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KMID : 1143420220150241688
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Public Health Weekly Report
2022 Volume.15 No. 24 p.1688 ~ p.1695
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Effectiveness of COVID-19 vaccine and Paxlovid treatment against SARS-Cov-2 infection related severe outcome and death during the Omicron variant outbreak
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Park Ha-Nul
Lee Hye-Young
Yu Mi
Song Yeong-Jun
Lee Eun-Sang
Park Young-Joon
Lee Ji-Joo
Lee Eun-Sol
Kim Yeon-Jung
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Abstract
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On November 5, 2021, Pfizer Inc. announced a treatment method using Paxlovid (nirmatrelvir + ritonavir) that could reduce
the risk of hospitalization or death for confirmed patients with coronavirus disease 2019 (COVID-19). From February 6 to
April 2, 2022, the incidence of COVID-19 as well as the effects of Paxlovid treatment and COVID-19 vaccine were analyzed in 2,241 patients and workers at five long term care facilities (LTCFs) during the outbreak of the Omicron variant of COVID-19. Among the patients at LTCFs, the incidence of severe cases was 7.14% for those who did not receive Paxlovid and 3.69% for patients who did, and the fatality rates were was 5.61% and 3.53%, respectively. There was 51% (adjusted relative risk [aRR]=0.49; 95% confidence interval [CI]: 0.24-0.98) reduction in the rate of severe illness or death among patients who were administered Paxlovid compared with that noted among those who were not administered Paxlovid. In addition, the condition of 9.84% of patients who were not vaccinated progressed to severe illness, whereas the condition of only 3.27% of patients who completed the third vaccination progressed to severe illness; the fatality rates were 8.20% and 3.27%, respectively. Compared with patients who were unvaccinated, those who completed the third vaccination showed 71% (aRR=0.29; 95% CI: 0.13-0.64) reduction in the rate of severe illness or death and 65% (aRR=0.35; 95% CI: 0.15-0.79)
reduction in the risk of death. Among patients at the LTCFs, the rates of severe illness or death and fatality were lower in
the group that was administered Paxlovid than in the non-administered group, and these rates were also lower in the group that completed the third vaccination than in the unvaccinated group. As the COVID-19 outbreak continues, the fatality rate has decreased; however, patients of LTCFs are still a high-risk group for COVID-19. The current countermeasures must first be supplemented through continuous analysis of the effects of vaccinations and the use of therapeutics at LTCFs and other facilities that are at high risk for severe COVID-19, while preparing for future outbreaks of COVID-19 and other infectious diseases.
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KEYWORD
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Coronavirus disease 2019 (COVID-19), Long term care facilities (LTCFs), Paxlovid, Effects of COVID-19
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