{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T15:23:01Z","timestamp":1779895381552,"version":"3.53.1"},"reference-count":44,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,5,22]],"date-time":"2023-05-22T00:00:00Z","timestamp":1684713600000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>This study assessed the clinical efficacy of nirmatrelvir plus ritonavir (NMV\u2010r) in treating patients with coronavirus disease\u20102019 (COVID\u201019) and substance use disorders (SUDs). This study included two cohorts: the first examined patients with SUDs, with and without a prescription for NMV\u2010r, while the second compared patients prescribed with NMV\u2010r, with and without a diagnosis of SUDs. SUDs were defined using ICD\u201010 codes, related to SUDs, including alcohol, cannabis, cocaine, opioid, and tobacco use disorders (TUD). Patients with underlying SUDs and COVID\u201019 were identified using the TriNetX network. We used 1:1 propensity score matching to create balanced groups. The primary outcome of interest was the composite outcome of all\u2010cause hospitalization or death within 30 days. Propensity score matching yielded two matched groups of 10\u2009601 patients each. The results showed that the use of NMV\u2010r was associated with a lower risk of hospitalization or death, 30 days after COVID\u201019 diagnosis (hazard ratio (HR), 0.640; 95% confidence interval (CI): 0.543\u20130.754), as well as a lower risk of all\u2010cause hospitalization (HR, 0.699; 95% CI: 0.592\u20130.826) and all\u2010cause death (HR, 0.084; 95% CI: 0.026\u20130.273). However, patients with SUDs had a higher risk of hospitalized or death within 30 days of COVID\u201019 diagnosis than those without SUDs, even with the use of NMV\u2010r (HR, 1.783; 95% CI: 1.399\u20132.271). The study also found that patients with SUDs had a higher prevalence of comorbidities and adverse socioeconomic determinants of health than those without SUDs. Subgroup analysis showed that the benefits of NMV\u2010r were consistent across most subgroups with different characteristics, including age (patients aged \u226560 years [HR, 0.507; 95% CI: 0.402\u20130.640]), sex (women [HR, 0.636; 95% CI: 0.517\u20130.783] and men [HR, 0.480; 95% CI: 0.373\u20130.618]), vaccine status (vaccinated &lt;2 doses [HR, 0.514; 95% CI: 0.435\u20130.608]), SUD subtypes (alcohol use disorder [HR, 0.711; 95% CI: 0.511\u2013 0.988], TUD [HR, 0.666; 95% CI: 0.555\u20130.800]) and Omicron wave (HR, 0.624; 95% CI: 0.536\u20130.726). Our findings indicate that NMV\u2010r could reduce all\u2010cause hospitalization and death in the treatment of COVID\u201019 among patients with SUDs and support the use of NMV\u2010r for treating patients with SUDs and COVID\u201019.<\/jats:p>","DOI":"10.1002\/jmv.28801","type":"journal-article","created":{"date-parts":[[2023,5,23]],"date-time":"2023-05-23T06:28:16Z","timestamp":1684823296000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Clinical effectiveness of nirmatrelvir plus ritonavir in patients with COVID\u201019 and substance use disorders based on real\u2010world data"],"prefix":"10.1002","volume":"95","author":[{"given":"Ting\u2010Hui","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Psychiatry Chi Mei Medical Center Tainan 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