April 22, 2026 · The New England journal of medicine · DOI: 10.1056/NEJMoa2502457

Oral Nirmatrelvir-Ritonavir for Covid-19 in Higher-Risk Outpatients

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The authors aimed to evaluate the effectiveness of oral nirmatrelvir-ritonavir in reducing hospitalization or death among vaccinated higher-risk outpatients with SARS-CoV-2 infection. In two open-label trials, the results indicated no significant reduction in these outcomes for participants receiving nirmatrelvir-ritonavir compared to usual care alone. Additionally, while the treatment reduced viral load, serious adverse events were reported, highlighting the need for further investigation.

Christopher C Butler, Andrew D Pinto, Victoria Harris, Jane Holmes, Najib M Rahman, Lucy Cureton, Gail Hayward, Duncan B Richards, David M Lowe, Joseph F Standing, Judith Breuer, Kerenza Hood, May Ee Png, Stavros Petrou, Jienchi Dorward, Mahendra G Patel, Nicholas P B Thomas, Philip Evans, Nigel D Hart, Bhautesh D Jani, Banafshe Hosseini, Srinivas Murthy, Kerry McBrien, Amanda Condon, Emily G McDonald, Peter Daley, Michelle Greiver, Bruno R da Costa, Peter Selby, Peter Jüni, Todd C Lee, Haolun Shi, Michelle A Detry, Christina T Saunders, Mark Fitzgerald, Nicholas S Berry, Benjamin R Saville, Saye H Khoo, Jonathan S Nguyen-Van-Tam, F D Richard Hobbs, Ly-Mee Yu, Paul Little, PANORAMIC Trial and CanTreatCOVID Trial Collaborative Groups

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