Nirmatrelvir-ritonavir is approved for coronavirus disease 2019 (COVID-19) but not initially recommended in patients with severe renal impairment. Increasing observational data have shown the feasibility of dose-adjusted nirmatrelvir-ritonavir administration in patients with estimated glomerular filtration rate lower than 30 ml/min/1.73 m\^2. The study is planned to assess the safety, clinical and virologic outcomes of early oral nirmatrevir-ritonavir treatment of COVID-19 in patients with stage 4 and 5 chronic kidney disease.
The objectives of the study are to evaluate the safety and clinical and virologic outcomes of dose-adjusted nirmatrelvir-ritonavir in patients with eGFR lower than 30 ml/min/1.73 m\^2. Patients with eGFR greater than 30 ml/min/1.73 m2 and prescribed nirmatrelvir-ritonavir will be used for comparison. In the single-centre study, patients with stage 4 and 5 chronic kidney disease prescribed early treatment dose-adjusted nirmatrelvir-ritonavir will be assessed for the primary endponts of adverse events during or after treatment with nirmatrelvir-ritonavir (starting on or before day 30), serious adverse events and adverse events leading to discontinuation of nirmatrelvir-ritonavir.
Study Type
OBSERVATIONAL
Enrollment
85
Nirmatrelvir-ritonavir (Paxlovid)
Prince of Wales Hospital, Chinese University of Hong Kong
Shatin, New Territories, Hong Kong
adverse event
Adverse events during or after treatment with nirmatrelvir-ritonavir (starting on or before day 30), serious adverse events and adverse events leading to discontinuation of nirmatrelvir-ritonavir
Time frame: 30 days
RAT
Time to negative rapid antigen test result
Time frame: 30 days
Rebound
Rebound of positive rapid antigen test or polymerase chain reaction PCR up to day 30
Time frame: 30 days
WHO Clinical Progression Scale CPS
Time to progression to CPS 5 up to day 30
Time frame: 30 days
Symptoms
Time to resolution of symptoms
Time frame: 30 days
Symptomatic rebound
Symptomatic rebound (symptomatic again after resolution of symptom with positive RAT or PCR)
Time frame: 30 days
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