Nirmatrelvir–ritonavir compared with other antiviral drugs for the treatment of COVID‐19 patients: A systematic review and meta‐analysis

Abstract

AbstractAt present, there are some differences in the research results of nirmatrelvir–ritonavir compared with other antiviral drugs for the treatment of COVID‐19 patients. We aimed to evaluate the efficacy and safety of nirmatrelvir–ritonavir compared with other antiviral drugs and the impact of different antiviral drugs on the short‐ and long‐term effects of COVID‐19. PubMed, Embase, CENTRAL (Cochrane Central Register of Controlled Trials), Web of Science, Google Scholar, and MedRxiv were searched to identify relevant studies from inception to March 30, 2023. We conducted a meta‐analysis to estimate the effects of nirmatrelvir–ritonavir compared with other antiviral drugs for the treatment of COVID‐19 patients and safety outcomes. The RoB1 and ROBINS‐I were used to assess the bias risk of the included studies. Revman 5.4 software was used for meta‐analysis (PROSPERO Code No: CRD42023397816). Twelve studies were included, including 30 588 COVID‐19 patients, of whom 13 402 received nirmatrelvir–ritonavir. The meta‐analysis results showed that the nirmatrelvir–ritonavir group had a lower proportion of patients than the control group in terms of long‐term mortality (odds ratio [OR] = 0.29, 95% confidence interval [CI]: 0.13–0.66), hospitalization (OR = 0.44, 95% CI: 0.37–0.53, short term; OR = 0.52, 95% CI: 0.36–0.77, long term), and disease progression (OR = 0.56, 95% CI: 0.38–0.83, short term; OR = 0.60, 95% CI: 0.48–0.74, long term), and nirmatrelvir ritonavir showed little difference in safety compared to the control group. Nirmatrelvir–ritonavir can reduce the mortality and hospitalization of COVID‐19 patients compared with other antiviral drugs. Further large‐scale studies remain to validate these findings.