{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T01:34:23Z","timestamp":1780536863369,"version":"3.54.1"},"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Administration of Paxlovid in early stage has been proved to reduce the risk of hospitalization or death by 89% in mild to moderate COVID-19 patients with high-risk. There were few evidences of Paxlovid in severe COVID-19 patients. RECOVERY study has previously shown that the use of glucocorticoids reduces the risk of death in hospitalized COVID-19 patients requiring oxygen or ventilatory support. The efficacy of Paxlovid plus glucocorticoids in COVID-19 patients with hypoxaemia is unclear.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>In this multiple-centers prospective study, we collected the data of hospitalized adult Omicron infected subjects with hypoxaemia at 4 hospitals, who were treated with glucocorticoids or Paxlovid plus glucocorticoid. We compared the efficacy of Paxlovid plus glucocorticoids (P\u2009+\u2009GCS group) vs. glucocorticoids (GCS group). A 28-day composite outcome of disease progression was evaluated.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Totally 266 Omicron infected patients with hypoxaemia were enrolled in this study. There was no difference in most of the baseline characteristics in two groups, including ages, sex and underlying diseases. The 28-day composite outcome in severe patients of P\u2009+\u2009GCS group was significantly lower than that of GCS group (16.9% vs. 33.8%, P\u2009=\u20090.013). The viral shedding time was shorter in P\u2009+\u2009GCS group than that in G group (6 days vs. 8 days, P\u2009=\u20090.015). The hospitalized time in severe patients of P\u2009+\u2009GCS group was significantly shorter than that of GCS group (15 days vs. 17 days, P\u2009=\u20090.0008). Cox analysis showed the benefit of P\u2009+\u2009GCS in sub-group of MODS, CRP\u2009\u2265\u200936\u2009mg\/L, d-dimer \u22651 \u00b5g\/L, creatinine\u2009\u2265\u200990\u00b5mol\/L).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Our study demonstrated the benefit of Paxlovid plus glucocorticoid administration in hospitalized Omicron infection patients with hypoxaemia. These results, as least partly, supported direct evidence about the necessity of antiviral treatment in severe COVID-19 patients with hypoxaemia.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0328929","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T17:30:12Z","timestamp":1758907812000},"page":"e0328929","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Paxlovid plus glucocorticoids treatment in severe Omicron infected patients with hypoxaemia: A prospective multiple-center cohort 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