奈玛特韦/利托那韦治疗新型冠状病毒肺炎临床观察

Clinical Observation of Nirmatrelvir/ritonavir in the Treatment of COVID-19

目的:探讨奈玛特韦/利托那韦治疗新型冠状病毒肺炎的疗效及不良反应情况。方法:纳入2022年4月4日—4月30日定点医院天津市海河医院收治的发病5d以内的轻型和普通型且伴有进展为重症高风险因素的新型冠病毒肺炎成人患者9例,并使用奈玛特韦/利托那韦抗病毒治疗,分析其用药后的临床疗效和不良反应情况。结果:患者的临床症状明显改善,白介素、CRP及淋巴细胞数逐渐好转,奈玛特韦/利托那韦治疗有效率100%;患者均出现不同程度的不良反应,以神经系统疾病居多7例(77.8%),其中口苦5例(55.6%),嗅觉消失1例(11.1%),头痛1例(11.1%);其次为胃肠系统疾病4例(44.4%),其中腹泻2例(22.2%)、反酸烧心1例(11.1%)、腹部不适1例(11.1%);仍有少部分出现肌肉骨骼及结缔组织疾病1例(11.1%),即四肢肌肉酸痛1例(11.1%);1例出现三碘甲状腺原氨酸及游离三碘甲状腺原氨酸降低;总体未发生严重不良反应,症状和异常实验室指标在停药后可消失或缓解。结论:奈玛特韦/利托那韦治疗新型冠状病毒肺炎可明显改善患者临床症状及生活质量,促进了核酸转阴,住院周期短,不良反应较轻。

Objective:To summarize the efficacy and adverse reactions of nirmatrelvir/ritonavir in the treatment of COVID-19.Methods:In April 4 to April 30,2022,the onset of fixed-point hospital of Tianjin Haihe hospital within 5 days of light and ordinary and high-risk factors associated with progression to severe will be coronavirus pneumonia(COVID-19)in adult patients,and use of nirmatrelvir/ritonavir treatment,there were 9 patients,to analyze its clinical curative effect and adverse reaction of the medicine.Results:The clinical symptoms were significantly improved,interleukin,CRP and lymphocyte count were gradually improved,and the effective rate of nirmatrelvir/ritonavir treatment was 100%.All patients had adverse reactions of varying degrees,most of them were nervous system diseases(77.8%),including 5 patients with bitter mouth(55.6%),1 patient with loss of smell(11.1%),and 1 patient with headache(11.1%).The second was gastrointestinal diseases(44.4%),including diarrhea 2 cases(22.2%),acid reflux heartburn 1 case(11.1%),abdominal discomfort 1 case(11.1%).There were still a small number of musculoskeletal and connective tissue diseases(11.1%),including 1 case of limb muscle pain(11.1%).Triiodothyronine and free triiodothyronine decreased in 1 case.There were no serious adverse reactions in general,and the symptoms and abnormal laboratory indicators could disappear or be relieved after drug withdrawal.Conclusion:Nirmatrelvir/ritonavir treatment of COVID-19 patients can significantly improve clinical symptoms and quality of life,promote negative nucleic acid conversion,short hospitalization period,and mild adverse reactions.