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The antiviral drug Paxlovid appears to reduce the risk of dying from COVID-19 by 79% and decrease hospitalizations by 73% in at-risk patients who are ages 65 and older, according to a new study published in The New England Journal of Medicine.
The pill, which is a combination of the drugs nirmatrelvir and ritonavir, received FDA emergency use authorization in December 2021 to treat mild to moderate disease in ages 12 and older who face high risks for having severe COVID-19, hospitalization, and death.
"The results of the study show unequivocally that treatment with Paxlovid significantly reduces the risk of hospitalization and death from COVID-19," Doron Netzer, MD, the senior study author and a researcher with Clalit Health Services in Tel Aviv, Israel, told The Jerusalem Post.
"We are the country's leader in the provision of giving Paxlovid to relevant patients," he said. "It was given to patients all over the country, with medical teams monitoring the patients who took the pills."
The research is considered one of the most thorough studies published to date about how well Paxlovid works, the news outlet reported. The research team analyzed information from Clalit's electronic medical records. The health care organization covers about 52% of the Israeli population and almost two-thirds of older adults. More than 30,000 COVID-19 patients in Israel have been treated with the drug so far.
Netzer and colleagues looked at hospitalization and death data for at-risk COVID-19 patients ages 40 and older between Jan. 9 and March 31, when the original Omicron variant was the dominant strain in Israel. During that time, more than 1.1 million Clalit patients were infected with COVID-19, 109,000 patients were considered at-risk, and 3,900 patients received the drug.
The average age of the patients was 60, and 39% of the patients were 65 and older. Overall, 78% of the patients had previous COVID-19 immunity due to vaccination, prior infection, or both.
Among ages 65 and older, the rate of COVID-19 hospitalization was 14.7 cases per 100,000 person-days among treated patients, as compared with 58.9 cases per 100,000 person-days among untreated patients. This represented a 73% lower chance of being hospitalized.
Among ages 40 to 64, the rate of hospitalization due to COVID-19 was 15.2 cases per 100,000 person-days among treated patients, as compared with 15.8 cases per 100,000 person-days among untreated patients. The risk of hospitalization wasn't significantly lower for this age group.
Among ages 65 and older, there were two deaths from COVID-19 in 2,484 treated patients, as compared with 158 in the 40,337 untreated patients. This represented a 79% lower chance of dying from COVID-19.
Among ages 40 to 64, there was one death from COVID-19 in 1,418 treated patients, as compared with 16 in the 65,015 untreated patients. The risk of death wasn't significantly lower for this age group.
For both age groups, a lack of previous COVID-19 immunity and a previous hospitalization were most strongly linked to high rates of hospitalization during the Omicron wave.
The researchers noted that they didn't break down the data on ages 40 to 64 who had cancer and other severe conditions that weaken the immune system. These patients may be more likely to benefit from Paxlovid, they said, though future studies will need to analyze the data.
The study didn't receive any financial or in-kind support, the authors said.
The New England Journal of Medicine: "Nirmatrelvir Use and Severe Covid-19 Outcomes during the Omicron Surge."
The Jerusalem Post: "Paxlovid reduces risk of COVID-19 death by 81%, Clalit study shows."
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Cite this: Paxlovid Reduces Risk of COVID Death by 79% in Older Adults: Study - Medscape - Aug 26, 2022.