{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T08:40:19Z","timestamp":1774428019052,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,4,21]],"date-time":"2023-04-21T00:00:00Z","timestamp":1682035200000},"content-version":"vor","delay-in-days":20,"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":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The effect of nirmatrelvir plus ritonavir (NMV\u2010r) on post\u2010acute COVID\u201019 sequelae beyond 3 months of SARS\u2010CoV\u20102 infection remains unknown. This retrospective cohort study utilized data from the TriNetX Research Network. We identified nonhospitalized adult patients with COVID\u201019 receiving a diagnosis between January 1 and July 31, 2022. Propensity score matching (PSM) was used to create two matched cohorts: NMV\u2010r and non\u2010NMV\u2010r groups, respectively. We measured the primary outcomes using a composite of all\u2010cause emergency room (ER) visits or hospitalization and a composite of post\u2010COVID\u201019 symptoms according to the WHO Delphi consensus, which also stated that post COVID\u201019 condition occurs usually 3 months from the onset of COVID\u201019, during the follow\u2010up period between 90 days after the index diagnosis of COVID\u201019 and the end of follow\u2010up (180 days). Initially, we identified 12\u2009247 patients that received NMV\u2010r within 5 days of diagnosis and 465\u2009135 that did not. After PSM, 12\u2009245 patients remained in each group. During the follow\u2010up period, patients treated with NMV\u2010r had a lower risk of all\u2010cause hospitalization and ER visits compared with untreated patients (659 vs. 955; odds ratio [OR], 0.672; 95% confidence interval [CI], 0.607\u20130.745; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). However, the overall risk of post\u2010acute COVID\u201019 symptoms did not significantly differ between the two groups (2265 vs. 2187; OR, 1.043; 95% CI, 0.978\u20131.114; <jats:italic>p<\/jats:italic>\u2009=\u20090.2021). The reduced risk of all\u2010cause ER visits or hospitalization in the NMV\u2010r group and the similarities in the risk of post\u2010acute COVID\u201019 symptoms between the two groups were consistent in the subgroups stratified by sex, age, and vaccination status. Early NMV\u2010r treatment of nonhospitalized patients with COVID\u201019 was associated with reduced risk of hospitalization and ER visits during the period of 90\u2013180 days after diagnosis compared with no NMV\u2010r treatment; however, post\u2010acute COVID\u201019 symptoms and mortality risk did not differ significantly between the groups.<\/jats:p>","DOI":"10.1002\/jmv.28750","type":"journal-article","created":{"date-parts":[[2023,4,21]],"date-time":"2023-04-21T09:50:30Z","timestamp":1682070630000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Efficacy of nirmatrelvir and ritonavir for post\u2010acute COVID\u201019 sequelae beyond 3 months of SARS\u2010CoV\u20102 infection"],"prefix":"10.1002","volume":"95","author":[{"given":"Min\u2010Hsiang","family":"Chuang","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Chi Mei Medical Center Tainan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3290-1909","authenticated-orcid":false,"given":"Jheng\u2010Yan","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Nutrition Chi Mei Medical Center Tainan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ting\u2010Hui","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Chi Mei Medical Center Tainan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wan\u2010Hsuan","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Chi Mei Medical Center Tainan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4630-3923","authenticated-orcid":false,"given":"Ya\u2010Wen","family":"Tsai","sequence":"additional","affiliation":[{"name":"Center for Integrative Medicine Chi Mei Medical Center Tainan Taiwan"},{"name":"Department of Medical Laboratory Sciences and Biotechnology Fooyin University Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8682-1322","authenticated-orcid":false,"given":"Po\u2010Yu","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Chi Mei Medical Center Tainan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6334-2388","authenticated-orcid":false,"given":"Chih\u2010Cheng","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine,\u00a0Division of Hospital Medicine Chi Mei Medical Center Tainan Taiwan"},{"name":"School of Medicine, College of Medicine National Sun Yat\u2010sen University Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,4,21]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"WHO. Accessed February 11 \u00a02023.https:\/\/covid19.who.int\/"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmii.2022.10.003"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-021-01283-z"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41579-022-00846-2"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)01214-4"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2021.101019"},{"key":"e_1_2_8_8_1","doi-asserted-by":"crossref","unstructured":"DemkoZO YuT MullapudiSK et al. Post\u2010acute sequelae of SARS\u2010CoV\u20102 (PASC) impact quality of life at 6 12 and 18 months post\u2010infection.\u00a0medRxiv.\u00a0Preprint. 2022.doi:10.1101\/2022.08.08.22278543","DOI":"10.1101\/2022.08.08.22278543"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2118542"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.7326\/M22-2141"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciac673"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciac600"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanwpc.2022.100602"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(22)00507-2"},{"key":"e_1_2_8_15_1","doi-asserted-by":"crossref","unstructured":"XieY ChoiT Al\u2010AlyZ. Association of treatment with nirmatrelvir and the risk of post\u2010COVID\u201019 condition.JAMA Intern Med. 2023:e230743.doi:10.1001\/jamainternmed.2023.0743","DOI":"10.1001\/jamainternmed.2023.0743"},{"key":"e_1_2_8_16_1","doi-asserted-by":"crossref","unstructured":"BajemaKL BerryK StrejaE et al. Effectiveness of COVID\u201019 treatment with nirmatrelvir\u2010ritonavir or molnupiravir among U.S. veterans: target trial emulation studies with one\u2010month and six\u2010month outcomes.medRxiv. Preprint.\u00a02022.doi:10.1101\/2022.12.05.22283134","DOI":"10.1101\/2022.12.05.22283134"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2023.01.014"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2023.02.007"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(21)00703-9"},{"key":"e_1_2_8_20_1","unstructured":"TriNetX. Accessed February 11 \u00a02023.https:\/\/trinetx.com"},{"key":"e_1_2_8_21_1","unstructured":"US Food and Drug Administration (FDA). Fact sheet for healthcare providers: emergency use authorization for Paxlovid (nirmatrelvir and ritonavir). \u00a0Accessed March 24 \u00a02023.https:\/\/www.fda.gov\/media\/155050\/download"},{"key":"e_1_2_8_22_1","unstructured":"GISAID. Tracking of hCoV\u201019 variants. Accessed March 24 \u00a02023.https:\/\/gisaid.org\/hcov19-variants\/"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.envres.2022.112816"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003773"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2204919"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)01586-0"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciac443"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-022-01689-3"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-022-02001-z"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(22)00044-4"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2021060734"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.3390\/pathogens11020269"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc21-1318"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2020.2730"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.18931"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiac136"}],"container-title":["Journal of Medical Virology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jmv.28750","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T07:59:05Z","timestamp":1692259145000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jmv.28750"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4]]},"references-count":35,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,4]]}},"alternative-id":["10.1002\/jmv.28750"],"URL":"https:\/\/doi.org\/10.1002\/jmv.28750","archive":["Portico"],"relation":{},"ISSN":["0146-6615","1096-9071"],"issn-type":[{"value":"0146-6615","type":"print"},{"value":"1096-9071","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4]]},"assertion":[{"value":"2023-02-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-21","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e28750"}}