Systematic evaluation of therapeutic effectiveness of Azvudine in treating COVID-19 hospitalized patients: a retrospective cohort study

BackgroundAzvudine, a repurposed oral small molecule antiviral drug, has potential effects in combating the SARS-CoV-2 virus. However, studies on its clinical efficacy in patients with COVID-19 are still limited and controversial, and further research and validation are necessary.MethodsA retrospect...

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Main Authors: Yingkai Xu, Yuan Huang, Zihan Yuan, Wanbing Liu, Li Wang, Lei Liu
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-11-01
Series:Frontiers in Cellular and Infection Microbiology
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Online Access:https://www.frontiersin.org/articles/10.3389/fcimb.2024.1453234/full
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author Yingkai Xu
Yingkai Xu
Yuan Huang
Zihan Yuan
Zihan Yuan
Wanbing Liu
Li Wang
Lei Liu
author_facet Yingkai Xu
Yingkai Xu
Yuan Huang
Zihan Yuan
Zihan Yuan
Wanbing Liu
Li Wang
Lei Liu
author_sort Yingkai Xu
collection DOAJ
description BackgroundAzvudine, a repurposed oral small molecule antiviral drug, has potential effects in combating the SARS-CoV-2 virus. However, studies on its clinical efficacy in patients with COVID-19 are still limited and controversial, and further research and validation are necessary.MethodsA retrospective cohort study was conducted on COVID-19 patients who were hospitalized in the General Hospital of Central Theater Command from 1 December 2022 to 31 January 2023. We included 132 patients treated with Azvudine and 132 controls after screening and propensity score matching. The primary outcomes including all-cause mortality and a composite outcome of disease progression such as non-invasive respiratory support, invasive respiratory support, admission to intensive care unit (ICU), and death were compared.ResultsAzvudine recipients had a much lower incidence rate of composite disease progression outcome than controls (13.9075/1000 person-days versus 25.7731/1000 person-days, P<0.05). Azvudine recipients also possessed a lower all-cause mortality rate than controls (2.6797/1000 person-days versus 8.5910/1000 person-days, P<0.01). Azvudine treatment significantly reduced the risk of composite disease progression (HR: 0.37, 95% CI: 0.16-0.84, P=0.017) and all-cause death (HR: 0.25, 95% CI: 0.08-0.81, P=0.021) after adjusting potential confounding factors such as age, sex, severity of COVID-19, complications, concomitant therapy, time from symptoms to treatment, and important laboratory indicators. The subgroup analyses of composite disease progression outcome and all-cause death indicated robustness of Azvudine’s in treating COVID-19 patients in general.ConclusionOur study demonstrates that Azvudine has a significant positive impact on the clinical recovery of hospitalized patients with COVID-19. These findings provide important support for the use of Azvudine as a therapeutic option for COVID-19, given the current divergent views on its therapeutic efficacy and its importance in public health and medical care.
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spelling doaj-art-2ca0bba0526c41a2917078c0c43a63bf2025-08-20T02:12:42ZengFrontiers Media S.A.Frontiers in Cellular and Infection Microbiology2235-29882024-11-011410.3389/fcimb.2024.14532341453234Systematic evaluation of therapeutic effectiveness of Azvudine in treating COVID-19 hospitalized patients: a retrospective cohort studyYingkai Xu0Yingkai Xu1Yuan Huang2Zihan Yuan3Zihan Yuan4Wanbing Liu5Li Wang6Lei Liu7Medical College, Wuhan University of Science and Technology, Wuhan, Hubei, ChinaDepartment of Transfusion Medicine; General Hospital of Central Theater Command, Wuhan, Hubei, ChinaDepartment of Gynaecology and Obstetrics; General Hospital of Central Theater Command, Wuhan, Hubei, ChinaMedical College, Wuhan University of Science and Technology, Wuhan, Hubei, ChinaDepartment of Transfusion Medicine; General Hospital of Central Theater Command, Wuhan, Hubei, ChinaDepartment of Transfusion Medicine; General Hospital of Central Theater Command, Wuhan, Hubei, ChinaDepartment of Clinical Laboratory, The First Affiliated Hospital of Henan University, Kaifeng, Henan, ChinaDepartment of Transfusion Medicine; General Hospital of Central Theater Command, Wuhan, Hubei, ChinaBackgroundAzvudine, a repurposed oral small molecule antiviral drug, has potential effects in combating the SARS-CoV-2 virus. However, studies on its clinical efficacy in patients with COVID-19 are still limited and controversial, and further research and validation are necessary.MethodsA retrospective cohort study was conducted on COVID-19 patients who were hospitalized in the General Hospital of Central Theater Command from 1 December 2022 to 31 January 2023. We included 132 patients treated with Azvudine and 132 controls after screening and propensity score matching. The primary outcomes including all-cause mortality and a composite outcome of disease progression such as non-invasive respiratory support, invasive respiratory support, admission to intensive care unit (ICU), and death were compared.ResultsAzvudine recipients had a much lower incidence rate of composite disease progression outcome than controls (13.9075/1000 person-days versus 25.7731/1000 person-days, P<0.05). Azvudine recipients also possessed a lower all-cause mortality rate than controls (2.6797/1000 person-days versus 8.5910/1000 person-days, P<0.01). Azvudine treatment significantly reduced the risk of composite disease progression (HR: 0.37, 95% CI: 0.16-0.84, P=0.017) and all-cause death (HR: 0.25, 95% CI: 0.08-0.81, P=0.021) after adjusting potential confounding factors such as age, sex, severity of COVID-19, complications, concomitant therapy, time from symptoms to treatment, and important laboratory indicators. The subgroup analyses of composite disease progression outcome and all-cause death indicated robustness of Azvudine’s in treating COVID-19 patients in general.ConclusionOur study demonstrates that Azvudine has a significant positive impact on the clinical recovery of hospitalized patients with COVID-19. These findings provide important support for the use of Azvudine as a therapeutic option for COVID-19, given the current divergent views on its therapeutic efficacy and its importance in public health and medical care.https://www.frontiersin.org/articles/10.3389/fcimb.2024.1453234/fullCOVID-19Azvudinecomposite disease progression outcomeall-cause deathretrospective cohort study
spellingShingle Yingkai Xu
Yingkai Xu
Yuan Huang
Zihan Yuan
Zihan Yuan
Wanbing Liu
Li Wang
Lei Liu
Systematic evaluation of therapeutic effectiveness of Azvudine in treating COVID-19 hospitalized patients: a retrospective cohort study
Frontiers in Cellular and Infection Microbiology
COVID-19
Azvudine
composite disease progression outcome
all-cause death
retrospective cohort study
title Systematic evaluation of therapeutic effectiveness of Azvudine in treating COVID-19 hospitalized patients: a retrospective cohort study
title_full Systematic evaluation of therapeutic effectiveness of Azvudine in treating COVID-19 hospitalized patients: a retrospective cohort study
title_fullStr Systematic evaluation of therapeutic effectiveness of Azvudine in treating COVID-19 hospitalized patients: a retrospective cohort study
title_full_unstemmed Systematic evaluation of therapeutic effectiveness of Azvudine in treating COVID-19 hospitalized patients: a retrospective cohort study
title_short Systematic evaluation of therapeutic effectiveness of Azvudine in treating COVID-19 hospitalized patients: a retrospective cohort study
title_sort systematic evaluation of therapeutic effectiveness of azvudine in treating covid 19 hospitalized patients a retrospective cohort study
topic COVID-19
Azvudine
composite disease progression outcome
all-cause death
retrospective cohort study
url https://www.frontiersin.org/articles/10.3389/fcimb.2024.1453234/full
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