Ensitrelvir in hospitalized patients with COVID-19 who were moderately to severely immunocompromised: a single-center cohort study
Masaya Yamato, Masahiro Kinoshita, Yuki Yoshida, Yudai Yamamoto, Rie Izuhara, Takuhiro SonoyamaBackground:
Immunocompromised patients have a risk of severe COVID-19.
Objectives:
To describe the outcomes of ensitrelvir in hospitalized immunocompromised patients with COVID-19, with remdesivir as a reference.
Design:
Single-center retrospective cohort study.
Methods:
We analyzed patients with moderate/severe immunodeficiency who received ensitrelvir or remdesivir as initial therapy. The primary outcome was 28-day all-cause mortality; secondary outcomes were time to discharge and viral clearance. Exploratory analyses used inverse probability of treatment weighting (IPTW) based on propensity scores and Cox proportional-hazards models.
Results:
Among 56 patients (22 ensitrelvir; 34 remdesivir), 28-day mortality was 4.5% versus 8.8%, respectively. Time to discharge and viral clearance were similar. IPTW-adjusted 28-day mortality was 4.2% with ensitrelvir and 10.7% with remdesivir (hazard ratio 0.39; 95% CI 0.04–3.64).
Conclusion:
In this small, single-center exploratory cohort, ensitrelvir was associated with low mortality, although comparison with remdesivir should be interpreted cautiously given treatment selection, treatment switching, and limited sample size.