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The following is a summary of “Efficacy of Nirmatrelvir/ritonavir in reducing the risk of severe outcome in patients with SARS-CoV-2 infection: a real-life full-matched case-control study (SAVALO Study),” published in the December 2024 issue of Infectious Disease by Gentile et al. 

Ritonavir-boosted nirmatrelvir (N/r) is an antiviral medication targeting the main viral protease of SARS-CoV-2, used to prevent high-risk in patients with severe COVID-19.  

Researchers conducted a retrospective study to examine the efficacy of N/r therapy in SARS-CoV-2 Omicron variant-positive outpatients in the Campania region, Italy, by assessing hospital admission, ICU admission, and death rates in cases and controls.  

They enrolled individuals with SARS-CoV-2-positive who presented at the Early Antiviral Treatment Ambulatory of the Infectious Diseases Ward at University Federico II of Naples, Italy, from January 1 to December 31, 2022, within 5 days of symptom onset. Participants were categorized as cases or controls based on receiving N/r treatment or no treatment, respectively.  

The results showed 1064 patients were included (cases: 423, controls: 1184). Cases had lower mortality compared to controls, with no significant differences in other outcomes. Vaccinated individuals had a lower mortality rate than non-vaccinated ones (0.5% vs 7.8%, P < 0.001). After full-matching propensity score, N/r reduced hospitalization rates only in unvaccinated patients. However, N/r significantly reduced mortality regardless of vaccination status.  

 Investigators concluded the N/r treatment effectively reduced mortality in outpatients with SARS-CoV-2 infection during multiple omicron variant waves, with a more pronounced benefit observed in individuals without vaccination. 

Source: bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-024-10303-5