Real-World Data Casts Doubt on Antiviral Benefit for Hospitalized COVID-19 patients During Omicron Wave
New research suggests that commonly used antiviral treatments – remdesivir and nirmatrelvir/ritonavir – may not significantly reduce mortality in patients hospitalized with COVID-19 during the Omicron era.The findings, published in Clinical Microbiology and Infection (DOI: 10.1016/j.cmi.2025.09.012), challenge previous clinical trial data and highlight the need for further investigation into the effectiveness of thes drugs in severely ill, hospitalized individuals, notably as population immunity increases.
Despite widespread vaccination and prior infection leading to substantial population immunity, SARS-CoV-2 continues to drive hospitalizations. While initial clinical trials showed promise for antiviral therapies like remdesivir and nirmatrelvir/ritonavir, particularly when administered in outpatient settings, real-world evidence regarding their impact on mortality in hospitalized patients has been inconsistent. This study, led by john Karlsson Valik, Pontus Hedberg, Piotr Nowak, Ola Blennow, Robert Dyrdak, Jan Vesterbacka, Johan zetterqvist, and Pontus Naucler, aimed to clarify this discrepancy by assessing the effect of these antivirals in acute SARS-CoV-2 infection requiring hospital admission, with a specific focus on clinically relevant subgroups and the potential influence of immunity status and viral load. The research utilizes an emulated target trial design to provide a robust assessment of treatment effects in a real-world setting.
