Clinical advancement of patients infected with SARS-CoV-2 Omicron variant in Shanghai, China

Shao et al., medRxiv, doi:10.1101/2022.07.03.22277169

Jul 2022

Retrospective 17 paxlovid and 114 lianhuaqingwen patients in China, showing faster viral clearance with paxlovid.

Confounding by contraindication. Hoertel et al. find that over 50% of patients that died had a contraindication for the use of Paxlovid Hoertel. Retrospective studies that do not exclude contraindicated patients may significantly overestimate efficacy.

Black box warning. The FDA notes that "severe, life-threatening, and/or fatal adverse reactions due to drug interactions have been reported in patients treated with paxlovid" FDA.

This study is excluded in the after exclusion results of meta analysis: unadjusted results with no group details.

1. FDA, Fact sheet for healthcare providers: emergency use authorization for paxlovid, www.fda.gov/media/155050/download.fda.gov.

2. Hoertel et al., Prevalence of Contraindications to Nirmatrelvir-Ritonavir Among Hospitalized Patients With COVID-19 at Risk for Progression to Severe Disease, JAMA Network Open, doi:10.1001/jamanetworkopen.2022.42140.jamanetwork.com, doi.org.

Important missing comments or errors? Let us know.

time to viral-, 20.0% lower, relative time 0.80, p < 0.001, treatment 17, control 114.

Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates

Shao et al., 6 Jul 2022, retrospective, China, preprint, median age 52.0, 12 authors, study period 6 April, 2022 - 11 May, 2022, this trial compares with another treatment - results may be better when compared to placebo. Contact: huanggang@sumhs.edu.cn, hujianrong@jdhospital.com.

This Paper Paxlovid All

Clinical advancement of patients infected with SARS-CoV-2 Omicron variant in Shanghai, China

Jiasheng Shao, Rong Fan, Tiejun Zhang, Catherine Lee, Xuyuan Huang, Fei Wang, Haiying Liang, Ye Jin, Ying Jiang, Yanhua Gu, Jianrong Hu, Gang Huang

doi:10.1101/2022.07.03.22277169

References

Abas, Marfuah, Idroes, Kusumawaty, Fatimawali et al., Can the SARS-CoV-2 Omicron Variant Confer Natural Immunity against COVID-19?, Molecules, doi:10.3390/molecules2707222

Anjos, Fiaccadori, Servian, Da Fonseca, Guilarde et al., SARS-CoV-2 loads in urine, sera and stool specimens in association with clinical features of COVID-19 patients, J Clin Virol Plus, doi:10.1016/j.jcvp.2021.100059

Bennasrallah, Zemni, Dhouib, Sriha, Mezhoud et al., Factors associated with a prolonged negative conversion of viral RNA in patients with COVID-19, Int J Infect Dis, doi:10.1016/j.ijid.2021.02.089

Butt, Dargham, Loka, Shaik, Chemaitelly et al., COVID-19 Disease Severity in Children Infected with the Omicron Variant, Clin Infect Dis, doi:10.1093/cid/ciac275

Cann, Fever: Could A Cardinal Sign of COVID-19 Infection Reduce Mortality?, Am J Med Sci, doi:10.1016/j.amjms.2021.01.004

Chen, Qi, Liu, Ling, Qian et al., Clinical progression of patients with COVID-19 in Shanghai, China, J Infect, doi:10.1016/j.jinf.2020.03.004

Choi, Kang, Kim, Choi, Joh et al., Clinical Presentation and Outcomes of Middle East Respiratory Syndrome in the Republic of Korea, Infect Chemother

Esr, None

Graham, Daily briefing: Omicron struggles to infect the lungs, Nature, doi:10.3947/ic.2016.48.2.118

Gupta, SARS-CoV-2 Omicron spike mediated immune escape and tropism shift, Res Sq

He, Lau, Wu, Deng, Wang et al., Temporal dynamics in viral shedding and transmissibility of COVID-19, Nat Med, doi:10.1038/s41591-020-0869-5

Huang, Zeng, Letter to the editor: Epidemiology of the SARS-CoV-2 variant Omicron BA.2 -vigilance needed, Euro Surveill, doi:10.2807/1560-7917.ES.2022.27.13.2200254

Hui, Ho, Cheung, Ng, Ching et al., SARS-CoV-2 Omicron variant replication in human bronchus and lung ex vivo, Nature

Kim, Lee, Choi, Um, Lee et al., Clinical Characteristics of 40 Patients Infected With the SARS-CoV-2 Omicron Variant in Korea, J Korean Med Sci, doi:10.3346/jkms.2022.37.e31

Lee, Choe, Jeong, Kim, Kim et al., Importation and Transmission of SARS-CoV-2 B.1.1.529 (Omicron) Variant of Concern in Korea, November 2021, J Korean Med Sci, doi:10.3346/jkms.2021.36.e346

Liang, Hui, Liu, Qiao, Li et al., Insights into forsythia honeysuckle (Lianhuaqingwen) capsules: A Chinese herbal medicine repurposed for COVID-19 pandemic, Phytomed Plus, doi:10.1016/j.phyplu.2021.100027

Liu, Gao, Yuan, Yang, Shi et al., Efficacy and safety of herbal medicine (Lianhuaqingwen) for treating COVID-19: A systematic review and meta-analysis

Martin, Dewitt, Russell, Sanchez-Pinto, Haendel et al., Acute Upper Airway Disease in Children With the Omicron (B.1.1.529) Variant of SARS-CoV-2-A Report From the US National COVID Cohort Collaborative, JAMA Pediatr, doi:10.1001/jamapediatrics.2022.1110

Maslo, Friedland, Toubkin, Laubscher, Akaloo et al., Characteristics and Outcomes of Hospitalized Patients in South Africa During the COVID-19 Omicron Wave Compared With Previous Waves, JAMA, doi:10.1001/jama.2021.24868

Mefsin, Bond, Lin, Cheung, Wong et al., Epidemiology of infections with SARS-CoV-2 Omicron BA.2 variant in Hong Kong, doi:10.2807/1560-7917.ES.2022.27.18.2200178

Nhcotpsro, Notice on printing and distributing the COVID-19 pneumonia diagnosis and treatment plan (

Rossler, Riepler, Bante, Laer, Kimpel, SARS-CoV-2 Omicron Variant Neutralization in Serum from Vaccinated and Convalescent Persons, N Engl J Med, doi:10.1056/NEJMc2119236

Runfeng, Yunlong, Jicheng, Weiqi, Qinhai et al., Lianhuaqingwen exerts anti-viral and anti-inflammatory activity against novel coronavirus (SARS-CoV-2), Pharmacol Res, doi:10.1016/j.phrs.2020.104761

Singhal, The Emergence of Omicron: Challenging Times Are Here Again!, Indian J Pediatr, doi:10.1007/s12098-022-04077-4

Sun, Li, Huang, Shi, Xing et al., Case Report of China/Tianjin's First Novel Coronavirus Variant Omicron, Iran J Immunol, doi:10.22034/IJI.2022.94050.2278

Team, Omicron) Variant -United States, December 1, MMWR Morb Mortal Wkly Rep, doi:10.15585/mmwr.mm7050e1

Thakur, Ratho, A new SARS-CoV-2 variant of concern mounting worldwide fear, J Med Virol, doi:10.1002/jmv.27541

Torjesen, Covid-19: Peak of viral shedding is later with omicron variant, Japanese data suggest, BMJ, doi:10.1136/bmj.o89

Wang, Prather, Sznitman, Jimenez, Lakdawala et al., Airborne transmission of respiratory viruses, Science, doi:10.1126/science.abd9149

Widders, Broom, Broom, SARS-CoV-2: The viral shedding vs infectivity dilemma, Infect Dis Health, doi:10.1016/j.idh.2020.05.002

Wu, Guo, Tang, Hong, Zhou et al., Prolonged presence of SARS-CoV-2 viral RNA in faecal samples, Lancet Gastroenterol Hepatol, doi:10.1016/S2468-1253(20)30083-2.130-175130.0(121.0-141.0)138.0(131.0-143.0)130.0

Yan, Zhang, Chen, Jiang, Liu et al., Characteristics of Viral Shedding Time in SARS-CoV-2 Infections: A Systematic Review and Meta-Analysis, Front Public Health, doi:10.3389/fpubh.2021.652842

Yuan, Hou, Lin, Chen, Ren, How China responds to Omicron, J Infect, doi:10.1016/j.jinf.2022.04.017

Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.

Submit

Post

@CovidAnalysis

FAQ

Public domain CC0 1.0