Effectiveness and safety of azvudine in older adults with mild and moderate COVID-19: a retrospective observational study
The study titled “Effectiveness and safety of azvudine in older adults with mild and moderate COVID-19: a retrospective observational study” evaluated the use of azvudine, a nucleoside analog, in treating older adults with mild or moderate COVID-19.
Here’s a detailed summary:
Background of the Study: The COVID-19 pandemic has significantly impacted global health, with older adults particularly at risk due to their likelihood of having comorbidities. Despite the known benefits and safety of azvudine in treating COVID-19, there was limited data on its effectiveness and safety in older adult patients. This study aimed to fill this gap.
Methodology: Conducted at the Central Hospital of Shaoyang, China, this retrospective cohort study included patients aged 80 and above diagnosed with mild or moderate COVID-19 between October and November 2022. Participants were divided into three groups based on their treatment: azvudine, nirmatrelvir/ritonavir, and standard-of-care (SOC). The primary outcomes measured were the progression to severe COVID-19, time to nucleic acid negative conversion (NANC), and NANC rates from admission at different intervals.
Patient Characteristics and Clinical Outcomes: The study included 55 patients: 14 in the azvudine group, 18 in the nirmatrelvir/ritonavir group, and 23 in the SOC group. Results showed that the median time from symptom onset to NANC was shortest in the azvudine group (14 days), followed by the nirmatrelvir/ritonavir (15 days), and SOC groups (19 days). Similarly, the median time from treatment initiation to NANC was shortest for the azvudine group (8 days). No patients in the azvudine or nirmatrelvir/ritonavir groups progressed to severe COVID-19, whereas two patients in the SOC group did. The study also found that azvudine had a higher NANC rate at various intervals compared to the other groups, indicating faster viral clearance.
Discussion: The study concluded that azvudine was effective in reducing the viral load and accelerating viral clearance in older adults with mild to moderate COVID-19. No treatment-related adverse events or serious adverse events were reported, suggesting that azvudine is a safe treatment option for this population. The study supports the use of antiviral drugs in older adults, who often face comorbidities and are at higher risk of poor COVID-19 outcomes.
Limitations: The study had a few limitations, including a small sample size, which limited its statistical power and led to only descriptive analyses being performed. As a retrospective study, there might have been information bias, especially regarding treatment-related adverse events. Additionally, due to limited resources during the Omicron outbreak, there could have been delays in patient admissions and extended times from diagnosis to NANC.
Conclusion: Azvudine showed satisfactory effectiveness and acceptable safety in treating older adults with mild or moderate COVID-19, making it a viable treatment option for this demographic. The study provides valuable insights into managing COVID-19 among older adults, particularly those with multiple comorbidities.