program.
- Authors
Mitchell, Robyn; Lee, Diane; Pelude, Linda; Comeau, Jeannette; Conly, John; Ellis, Chelsey; Ellison, Jennifer; Embil, John; Evans, Gerald; Johnston, Lynn; Johnstone, Jennie; Katz, Kevin; Kibsey, Pamela; Lee, Bonita; Lefebvre, Marie-Astrid; Longtin, Yves; McGeer, Allison; Mertz, Dominik; Minion, Jessica; Smith, Stephanie
- Abstract
Background: Recent studies have demonstrated the effectiveness of nirmatrelvir-ritonavir in reducing the risk of progression to severe disease among outpatients with mild to moderate coronavirus disease 2019 (COVID-19); however, data are limited regarding the use and role of nirmatrelvir-ritonavir among hospitalized patients. This study describes the use and outcomes of nirmatrelvir-ritonavir among adults hospitalized with COVID-19 in a sentinel network of Canadian acute care hospitals during the Omicron variant phase of the pandemic. Methods: The Canadian Nosocomial Infection Surveillance Program conducts surveillance of hospitalized patients with COVID-19 in acute care hospitals across Canada. Demographic, clinical, treatment and 30-day outcome data were collected by chart review by trained infection control professionals using standardized questionnaires. Results: From January 1 to December 31, 2022, 13% (n=490/3,731) of adult patients (18 years of age and older) hospitalized with COVID-19 in 40 acute care hospitals received nirmatrelvir-ritonavir either at admission or during hospitalization. Most inpatients who received nirmatrelvir-ritonavir, 79% of whom were fully vaccinated, had at least one pre-existing comorbidity (97%) and were of advanced age (median=79 years). Few were admitted to an intensive care unit (2.3%) and among the 490 nirmatrelvir-ritonavir treated inpatients, there were 13 (2.7%) deaths attributable to COVID-19. Conclusion: These findings from a large sentinel network of Canadian acute-care hospitals suggest that nirmatrelvir-ritonavir is being used to treat adult COVID-19 patients at admission who are at risk of progression to severe disease or those who acquired COVID-19 in hospital. Additional research on the efficacy and indications for nirmatrelvir-ritonavir use in hospitalized patients is warranted to inform future policies and guidelines.
- Subjects
CANADA; COVID-19 pandemic; NOSOCOMIAL infections; SARS-CoV-2 Omicron variant; COVID-19; ADULTS
- Publication
Canada Communicable Disease Report, 2023, Vol 49, Issue 7/8, p351
- ISSN
1188-4169
- Publication type
Article
- DOI
10.14745/ccdr.v49i78a07