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Use of Paxlovid in patients primary vaccinated against COVID-19
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Keywords

Immunosuppression
COVID-19 vaccine
Nirmatrelvir
Ritonavir

Categories

How to Cite

1.
Use of Paxlovid in patients primary vaccinated against COVID-19. Rev Med Clin [Internet]. 2024 Oct. 30 [cited 2024 Dec. 25];8(3):e01092408015. Available from: https://mail.medicinaclinica.org/index.php/rmc/article/view/574

Abstract

Introduction: In March 2022, Spanish health authorities authorized the use of Paxlovid® (Nirmatrelvir, Ritonavir), primarily indicated for patients with immunosuppression, advanced age, or no prior vaccination. Objective: To compare the clinical and epidemiological characteristics between primovaccinated and non-primovaccinated patients with COVID-19 who received Paxlovid at the Ramón y Cajal University Hospital. Patients and methods: Patients over 18 years old who received Paxlovid between April 13 and August 31, 2022, were selected. Primovaccinated patients were defined as those who had received at least 3 doses of the COVID-19 vaccine. The distribution of clinical and epidemiological characteristics was compared using bivariate analysis between primovaccinated and non-primovaccinated patients with COVID-19. The Odds Ratio (OR) was used as a measure of association with a 95% confidence level. Results: A total of 107 patients received Paxlovid, including 82 primovaccinated and 25 non-primovaccinated individuals. Primovaccinated patients were older (74.9 vs. 55.9; p 0.016). There was a female predominance among non-primovaccinated patients (80%, p 0.06). Non-primovaccinated patients had more previous hospitalizations due to COVID-19 (24% vs. 3.66%; p 0.067). The most frequent pathological antecedents were neoplasms (> 43%). Pathological conditions associated with a high risk of severe COVID-19 were similar between primovaccinated and non-primovaccinated patients. Thirty-day outcomes following Paxlovid administration were worse among non-primovaccinated patients, with one death, one ICU admission, and two subsequent hospitalizations. Conclusion: Non-primovaccinated patients who received Paxlovid were younger, had more previous hospitalizations, and had worse outcomes.

PDF Artículo Original (Spanish)

References

Paxlovid | European Medicines Agency [Internet]. [citado 30 de diciembre de 2023]. Disponible en: https://www.ema.europa.eu/en/medicines/human/EPAR/paxlovid

Agencia Española de Medicamentos y Productos Sanitarios [Internet]. 2021 [citado 30 de diciembre de 2023]. Criterios para valorar la administración de las nuevas alternativas terapéuticas antivirales frente a la infección por SARS-CoV-2. Disponible en: https://www.aemps.gob.es/medicamentos-de-uso-humano/acceso-a-medicamentos-en-situaciones-especiales/criterios-para-valorar-la-administracion-de-las-nuevas-alternativas-terapeuticas-antivirales-frente-a-la-infeccion-por-sars-cov-2/

Hammond J, Leister-Tebbe H, Gardner A, Abreu P, Bao W, Wisemandle W, et al. Oral Nirmatrelvir for High-Risk, Nonhospitalized Adults with Covid-19. N Engl J Med. 14 de abril de 2022;386(15):1397-408.

Reis S, Metzendorf MI, Kuehn R, Popp M, Gagyor I, Kranke P, et al. Nirmatrelvir combined with ritonavir for preventing and treating COVID-19. Cochrane Database Syst Rev. 20 de septiembre de 2022;9(9):CD015395.

Najjar-Debbiny R, Gronich N, Weber G, Khoury J, Amar M, Stein N, et al. Effectiveness of Paxlovid in Reducing Severe Coronavirus Disease 2019 and Mortality in High-Risk Patients. Clin Infect Dis Off Publ Infect Dis Soc Am. 8 de febrero de 2023;76(3):e342-9.

European Centre for Disease Prevention and Control [Internet]. 2021 [citado 7 de mayo de 2022]. Interim public health considerations for the provision of additional COVID-19 vaccine doses. Disponible en: https://www.ecdc.europa.eu/en/publications-data/covid-19-public-health-considerations-additional-vaccine-doses

Caillard S, Thaunat O, Benotmane I, Masset C, Blancho G. Antibody Response to a Fourth Messenger RNA COVID-19 Vaccine Dose in Kidney Transplant Recipients: A Case Series. Ann Intern Med. 15 de marzo de 2022;175(3):455-6.

Bonanad C, García-Blas S, Tarazona-Santabalbina FJ, Díez-Villanueva P, Ayesta A, Sanchis Forés J, et al. Coronavirus: la emergencia geriátrica de 2020. Documento conjunto de la Sección de Cardiología Geriátrica de la Sociedad Española de Cardiología y la Sociedad Española de Geriatría y Gerontología. Rev Esp Cardiol. julio de 2020;73(7):569-76.

Fernández Ibáñez JM, Morales Ballesteros M del C, Galindo Andúgar MÁ, Fernández Anguita MJ, Arias Arias Á, Barberá-Farré JR. Factores de riesgo de mortalidad en pacientes mayores de 65 años hospitalizados por COVID-19. Rev Esp Geriatría Gerontol. 1 de enero de 2022;57(1):6-12.

Agencia Española de Medicamentos y Productos Sanitarios [Internet]. 2021 [citado 30 de diciembre de 2023]. 3o Informe de Farmacovigilancia sobre Vacunas COVID-19. Disponible en: https://www.aemps.gob.es/informa/3o-informe-de-farmacovigilancia-sobre-vacunas-covid-19/

Lopez Bernal J, Andrews N, Gower C, Gallagher E, Simmons R, Thelwall S, et al. Effectiveness of Covid-19 Vaccines against the B.1.617.2 (Delta) Variant. N Engl J Med. 21 de julio de 2021;NEJMoa2108891.

Tian Y, Qiu X, Wang C, Zhao J, Jiang X, Niu W, et al. Cancer associates with risk and severe events of COVID-19: A systematic review and meta-analysis. Int J Cancer. 2021;148(2):363-74.

Cortés A, Casado JL, Longo F, Serrano JJ, Saavedra C, Velasco H, et al. Limited T cell response to SARS-CoV-2 mRNA vaccine among patients with cancer receiving different cancer treatments. Eur J Cancer Oxf Engl 1990. mayo de 2022;166:229-39.

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Copyright (c) 2024 Abelardo Fernandez-Chávez, Guillermo Ordoñez-León, Ysabel Mendoza-Gómez, Marco Espinel-Ruiz, Carmen Palomar-Fernández, Jesús Aranaz-Andrés

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