Safety and Clinical and Virologic Outcomes in CKD Patients Treated With Nirmatrelvir-ritonavir

Nirmatrelvir-ritonavir is approved for coronavirus disease 2019 (COVID-19) but not initially recommended in patients with severe renal impairment. Increasing observational data have shown the feasibility of dose-adjusted nirmatrelvir-ritonavir administration in patients with estimated glomerular filtration rate lower than 30 ml/min/1.73 m^2. The study is planned to assess the safety, clinical and virologic outcomes of early oral nirmatrevir-ritonavir treatment of COVID-19 in patients with stage 4 and 5 chronic kidney disease.

Inclusion Criteria:Aged 18 and above.COVID-19 infection and symptom onset no more than 5 days, with or without prior vaccination.WHO CPS 1-4Indicated for nirmatrelvir-ritonavir treatmentExclusion Criteria:Patients cannot swallow capsules or adhere to protocol.Severe COVID-19 disease, including patients who require oxygen supplement therapySignificant hypersensitivity to nirmatrelvir, ritonavir, or any component of the formulationPatients require co-administration of drugs that are highly dependent on CYP3A4 for clearance and cannot be omitted during the treatment period