Effectiveness of Vaccines and Antiviral Drugs in Preventing Severe and Fatal COVID-19, Hong Kong

We compared the effectiveness and interactions of molnupiravir and nirmatrelvir/ritonavir and 2 vaccines, CoronaVac and Comirnaty, in a large population of inpatients with COVID-19 in Hong Kong. Both the oral antiviral drugs and vaccines were associated with lower risks for all-cause mortality and p...

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Bibliographic Details
Published in:	Emerging infectious diseases 2024-01, Vol.30 (1), p.70-78
Main Authors:	Cheung, Yue Yat Harrison, Lau, Eric Ho Yin, Yin, Guosheng, Lin, Yun, Cowling, Benjamin J, Lam, Kwok Fai
Format:	Article
Language:	eng
Subjects:	Age Antiviral agents Antiviral Agents - therapeutic use Antiviral drugs BNT162 Vaccine Child, Preschool China Clinical outcomes Clinical trials Comirnaty Comorbidity Comparative analysis Complications and side effects CoronaVac COVID-19 COVID-19 - prevention & control COVID-19 Testing COVID-19 Vaccines Drug dosages Drugs Effectiveness of Vaccines and Antiviral Drugs in Preventing Severe and Fatal COVID-19, Hong Kong Evaluation Gender Health aspects Hong Kong Hong Kong - epidemiology Hospital patients Hospitalization Humans Infections molnupiravir Mortality nirmatrelvir Pandemics Patient outcomes Patients Performance evaluation Prescription drugs ritonavir Severe acute respiratory syndrome coronavirus 2 Vaccination Vaccines Variables
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Summary:	We compared the effectiveness and interactions of molnupiravir and nirmatrelvir/ritonavir and 2 vaccines, CoronaVac and Comirnaty, in a large population of inpatients with COVID-19 in Hong Kong. Both the oral antiviral drugs and vaccines were associated with lower risks for all-cause mortality and progression to serious/critical/fatal conditions (study outcomes). No significant interaction effects were observed between the antiviral drugs and vaccinations; their joint effects were additive. If antiviral drugs were prescribed within 5 days of confirmed COVID-19 diagnosis, usage was associated with lower risks for the target outcomes for patients >60, but not 80 years of age, 3-4 doses of Comirnaty vaccine were associated with significantly lower risks for target outcomes. Policies should encourage COVID-19 vaccination, and oral antivirals should be made accessible to infected persons within 5 days of confirmed diagnosis.
ISSN:	1080-6040 1080-6059