Antiviral effectiveness and safety of azvudine in hospitalized SARS‐CoV‐2 patients with pre‐existing chronic respiratory diseases: A multicenter, retrospective cohort study
Abstract Although azvudine has become a priority in the treatment of SARS‐CoV‐2, its effectiveness and safety among COVID‐19 patients who already have chronic respiratory diseases (CRDs) have not been sufficiently validated. A retrospective, multicenter cohort study involving 10 hospitals in Henan P...
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Wiley
2025-04-01
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| Online Access: | https://doi.org/10.1002/VIW.20240133 |
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| author | Junyi Sun Mengzhao Yang Daoke Yao Yongjian Zhou Xiaobo Hu Guowu Qian Yiqiang Yuan Silin Li Hong Luo Shixi Zhang Guangming Li Donghua Zhang Guotao Li Yanyang Zhang Xinjun Hu Zujiang Yu Guangying Cui Zhigang Ren |
| author_facet | Junyi Sun Mengzhao Yang Daoke Yao Yongjian Zhou Xiaobo Hu Guowu Qian Yiqiang Yuan Silin Li Hong Luo Shixi Zhang Guangming Li Donghua Zhang Guotao Li Yanyang Zhang Xinjun Hu Zujiang Yu Guangying Cui Zhigang Ren |
| author_sort | Junyi Sun |
| collection | DOAJ |
| description | Abstract Although azvudine has become a priority in the treatment of SARS‐CoV‐2, its effectiveness and safety among COVID‐19 patients who already have chronic respiratory diseases (CRDs) have not been sufficiently validated. A retrospective, multicenter cohort study involving 10 hospitals in Henan Province was performed to assess inpatients with COVID‐19 and CRDs (Clinical Trial Registration Number: NCT06349655). Azvudine recipients and the control group were matched at a 1:1 ratio using propensity scores. The clinical outcomes (all‐cause death and composite disease progression) were analyzed using Kaplan‒Meier and Cox regression analyses, with additional subgroup and sensitivity analyses performed. Eighteen clinical features were included to construct a nomogram for predicting the survival of inpatients with COVID‐19 and CRDs. Out of 37,606 hospitalized COVID‐19 patients, 1462 azvudine recipients and 1462 matched controls were included in the analysis. The results of Kaplan‒Meier and multivariate Cox regression analyses demonstrated that in contrast to the controls, azvudine use was associated with a decreased risk of all‐cause death in patients with COVID‐19 and pre‐existing CRDs (log‐rank: p = .012; HR: 0.73; 95% CI: 0.553‒0.956); but was not significantly different in terms of composite disease progression (log‐rank: p = .82; HR: 1.15; 95% CI: 0.948‒1.383). An analysis of subgroups and three sensitivity appraisals validate the above outcomes. The number and type of adverse events associated with azvudine treatment were acceptable. The concordance index (0.8499, 0.8497) and area under the curve (86.1%, 80.4%) of the nomogram showed satisfactory discriminative ability in the training and test sets. Azvudine could be effective in reducing all‐cause death among inpatients with COVID‐19 and CRDs and had few serious adverse events. |
| format | Article |
| id | doaj-art-1f24f304b6274cb486d6cbab294f6cee |
| institution | OA Journals |
| issn | 2688-3988 2688-268X |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Wiley |
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| spelling | doaj-art-1f24f304b6274cb486d6cbab294f6cee2025-08-20T02:12:38ZengWileyView2688-39882688-268X2025-04-0162n/an/a10.1002/VIW.20240133Antiviral effectiveness and safety of azvudine in hospitalized SARS‐CoV‐2 patients with pre‐existing chronic respiratory diseases: A multicenter, retrospective cohort studyJunyi Sun0Mengzhao Yang1Daoke Yao2Yongjian Zhou3Xiaobo Hu4Guowu Qian5Yiqiang Yuan6Silin Li7Hong Luo8Shixi Zhang9Guangming Li10Donghua Zhang11Guotao Li12Yanyang Zhang13Xinjun Hu14Zujiang Yu15Guangying Cui16Zhigang Ren17Department of Infectious Diseases State Key Laboratory of Antiviral Drugs Pingyuan Laboratory The First Affiliated Hospital of Zhengzhou University Zhengzhou ChinaDepartment of Infectious Diseases State Key Laboratory of Antiviral Drugs Pingyuan Laboratory The First Affiliated Hospital of Zhengzhou University Zhengzhou ChinaDepartment of Anesthesiology and Perioperative Medicine The Second Affiliated Hospital of Zhengzhou University Zhengzhou ChinaDepartment of Infectious Diseases State Key Laboratory of Antiviral Drugs Pingyuan Laboratory The First Affiliated Hospital of Zhengzhou University Zhengzhou ChinaDepartment of Infectious Diseases State Key Laboratory of Antiviral Drugs Pingyuan Laboratory The First Affiliated Hospital of Zhengzhou University Zhengzhou ChinaDepartment of Gastrointestinal Surgery Nanyang Central Hospital Nanyang ChinaDepartment of Cardiovascular Medicine Henan Provincial Chest Hospital Affiliated to Zhengzhou University Zhengzhou ChinaDepartment of Respiratory and Critical Care Medicine Fengqiu County People's Hospital Xinxiang ChinaGuangshan County People's Hospital Guangshan County Xinyang ChinaDepartment of Infectious Diseases Shangqiu Municipal Hospital Shangqiu Henan Province ChinaDepartment of Liver Disease The Affiliated Infectious Disease Hospital of Zhengzhou University Zhengzhou ChinaDepartment of Infectious Diseases Anyang City Fifth People's Hospital Anyang ChinaDepartment of Infectious Diseases Luoyang Central Hospital Affiliated to Zhengzhou University Luoyang ChinaHenan Center for Disease Control and Prevention Zhengzhou ChinaDepartment of Infectious Diseases The First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and Technology Luoyang ChinaDepartment of Infectious Diseases State Key Laboratory of Antiviral Drugs Pingyuan Laboratory The First Affiliated Hospital of Zhengzhou University Zhengzhou ChinaDepartment of Infectious Diseases State Key Laboratory of Antiviral Drugs Pingyuan Laboratory The First Affiliated Hospital of Zhengzhou University Zhengzhou ChinaDepartment of Infectious Diseases State Key Laboratory of Antiviral Drugs Pingyuan Laboratory The First Affiliated Hospital of Zhengzhou University Zhengzhou ChinaAbstract Although azvudine has become a priority in the treatment of SARS‐CoV‐2, its effectiveness and safety among COVID‐19 patients who already have chronic respiratory diseases (CRDs) have not been sufficiently validated. A retrospective, multicenter cohort study involving 10 hospitals in Henan Province was performed to assess inpatients with COVID‐19 and CRDs (Clinical Trial Registration Number: NCT06349655). Azvudine recipients and the control group were matched at a 1:1 ratio using propensity scores. The clinical outcomes (all‐cause death and composite disease progression) were analyzed using Kaplan‒Meier and Cox regression analyses, with additional subgroup and sensitivity analyses performed. Eighteen clinical features were included to construct a nomogram for predicting the survival of inpatients with COVID‐19 and CRDs. Out of 37,606 hospitalized COVID‐19 patients, 1462 azvudine recipients and 1462 matched controls were included in the analysis. The results of Kaplan‒Meier and multivariate Cox regression analyses demonstrated that in contrast to the controls, azvudine use was associated with a decreased risk of all‐cause death in patients with COVID‐19 and pre‐existing CRDs (log‐rank: p = .012; HR: 0.73; 95% CI: 0.553‒0.956); but was not significantly different in terms of composite disease progression (log‐rank: p = .82; HR: 1.15; 95% CI: 0.948‒1.383). An analysis of subgroups and three sensitivity appraisals validate the above outcomes. The number and type of adverse events associated with azvudine treatment were acceptable. The concordance index (0.8499, 0.8497) and area under the curve (86.1%, 80.4%) of the nomogram showed satisfactory discriminative ability in the training and test sets. Azvudine could be effective in reducing all‐cause death among inpatients with COVID‐19 and CRDs and had few serious adverse events.https://doi.org/10.1002/VIW.20240133azvudinechronic respiratory diseasesreal worldSARS‐CoV‐2 |
| spellingShingle | Junyi Sun Mengzhao Yang Daoke Yao Yongjian Zhou Xiaobo Hu Guowu Qian Yiqiang Yuan Silin Li Hong Luo Shixi Zhang Guangming Li Donghua Zhang Guotao Li Yanyang Zhang Xinjun Hu Zujiang Yu Guangying Cui Zhigang Ren Antiviral effectiveness and safety of azvudine in hospitalized SARS‐CoV‐2 patients with pre‐existing chronic respiratory diseases: A multicenter, retrospective cohort study View azvudine chronic respiratory diseases real world SARS‐CoV‐2 |
| title | Antiviral effectiveness and safety of azvudine in hospitalized SARS‐CoV‐2 patients with pre‐existing chronic respiratory diseases: A multicenter, retrospective cohort study |
| title_full | Antiviral effectiveness and safety of azvudine in hospitalized SARS‐CoV‐2 patients with pre‐existing chronic respiratory diseases: A multicenter, retrospective cohort study |
| title_fullStr | Antiviral effectiveness and safety of azvudine in hospitalized SARS‐CoV‐2 patients with pre‐existing chronic respiratory diseases: A multicenter, retrospective cohort study |
| title_full_unstemmed | Antiviral effectiveness and safety of azvudine in hospitalized SARS‐CoV‐2 patients with pre‐existing chronic respiratory diseases: A multicenter, retrospective cohort study |
| title_short | Antiviral effectiveness and safety of azvudine in hospitalized SARS‐CoV‐2 patients with pre‐existing chronic respiratory diseases: A multicenter, retrospective cohort study |
| title_sort | antiviral effectiveness and safety of azvudine in hospitalized sars cov 2 patients with pre existing chronic respiratory diseases a multicenter retrospective cohort study |
| topic | azvudine chronic respiratory diseases real world SARS‐CoV‐2 |
| url | https://doi.org/10.1002/VIW.20240133 |
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