Clinical observation on the effects of four anti-novel coronavirus drugs on liver function
Objective To observe the effects of azvudine,nirmatrelvir,molnupiravir and simnotrelvir on liver function in patients with novel coronavirus infection. Methods Clinical data of 196 patients with novel coronavirus infection applying oral small molecule antiviral drugs were retrospectively collected,and the patients were categorized into the azivudine group (92 patients),the nirmatrelvir group (41 patients),the molnupiravir group (42 patients),and the simnotrelvir group (21 patients) according to the different drugs used. The azivudine group received azivudine treatment,the nirmatrelvir group received nirmatrelvir/ritonavir treatment,the molnupiravir group received molnupiravir treatment,and the simnotrelvir group received simnotrelvir/ritonavir treatment. The level of liver function indicators before and after treatment in the four groups was compared,the number and percentage of patients with abnormal liver function after treatment in the four groups were analyzed,and the age and underlying diseases of patients with abnormal liver function in the four groups were analyzed. Results In the azivudine group,the alanine aminotrasferase of (47.24±13.86) U/L and aspartate transaminase of (48.59±16.71) U/L after 7 d of treatment were higher than (38.87±19.14) and (40.18±22.33) U/L before treatment (P<0.05),and there was no statistically significant difference in the alkaline phosphatase,total bilirubin,and direct bilirubin when compared with those before treatment (P>0.05). In nirmatrelvir group,the alanine aminotransferase of (61.71±27.74) U/L after 5 d of treatment was higher than (44.95±20.55) U/L before treatment (P<0.05),and there was no statistically significant difference in the alanine aminotransferase,alkaline phosphatase,total bilirubin,and direct bilirubin when compared with those before treatment (P>0.05). In the molnupiravir group and simnotrelvir group,there was no statistical difference in alanine aminotrasferase,aspartate transaminase,alkaline phosphatase,total bilirubin,and direct bilirubin after 5 d of treatment when compared with those before treatment (P>0.05). In the azvudine group,the abnormal cases of alanine aminotrasferase,aspartate transaminase,alkaline phosphatase,total bilirubin,and direct bilirubin were 28 cases (30.4％),9 cases (9.8％),4 cases (4.3％),0,and 4 cases (4.3％);in the molnupiravir group,the abnormal cases of alanine aminotrasferase,aspartate transaminase,alkaline phosphatase,total bilirubin,and direct bilirubin were 7 cases (16.7％),7 cases (16.7％),7 cases (16.7％),1 case (2.4％),1 case (2.4％),and 1 case (2.4％);in the nirmatrelvir group,the abnormal cases of alanine aminotrasferase,aspartate transaminase,alkaline phosphatase,total bilirubin,and direct bilirubin were 14 cases (34.1％),11 cases (26.8％),5 cases (12.2％),1 case (2.4％),and 1 case (2.4％);in the simnotrelvir group,the abnormal cases of alanine aminotrasferase,aspartate transaminase,alkaline phosphatase,total bilirubin,and direct bilirubin were 4 cases (19.0％),2 cases (9.5％),0,0,and 0. There were 63 patients with abnormal liver function in the four groups after treatment,including 44 males (69.8％) and 19 females (30.2％);their ages ranged 23-90 years old,with an average of 73.06 years old. There were 14 cases (22.2％) without underlying diseases,31 cases (49.2％) with hypertension,16 cases (25.4％) with coronary artery related diseases,15 cases (23.8％) with cerebrovascular disease,11 cases (17.5％) with diabetes mellitus,5 cases (7.9％) with tumor,and 4 cases (6.3％) with chronic lung disease. Conclusion In patients with novel coronavirus infection,oral administration of azvudine significantly can increase alanine aminotrasferase,aspartate transaminase,oral administration of nirmatrelvir can significantly increase alanine aminotransferase,and oral administration of molnupiravir and simnotrelvir can not significantly change liver function. Liver function needs to be monitored in patients patients with oral small-molecule antiviral drugs.
Novel coronavirus infectionAntiviral drugsLiver function
万方数据
维普
