• Eunyoung Lee, Sehee Park, Jae-Phil Choi, Min-Kyung Kim, Eunmi Yang, Sin Young Ham, Seungjae Lee, Bora Lee, Jeong-Sun Yang, Byoung Kwon Park, Da Sol Kim, So-Young Lee, Joo-Yeon Lee, Hee-Chang Jang, Jaehyun Jeon, and Sang-Won Park.
• Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.
• J. Korean Med. Sci. 2023 Feb 27; 38 (8): e59e59.

BackgroundInformation on the effectiveness of nirmatrelvir/ritonavir against the omicron is limited. The clinical response and viral kinetics to therapy in the real world need to be evaluated.MethodsMild to moderate coronavirus disease 2019 (COVID-19) patients with risk factors for severe illness were prospectively enrolled as a treatment group with nirmatrelvir/ritonavir therapy versus a control group with supportive care. Serial viral load and culture from the upper respiratory tract were evaluated for seven days, and clinical responses and adverse reactions were evaluated for 28 days.ResultsA total of 51 patients were analyzed including 40 in the treatment group and 11 in the control group. Faster symptom resolution during hospitalization (P = 0.048) was observed in the treatment group. Only minor adverse reactions were reported in 27.5% of patients. The viral load on Day 7 was lower in the treatment group (P = 0.002). The viral culture showed a positivity of 67.6% (25/37) vs. 100% (6/6) on Day 1, 0% (0/37) vs. 16.7 (1/6) on Day 5, and 0% (0/16) vs. 50.0% (2/4) on Day 7 in the treatment and control groups, respectively.ConclusionsNirmatrelvir/ritonavir against the omicron was safe and resulted in negative viral culture conversion after Day 5 of treatment with better symptomatic resolution.© 2023 The Korean Academy of Medical Sciences.

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