Efficacy of Azvudine Therapy in Patients with Severe and Non-Severe COVID‐19: A Propensity Score-Matched Analysis

Siqin Zhang,1,* Songsong Tan,1,* Bin Yang,2 Yaoyao Wu,3 Guohang Yuan,3 Fengjiao Chen,4 Lin Liu3,5 1Department of Endocrinology and Metabolism, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, 550002, People’s Republic of China; 2Department of Central Laboratory, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, 550002, People’s Republic of China; 3Department of Respiratory and Critical Medicine, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, 550002, People’s Republic of China; 4Research Department, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, 550002, People’s Republic of China; 5NHC Key Laboratory of Pulmonary Immunological Diseases (Guizhou Provincial People’s Hospital), Guiyang, Guizhou, 550002, People’s Republic of China*These authors contributed equally to this workCorrespondence: Lin Liu, Department of Respiratory and Critical Medicine, Guizhou Provincial People’s Hospital, NHC Key Laboratory of Pulmonary Immunological Diseases (Guizhou Provincial People’s Hospital), No. 83, Zhongshan East Road, Guiyang, 550002, Guizhou, People’s Republic of China, Tel +86 28 18685109665, Fax +86 28 85423459, Email liulin0956@163.comObjective: Azvudine is used to treat patients with the coronavirus disease 2019 (COVID-19). This study evaluated the clinical efficacy of azvudine in hospitalized patients with different severities of COVID-19 because few studies have described this in patients with severe and non-severe COVID-19.Methods: This retrospective study included hospitalized patients with COVID-19 in Guizhou Provincial People’s Hospital between December 2022 and January 2023. Azvudine-treated patients and controls were matched for sex, age, and disease severity at admission. Laboratory results and outcomes, including all-cause mortality, invasive mechanical ventilation, intensive care unit admission, and hospital stay length, were evaluated. Stratified analysis was used to explore the difference in the efficacy of azvudine in severe and non-severe COVID-19 patients.Results: No significant differences in all-cause mortality were observed between the 303 azvudine recipients and 303 matched controls. However, azvudine-treated patients had shorter hospital stays (8.34± 4.79 vs 9.17± 6.25 days, P=0.046) and higher lymphocyte improvement rates (21.5% vs 13.9%, P=0.019), with a more pronounced effect in patients with non-severe COVID-19 (length of hospital stay, 8.07± 4.35 vs 10.00± 6.29 days, P=0.001; lymphocyte improvement rate, 23.8% vs 12.8%, P=0.015).Conclusion: Azvudine treatment shortens hospital stay length and increases the rate of lymphocyte count improvement in patients with non-severe COVID-19, suggesting that azvudine may be a treatment option for these patients.Keywords: azvudine, COVID-19, severity, effectiveness, clinical outcome, hospital stay length