國家衛生研究院 NHRI:Item 3990099045/14925
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    题名: Factors associated with viral rebound among COVID-19 patients receiving oral antivirals
    作者: Chen, PY;Wang, JT;Chang, SY;Hung, CC;Fang, CT;Cheng, A;Liu, WD;Huang, YS;Lin, KY;Sun, HY;Pan, SC;Cheng, YC;Wang, HY;Sheng, WH;Chen, YC;Ho, YL;Wu, MS;Chang, SC
    贡献者: National Institute of Infectious Diseases and Vaccinology
    摘要: Background: COVID-19 rebound is usually reported among patients experiencing concurrent symptomatic and viral rebound. But longitudinal viral RT-PCR results from early stage to rebound of COVID-19 was less characterized. Further, identifying the factors associated with viral rebound after nirmatrelvir-ritonavir (NMV/r) and molnupiravir may expand understanding of COVID-19 rebound. Methods: We retrospectively analyzed clinical data and sequential viral RT-PCR results from COVID-19 patients receiving oral antivirals between April and May, 2022. Viral rebound was defined by the degree of viral load increase (ΔCt ≥ 5 units). Results: A total of 58 and 27 COVID-19 patients taking NMV/r and molnupiravir, respectively, were enrolled. Patients receiving NMV/r were younger, had fewer risk factors for disease progression and faster viral clearance rate compared to those receiving molnupiravr (All P < 0.05). The overall proportion of viral rebound (n = 11) was 12.9%, which was more common among patients receiving NMV/r (10 [17.2%] vs. 1 [3.7%], P = 0.16). Of them, 5 patients experienced symptomatic rebound, suggesting the proportion of COVID-19 rebound was 5.9%. The median interval to viral rebound was 5.0 (interquartile range, 2.0–8.0) days after completion of antivirals. Initial lymphopenia (<0.8 × 109/L) was associated with viral rebound among overall population (adjusted odds ratio [aOR], 5.34; 95% confidence interval [CI], 1.33–21.71), and remained significant (aOR, 4.50; 95% CI, 1.05–19.25) even when patients receiving NMV/r were considered. Conclusion: Our data suggest viral rebound after oral antivirals may be more commonly observed among lymphopenic individuals in the context of SARS-CoV-2 Omicron BA.2 variant.
    日期: 2023-08
    關聯: Journal of the Formosan Medical Association. 2023 Aug;122(8):766-775.
    Link to: http://dx.doi.org/10.1016/j.jfma.2023.02.008
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=0929-6646&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:001148263700001
    Cited Times(Scopus): https://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85150257613
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