Evidence map›Paper›PMID 40369439›Full record

ArticleBMC infectious diseases2025

Effectiveness and safety of azvudine versus nirmatrelvir/ritonavir in hospitalized patients with COVID-19.

Jin Yang, Jiao Min, Ling Ding, Rong Liu, Ya Yang, Jian-Feng Zhang, Wei Lei

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Jin Yang *Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Jiao Min *Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Ling DingDepartment of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Rong LiuDepartment of Pulmonary and Critical Care Medicine, Suzhou Ninth People's Hospital, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, China.
Ya YangDepartment of Pulmonary and Critical Care Medicine, The Affiliated Huai'an Hospital of Xuzhou Medical University, Huai'an, Jiangsu, China.
Jian-Feng ZhangDepartment of Pulmonary and Critical Care Medicine, Rudong People's Hospital, Affiliated Rudong Hospital of Xinglin College, Nantong University, Nantong, Jiangsu, China.
Wei LeiDepartment of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China. leiweilw@suda.edu.cn.

Funding

the Crosswise tasks of Soochow University P112210923
6 · The paper itself

Abstract

purposeTo compare the effectiveness and safety of two antiviral drugs, azvudine and nirmatrelvir/ritonavir, in treating hospitalized patients with COVID-19.

methodsWe conducted a retrospective analysis of patients who were admitted to the First Affiliated Hospital of Soochow University and diagnosed with SARS-CoV-2 infection between December 2022 and February 2023. These patients were treated with either azvudine or nirmatrelvir/ritonavir.

resultsThe study initially included a total of 1097 patients. After applying a 1:3 propensity score matching, we ultimately included 728 patients, comprising 521 recipients of azvudine and 207 recipients of nirmatrelvir/ritonavir. Among them, 463 patients (88.9%) in the azvudine group and 182 patients (87.9%) in the nirmatrelvir/ritonavir group achieved recovery and discharge, with no significant difference between the two groups (P = 0.816). The median time of improvement was 5.5 days (3.3, 9.0) in the nirmatrelvir/ritonavir group and 5.0 days (4.0, 8.0) in the azvudine group, with no significant difference observed between the two groups (P = 0.732). Furthermore, no significant differences were noted in terms of the time to fever resolution in patients with fever (P = 0.547), the rates of usage of high-flow nasal cannula (P = 0.054), non-invasive mechanical ventilation (P = 0.531), and invasive mechanical ventilation (P = 0.667), the duration of invasive mechanical ventilation usage (P = 0.732), the rate of disease progression (P = 0.602), and hospital length of stay (P = 0.884). Regarding safety outcomes, there was a notable increase in the occurrence of myocardial injury in the nirmatrelvir/ritonavir group (13.5%) compared to the azvudine group (7.3%) (P = 0.012). The two groups did not exhibit differences in the incidence of other adverse events.

conclusionIn hospitalized patients with COVID-19, the effectiveness of azvudine and nirmatrelvir/ritonavir was found to be comparable in various aspects, including the improved discharge rate, the improvement time, time to fever resolution, usage rates of high-flow nasal cannula, non-invasive mechanical ventilation, and invasive mechanical ventilation, rate of disease progression, time to discharge, and hospital length of stay. The occurrence of myocardial injury was higher in nirmatrelvir/ritonavir group compared to azvudine group, while no significant differences were observed in other adverse reactions.

Indexed as

Antiviral AgentsCOVID-19 Drug TreatmentRitonavirAdultAgedCOVID-19Drug CombinationsFemaleHospitalizationHumansMaleMiddle AgedRetrospective StudiesSARS-CoV-2Treatment OutcomeAntiviral AgentsDrug CombinationsRitonavirAzvudineCOVID-19EffectivenessNirmatrelvir/RitonavirSafety

Identifiers

PMID40369439
PMCPMC12079968

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.