Composite outcome of oral azvudine vs. nirmatrelvir-ritonavir in COVID-19 patients: a retrospective cohort study

This real-world study demonstrates comparable efficacy and safety profiles between azvudine and nirmatrelvir-ritonavir in treating COVID-19 patients, regardless of disease severity or baseline characteristics. The findings support azvudine as a practical alternative for treatment selection, particularly in resource-constrained settings or for patients with contraindications to specific therapies. Clinical decisions should prioritize patient-specific needs, accessibility, and cost-effectiveness. Further large-scale prospective studies are needed to validate these observations and refine subgroup-specific treatment strategies.