This study reviewed electronic medical records to show that of 699,848 adults aged ≥18 years who were eligible for Paxlovid during April-August 2022, 28.4% received a Paxlovid prescription within 5 days of COVID-19 diagnosis (of whom 68.8% previously had received two or more doses of mRNA vaccine). Being prescribed Paxlovid was associated with a lower hospitalization rate among the overall study population (adjusted hazard ratio [aHR] = 0.49). The reduction was similar among those who had received ≥3 mRNA COVID-19 vaccines (aHR = 0.50) and across all age groups. The proportion of persons with in-hospital death was also lower among persons who received Paxlovid (0.01%) than among those who did not (0.04%). The authors state that Paxlovid should be prescribed to eligible adults to reduce the risk of COVID-19-associated hospitalization.
SAB Comment: This study shows a significant real-world effect of Paxlovid during the Omicron era but with a reduction in hospitalization rate that is not nearly as large as that seen in the Paxlovid phase 2-3 trial done with unvaccinated patients during the Delta variant surge in 2021 (87.8% reduction of combined death or hospitalization).

https://www.cdc.gov/mmwr/volumes/71/wr/pdfs/mm7148e2-h.pdf