Association Between Paxlovid and Mortality Rates in Critically Ill Patients With COVID-19 Receiving Invasive Mechanical Ventilation

Paxlovid is a new oral antiviral drug that consists of nirmatrelvir and ritonavir. Current evidence shows that Paxlovid might be effective in patients with mild-to-moderate COVID-19 in terms of reducing mortality and hospitalization rates. 1 Hammond J. Leister-Tebbe H. Gardner A. et al. Oral nirmatrelvir for high-risk, nonhospitalized adults with Covid-19. N Engl J Med. 2022; 386: 1397-1408 Crossref PubMed Scopus (868) Google Scholar ,2 Wong C.K.H. Au I.C.H. Lau K.T.K. Lau E.H.Y. Cowling B.J. Leung G.M. Real-world effectiveness of early molnupiravir or nirmatrelvir–ritonavir in hospitalised patients with COVID-19 without supplemental oxygen requirement on admission during Hong Kong's omicron BA. 2 wave: a retrospective cohort study. Lancet Infect Dis. 2022; 22: 1681-1693 Abstract Full Text Full Text PDF PubMed Scopus (102) Google Scholar Thus, the United States Food and Drug Administration has approved Paxlovid to treat patients with mild-to-moderate COVID-19 who are at increased risk of progression to severe COVID-19. 3 Najjar-Debbiny R, Gronich N, Weber G, et al. Effectiveness of Paxlovid in reducing severe COVID-19 and mortality in high risk patients. Clin Infect Dis. Forthcoming. Google Scholar However, no studies have reported whether it also reduces the risk of death in critically ill patients who receive invasive mechanical ventilation. Therefore, the present study is aimed to evaluate the impact of Paxlovid on the risk of 28-day mortality rates in critically ill patients with COVID-19 who receive invasive mechanical ventilation.