Publication date: May 12, 2026
Since the benefit of nirmatrelvir-ritonavir (N-R) may have changed in contemporary patients, we assessed the effectiveness of N-R for preventing hospitalization and death among outpatients with COVID-19 in the Omicron era. This was a meta-analysis of cohort studies comparing rates of hospitalization and/or mortality in outpatients treated with N-R compared with untreated patients. Analysis was limited to studies conducted since December 2021 that performed an adjusted multivariate analysis. Quality was assessed using the Newcastle-Ottawa Scale. Summary estimates of adjusted relative risks (aRR) with 95% confidence intervals (CI) and prediction intervals (PI) were calculated overall and for prespecified subgroups. Heterogeneity was summarized visually and with τ and 95% PIs. Absolute effects were estimated by applying pooled aRRs to baseline risks to obtain absolute risk reductions (ARRs) and numbers needed to treat (NNTs). Forty-seven studies (10,791,211 patients) were included. Pooled aRRs were 0. 54 (95% CI, 0. 43-0. 68) for all-cause hospitalization and 0. 45 (0. 36-0. 56) for COVID-19 hospitalization. Pooled RRs were 0. 30 (0. 23-0. 39) for all-cause mortality and 0. 43 (0. 32-0. 59) for COVID-19 mortality. PIs were
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| Concepts | Keywords |
|---|---|
| December | cohort |
| Hospitalization | COVID-19 |
| Nirmatrelvir | hospitalization |
| Ottawa | mortality |
| nirmatrelvir-ritonavir | |
| outpatient | |
| paxlovid | |
| SARS-CoV-2 |
Semantics
| Type | Source | Name |
|---|---|---|
| drug | DRUGBANK | Ritonavir |
| disease | MESH | Infection |
| disease | MESH | death |
| disease | MESH | COVID-19 |
| disease | MESH | included |
| disease | MESH | hos |
| disease | MESH | mul |