Table 2.
Identification of risk factors associated with viral burden rebound*
|
Molnupiravir (n=563) |
Nirmatrelvir–ritonavir (n=242) |
Control (n=3787) |
||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Patients with viral burden rebound, n/N (%) | OR (95% CI) | p value | Patients with viral burden rebound, n/N (%) | OR (95% CI) | p value | Patients with viral burden rebound, n/N (%) | OR (95% CI) | p value | ||
| Overall | 27/563 (4·8%) | .. | .. | 16/242 (6·6%) | .. | .. | 170/3787 (4·5%) | .. | .. | |
| Age, years | ||||||||||
| 18–65 | 7/69 (10·1%) | 2·68 (1·09–6·58) | 0·032 | 5/34 (14·7%) | 3·09 (1·00–9·53) | 0·050 | 28/564 (5·0%) | 1·13 (0·75–1·72) | 0·55 | |
| >65 | 20/494 (4·0%) | 1 (ref) | .. | 11/208 (5·3%) | 1 (ref) | .. | 142/3223 (4·4%) | 1 (ref) | .. | |
| Sex | ||||||||||
| Male | 18/316 (5·7%) | 1·60 (0·70–3·62) | 0·26 | 10/138 (7·2%) | 1·28 (0·45–3·63) | 0·65 | 100/2140 (4·7%) | 1·10 (0·81–1·51) | 0·53 | |
| Female | 9/247 (3·6%) | 1 (ref) | .. | 6/104 (5·8%) | 1 (ref) | .. | 70/1647 (4·3%) | 1 (ref) | .. | |
| Charlson Comorbidity Index | ||||||||||
| 0–6 | 15/351 (4·3%) | 1 (ref) | .. | 6/183 (3·3%) | 1 (ref) | .. | 108/2537 (4·3%) | 1 (ref) | .. | |
| >6 | 12/212 (5·7%) | 1·34 (0·62–2·93) | 0·46 | 10/59 (16·9%) | 6·02 (2·09–17·38) | 0·0009 | 62/1250 (5·0%) | 1·17 (0·85–1·62) | 0·33 | |
| Vaccination status | ||||||||||
| Fully vaccinated† | 0/5 | 1 (ref) | .. | 3/11 (27·3%) | 1 (ref) | .. | 8/145 (5·5%) | 1 (ref) | .. | |
| Not fully vaccinated | 27/558 (4·8%) | NA | NA | 13/231 (5·6%) | 0·16 (0·04–0·67) | 0·012 | 162/3642 (4·4%) | 0·80 (0·38–1·65) | 0·54 | |
| Concomitant corticosteroid use | ||||||||||
| Yes | 21/305 (6·9%) | 3·11 (1·23–7·82) | 0·016 | 14/123 (11·4%) | 7·51 (1·67–33·82) | 0·0086 | 123/2515 (4·9%) | 1·34 (0·95–1·89) | 0·094 | |
| No | 6/258 (2·3%) | 1 (ref) | .. | 2/119 (1·7%) | 1 (ref) | .. | 47/1272 (3·7%) | 1 (ref) | .. | |
| Immunocompromised‡ | ||||||||||
| Yes | 8/73 (11·0%) | 3·05 (1·28–7·25) | 0·012 | 8/35 (22·9%) | 7·37 (2·56–21·26) | 0·0002 | 34/401 (8·5%) | 2·21 (1·50–3·27) | <0·0001 | |
| No | 19/490 (3·9%) | 1 (ref) | .. | 8/207 (3·9%) | 1 (ref) | .. | 136/3386 (4·0%) | 1 (ref) | .. | |
OR=odds ratio. NA=not applicable. Ct=cycle threshold.
Defined as a reduction in Ct value between two consecutive measurements larger than or equal to 3, with this decrease sustained in at least the immediately subsequent Ct measurement for those patients with three or more Ct measurements (ΔCt=Ct[measurement 1]– Ct[measurement 2] ≥3 and ΔCt=Ct[measurement 1] − Ct[measurement 3] ≥3).
Fully vaccinated status was defined as having at least two doses of BNT162b2 or three doses of CoronaVac, and being at least 14 days since the last dose at baseline or the index date.22
Immunocompromised patients included those with primary immunodeficiency or on active immunosuppressive treatment at baseline or in the past 12 months.