Therapeutic Advances in Infectious Disease · Published 2026-08-01 · DOI 10.1177/20499361261464359
Masaya Yamato, Masahiro Kinoshita, Yuki Yoshida, Yudai Yamamoto, Rie Izuhara, Takuhiro Sonoyama
Background: Immunocompromised patients have a risk of severe COVID-19. Objectives: To describe the outcomes of ensitrelvir in hospitalized immunocompromised patients with COVID-19, with remdesivir as a reference. Design: Single-center retrospective cohort study. Methods: We analyzed patients with moderate/severe immunodeficiency who received ensitrelvir or remdesivir as initial therapy. The primary outcome was 28-day all-cause mortality; secondary outcomes were time to discharge and viral clearance. Exploratory analyses used inverse probability of treatment weighting (IPTW) based on propensity scores and Cox proportional-hazards models. Results: Among 56 patients (22 ensitrelvir; 34 remdesivir), 28-day mortality was 4.5% versus 8.8%, respectively. Time to discharge and viral clearance were similar. IPTW-adjusted 28-day mortality was 4.2% with ensitrelvir and 10.7% with remdesivir (hazard ratio 0.39; 95% CI 0.04–3.64). Conclusion: In this small, single-center exploratory cohort, ensitrelvir was associated with low mortality, although comparison with remdesivir should be interpreted cautiously given treatment selection, treatment switching, and limited sample size.
Abstract from DOAJ. Public domain (CC0 1.0).
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Yamato, M., Kinoshita, M., Yoshida, Y., et al. (2026). Ensitrelvir in hospitalized patients with COVID-19 who were moderately to severely immunocompromised: a single-center cohort study. Therapeutic Advances in Infectious Disease. https://doi.org/10.1177/20499361261464359