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Preferred therapies for mild-to-moderate COVID-19 include a 3-day intravenous course of remdesivir or nirmatrelvir/ritonavir (Paxlovid). The only published randomized trial of nirmatrelvir/ritonavir was conducted prior to widespread vaccination (N Engl J Med 2022; 386:1397). Thus, clinicians need further information on the effectiveness of this treatment in more-heavily immune populations.
Investigators conducted a retrospective cohort study involving 44,551 patients aged ≥50 (of whom 90% had received at least 3 doses of vaccine) eligible to receive nirmatrelvir/ritonavir. The 28% of patients who received nirmatrelvir/ritonavir had more comorbidities and were more likely to be vaccinated. Black and Hispanic patients — but not patients from d…