Nirmatrelvir/ritonavir treatment and the risk of post-COVID condition over 180 days in Malaysia

• Published in: BMC infectious diseases Vol. 24; no. 1; pp. 780 - 10
• Main Authors: Low, Ee Vien, Pathmanathan, Mohan Dass, Ten, Yi Yang, Chidambaram, Suresh Kumar, Kim, Wee Ric, Lee, Wei Jia, Teh, Zhi Wei, Appannan, Maheshwara Rao, Ismail, Mastura, Samad, Azah Abdul, Peariasamy, Kalaiarasu M
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 05.08.2024; BioMed Central; BMC
• Subjects: Activities of daily living; Adult; Aged; Antiviral Agents - therapeutic use; Bathing; Clinics; Complications and side effects; COVID-19; COVID-19 - prevention & control; COVID-19 Drug Treatment; COVID-19 vaccines; Diabetes; Emotions; Epidemiology; Fatigue; FDA approval; Female; Health aspects; Hospitalization; Humans; Hypertension; Immunization; Infections; Infectious diseases; Kidney diseases; Long COVID; Malaysia; Malaysia - epidemiology; Male; Medical research; Middle Aged; Mortality; Nirmatrelvir/ritonavir; Pain; Patient outcomes; Patients; Population studies; post-COVID condition; Public health; Quality of Life; Questionnaires; Retrospective Studies; Ritonavir; Ritonavir - therapeutic use; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Vaccination; Malaysia; Malaysia; Nirmatrelvir/ritonavir; Long COVID; post-COVID condition
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-024-09679-1

The effect of nirmatrelvir/ritonavir on preventing post-COVID condition (PCC) in the BA4, BA5, and XBB Omicron predominant periods is not well understood. The purpose of this study was to assess how nirmatrelvir/ritonavir treatment affected both PCC and health-related quality of life. This retrospective cohort study enrolled 2,524 adults aged 18 years and older who were eligible for nirmatrelvir/ritonavir between July 14 to November 14, 2022. All outcomes were observed from the patient's first visit to the primary health clinic, 1 week, 1 month, 3 months, and 6 months after testing positive for COVID-19. The primary outcome was the presence of PCC. Secondary outcomes included the effects on health-related quality of life, such as walking, bathing and dressing, activities, cause adverse emotions or signs that prevent individuals from leading normal lives over a 180-day observation period. There were no significant differences observed between the nirmatrelvir/ritonavir and those not administered (control group) in terms of PCC symptoms at 3 months (OR 0.71 95% CI 0.31, 1.64) and 6 months (OR 1.30 95% CI 0.76, 2.21). At 3 months, the use of nirmatrelvir/ritonavir was associated with a 26% reduction in symptoms causing negative emotions (OR 0.74 95% CI 0.60, 0.92) and an increased likelihood of symptoms limiting walking (OR 1.58 95% CI 1.10, 2.27). However, there were no significant differences between the nirmatrelvir/ritonavir and the control group in terms of the impact of PCC on health-related quality of life at 6 months. Our study indicates that the administration of nirmatrelvir/ritonavir does not significantly reduce PCC after 3 months and 6 months in a population with high vaccination coverage.