Real-World Study on the effects of Nirmatrelvir/Ritonavir on Liver and Kidney Function in COVID-19 Patients

Corresponding author: huangxiaoli, 934974069@qq.com

DOI: 10.12201/bmr.202512.00050

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  Abstract: Objective: The purpose of this study is to explore the actual effects of Nirmatrelvir/Ritonavir treatment on liver and kidney function in COVID-19 patients, in order to provide scientific basis for clinical treatment and ensure the safety of medication for patients. Method: Collect clinical data of COVID-19 patients treated with Nirmatrelvir/Ritonavir from October 2022 to February 2025. Perform subgroup analysis based on the patients liver and kidney function before treatment. Using t-test, chi square test, and non-parametric test to compare the differences in liver and kidney function indicators between patients before treatment and 3, 7, 14, and 21 days after treatment. Result: A total of 106 COVID-19 patients receiving treatment with Nirmatrelvir/Ritonavir were included. Among them, there were 65 male patients and 41 female patients. In terms of liver function monitoring, subgroup analysis showed that the levels of γ-glutamyltransferase (GGT) in patients with normal liver function were significantly increased at 14 and 21 days after treatment compared to before treatment (P＜0.05). In patients with mild liver injury, the level of aspartate aminotransferase (AST) after 3 days of treatment was significantly lower than before treatment (P＜0.05). In terms of renal function monitoring, in the group with 30ml/min/1.73m2＜glomerular filtration rate (eGFR) ≤ 60ml/min/1.73m2, the blood urea nitrogen (URea) levels after 7 days of treatment were significantly lower than before treatment (P＜0.05). In the group of 60ml/min/1.73m2＜eGFR ≤ 90ml/min/1.73m2, serum creatinine (Cream) decreased after 7 days of treatment compared to before treatment (P<0.05). In the eGFR＞90ml/min/1.73m 2 group, the URea level of patients significantly decreased after 14 days of treatment compared to before treatment, and the difference was statistically significant (P＜0.05). Conclusion:

  Key words: Nematovir/Letonavir; COVID-19; Liver function; Renal function

  Submit time: 18 December 2025

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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