Oral Nirmatrelvir/Ritonavir Therapy for COVID-19: The Dawn in the Dark?

Abstract

Nirmatrelvir/ritonavir (Paxlovid™) is an effective and safe antiviral drug that inhibits the main protease (Mpro), 3CL protease, of SARS-CoV-2. A reduction in COVID-19-related hospitalization or death was observed in patients treated with nirmatrelvir/ritonavir within five days of symptom onset. Moreover, good oral availability enables the usage of nirmatrelvir/ritonavir, not only in hospitalized patients, but also among outpatients. Nirmatrelvir (PF-07321332) has been demonstrated to stop the spread of COVID-19 in animal models. Despite frequent mutations in the viral genomes of SARS-CoV-2, nirmatrelvir shows an effective antiviral effect against recent coronavirus mutants. Despite the promising antiviral effect of nirmatrelvir, there are several unresolved concerns. First, the final results of large-scale clinical trials for early therapy of mild cases of COVID-19 are not yet published. Second, the effectiveness of nirmatrelvir against upcoming variants in the coming years requires close monitoring. Considering the promising preliminary results of the EPIC-HR trial, nirmatrelvir/ritonavir in conjunction with vaccines and non-pharmacological interventions, may represent the dawn in the dark of the COVID-19 pandemic.

• Authors: Yuan-Pin Hung, Jen-Chieh Lee, Chun-Wei Chiu, Ching-Chi Lee, Pei-Jane Tsai, I-Lin Hsu, Wen-Chien Ko
• Journal: Antibiotics (Basel, Switzerland) (Antibiotics (Basel)) Vol. 11 Issue 2 (Feb 09 2022) ISSN: 2079-6382 [Print] Switzerland
• PMID: 35203821 (Publication Type: Journal Article)