Nickan Research Institute Journal of Renal Injury Prevention 2345-2781 14 3 2025 09 01 Nirmatrelvir-ritonavir efficacy and safety in high-risk COVID-19 patients: a review of recent retrospective cohort studies – nephrology point of view e32257 e32257 10.34172/jrip.2024.32257 EN Alireza Amin https://orcid.org/0009-0008-2523-0060 Shiva Maleki https://orcid.org/0009-0002-5725-1698 Mohammad Reza Moonesan https://orcid.org/0000-0003-4351-0732 Journal Article 10.34172/jrip.2024.32257 2023 10 19 2024 01 30 The COVID-19 pandemic has prompted researchers to look for efficient treatments to lower high-risk patients’ probabilities of hospitalization, rapid disease progression, and death. Nirmatrelvir-ritonavir (Paxlovid) is a promising treatment option that has been evaluated in several recent retrospective cohort studies. In this article, we review four such studies conducted in China and the USA between 2022 and 2023. The studies, which included large groups of COVID-19 patients, found that Paxlovid treatment was linked to a significant drop in the risk of hospitalization, severe disease progression, and death in high-risk patients. This was true even for patients who had been immune to the disease before from an infection or vaccination. However, more research is needed to validate these results and evaluate the long-term efficacy and safety of this medication. In addition to highlighting the need for larger studies to evaluate both the effectiveness and safety of this treatment in patients with a variety of populations, our review sheds light on the present understanding of Paxlovid and its application for high-risk COVID-19 patients.