Risk of postacute sequelae of COVID-19 and oral antivirals in adults aged over 60 years: A nationwide retrospective cohort study
Objectives: To investigate the association between oral antiviral administration and postacute sequelae of COVID-19 (PASC) risk in Korea. Methods: This retrospective cohort study used data from the Korea Disease Control and Prevention Agency and the Health Insurance Review and Assessment Service. We...
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Elsevier
2025-05-01
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| Series: | International Journal of Infectious Diseases |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971225000736 |
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| author | Hyejin Joo Eunji Kim Kyungmin Huh Gi Hwan Bae Hyungmin Lee Jungyeon Kim Dong-Hwi Kim Min-Gyu Yoo Il Uk Jo Poong Hoon Lee Geun Woo Lee Hee Sun Jung Jaehun Jung |
| author_facet | Hyejin Joo Eunji Kim Kyungmin Huh Gi Hwan Bae Hyungmin Lee Jungyeon Kim Dong-Hwi Kim Min-Gyu Yoo Il Uk Jo Poong Hoon Lee Geun Woo Lee Hee Sun Jung Jaehun Jung |
| author_sort | Hyejin Joo |
| collection | DOAJ |
| description | Objectives: To investigate the association between oral antiviral administration and postacute sequelae of COVID-19 (PASC) risk in Korea. Methods: This retrospective cohort study used data from the Korea Disease Control and Prevention Agency and the Health Insurance Review and Assessment Service. We analyzed data from COVID-19 patients aged >60 years from January to December 2022. The primary outcome was the occurrence of 27 PASCs within 30-120 days after COVID-19 diagnosis. The hazard ratio was calculated using the Cox proportional hazards model. Results: Nirmatrelvir/ritonavir significantly reduced the risk of cardiovascular diseases, including heart failure and cardiomyopathies (adjusted hazard ratio [aHR], 0.86), cardiac dysrhythmias (aHR, 0.83), and ischemic stroke (aHR, 0.88). Moreover, it also lowered the risk of hospitalization due to respiratory diseases including chronic obstructive pulmonary disease (aHR, 0.92), and decreased renal disorders including dialysis needs (aHR, 0.57), and acute renal failure (aHR, 0.85). Molnupiravir reduced the risk of ischemic stroke (aHR, 0.84) and other cerebrovascular diseases (aHR, 0.84). Respiratory conditions decreased by approximately 13-14% (aHR, 0.87 and 0.86, respectively). Conclusions: Nirmatrelvir/ritonavir and molnupiravir administration in ambulatory patients were associated with decreased PASC risk; thus, oral antivirals may mitigate the indirect Severe acute respiratory syndrome coronavirus 2 infection effects. |
| format | Article |
| id | doaj-art-80461e3aecc446ce93d2f9e2e2dcaeb7 |
| institution | DOAJ |
| issn | 1201-9712 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj-art-80461e3aecc446ce93d2f9e2e2dcaeb72025-08-20T03:08:47ZengElsevierInternational Journal of Infectious Diseases1201-97122025-05-0115410785010.1016/j.ijid.2025.107850Risk of postacute sequelae of COVID-19 and oral antivirals in adults aged over 60 years: A nationwide retrospective cohort studyHyejin Joo0Eunji Kim1Kyungmin Huh2Gi Hwan Bae3Hyungmin Lee4Jungyeon Kim5Dong-Hwi Kim6Min-Gyu Yoo7Il Uk Jo8Poong Hoon Lee9Geun Woo Lee10Hee Sun Jung11Jaehun Jung12Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea; Institute for Future Public Health, Graduate School of Public Health, Korea University, Seoul, Republic of KoreaDepartment of Preventive Medicine, Gachon University College of Medicine, Incheon, Republic of KoreaDepartment of Medicine, Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDepartment of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea; Institute for Future Public Health, Graduate School of Public Health, Korea University, Seoul, Republic of KoreaPatient Management Team, Central Headquarters of COVID-19, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea; Division of Immunization, Korea Disease Control and Prevention Agency, Cheongju, Republic of KoreaPatient Management Team, Central Headquarters of COVID-19, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea; Division of Clinical Research, Center for Emerging Virus Research, National Institute of Infectious Disease, Korea Disease Control and Prevention Agency, Cheongju, Republic of KoreaPatient Management Team, Central Headquarters of COVID-19, Korea Disease Control and Prevention Agency, Cheongju, Republic of KoreaPatient Management Team, Central Headquarters of COVID-19, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea; Division of Public Health Emergency Response Research, Bureau of Public Health Emergency Preparedness, Korea Disease Control and Prevention Agency, Cheongju, Republic of KoreaBig Data Management Division, Health Insurance Review & Assessment Service, Wonju, Republic of KoreaBig Data Management Division, Health Insurance Review & Assessment Service, Wonju, Republic of KoreaBig Data Management Division, Health Insurance Review & Assessment Service, Wonju, Republic of KoreaBig Data Management Division, Health Insurance Review & Assessment Service, Wonju, Republic of KoreaDepartment of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea; Corresponding author: Jaehun Jung, Department of Preventive Medicine, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea.Objectives: To investigate the association between oral antiviral administration and postacute sequelae of COVID-19 (PASC) risk in Korea. Methods: This retrospective cohort study used data from the Korea Disease Control and Prevention Agency and the Health Insurance Review and Assessment Service. We analyzed data from COVID-19 patients aged >60 years from January to December 2022. The primary outcome was the occurrence of 27 PASCs within 30-120 days after COVID-19 diagnosis. The hazard ratio was calculated using the Cox proportional hazards model. Results: Nirmatrelvir/ritonavir significantly reduced the risk of cardiovascular diseases, including heart failure and cardiomyopathies (adjusted hazard ratio [aHR], 0.86), cardiac dysrhythmias (aHR, 0.83), and ischemic stroke (aHR, 0.88). Moreover, it also lowered the risk of hospitalization due to respiratory diseases including chronic obstructive pulmonary disease (aHR, 0.92), and decreased renal disorders including dialysis needs (aHR, 0.57), and acute renal failure (aHR, 0.85). Molnupiravir reduced the risk of ischemic stroke (aHR, 0.84) and other cerebrovascular diseases (aHR, 0.84). Respiratory conditions decreased by approximately 13-14% (aHR, 0.87 and 0.86, respectively). Conclusions: Nirmatrelvir/ritonavir and molnupiravir administration in ambulatory patients were associated with decreased PASC risk; thus, oral antivirals may mitigate the indirect Severe acute respiratory syndrome coronavirus 2 infection effects.http://www.sciencedirect.com/science/article/pii/S1201971225000736COVID-19Antiviral agentsPostacute sequelae of COVID-19 (PASC)Nirmatrelvir/ritonavirMolnupiravirRetrospective cohort study |
| spellingShingle | Hyejin Joo Eunji Kim Kyungmin Huh Gi Hwan Bae Hyungmin Lee Jungyeon Kim Dong-Hwi Kim Min-Gyu Yoo Il Uk Jo Poong Hoon Lee Geun Woo Lee Hee Sun Jung Jaehun Jung Risk of postacute sequelae of COVID-19 and oral antivirals in adults aged over 60 years: A nationwide retrospective cohort study International Journal of Infectious Diseases COVID-19 Antiviral agents Postacute sequelae of COVID-19 (PASC) Nirmatrelvir/ritonavir Molnupiravir Retrospective cohort study |
| title | Risk of postacute sequelae of COVID-19 and oral antivirals in adults aged over 60 years: A nationwide retrospective cohort study |
| title_full | Risk of postacute sequelae of COVID-19 and oral antivirals in adults aged over 60 years: A nationwide retrospective cohort study |
| title_fullStr | Risk of postacute sequelae of COVID-19 and oral antivirals in adults aged over 60 years: A nationwide retrospective cohort study |
| title_full_unstemmed | Risk of postacute sequelae of COVID-19 and oral antivirals in adults aged over 60 years: A nationwide retrospective cohort study |
| title_short | Risk of postacute sequelae of COVID-19 and oral antivirals in adults aged over 60 years: A nationwide retrospective cohort study |
| title_sort | risk of postacute sequelae of covid 19 and oral antivirals in adults aged over 60 years a nationwide retrospective cohort study |
| topic | COVID-19 Antiviral agents Postacute sequelae of COVID-19 (PASC) Nirmatrelvir/ritonavir Molnupiravir Retrospective cohort study |
| url | http://www.sciencedirect.com/science/article/pii/S1201971225000736 |
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