Real-world experience with molnupiravir during the period of SARS-CoV-2 Omicron variant dominance

Abstract

Background The real-world effectiveness of molnupiravir (MOL) during the dominance of Omicron SARS-CoV-2 lineage is urgently needed since the available data relate to the period of circulation of other viral variants. Therefore, this study assessed the efficacy of MOL in patients hospitalized for COVID-19 in a real-world clinical practice during the wave of Omicron infections. Methods Among 11,822 patients hospitalized after 1 March 2020 and included in the SARSTer national database, 590 were treated between 1 January and 31 April 2022, a period of dominance of the Omicron SARS-CoV-2 variant. MOL was administered to 203 patients, whereas 387 did not receive any antiviral regimen. Both groups were similar in terms of sex, BMI and age allowing for direct comparisons. Results Patients who did not receive antiviral therapy significantly more often required the use of Dexamethasone and Baricitinib. Treatment with MOL resulted in a statistically significant reduction in mortality during the 28-day follow-up (9.9 vs. 16.3%), which was particularly evident in the population of patients over 80 years of age treated in the first 5 days of the disease (14.6 vs. 35.2%). MOL therapy did not affect the frequency of the need for mechanical ventilation, but patients treated with MOL required oxygen supplementation less frequently than those without antivirals (31.7 vs. 49.2%). The time of hospitalization did not differ between groups. Conclusions The use of molnupiravir in patients hospitalized for COVID-19 during the dominance of Omicron variant reduced mortality. This effect is particularly evident in patients over 80 years of age.

Molnupiravir Outpatient Treatment for Adults with COVID-19 in a Real-World Setting—A Single Center Experience

“…Even though the effectiveness of the molnupiravir treatment is infeasible to assess due to the lack of a formal control group enrolled, our results appear to be in keeping with the previously published outcomes of clinical trials which documented molnupiravir effectiveness in preventing severe COVID-19 defined as a need for hospital admission or death [ 7 , 8 ]. Additionally, the most recent analysis of molnupiravir effectiveness in the real-world setting during SARS-CoV-2 Omicron variant dominance both in the general population and in STORs supports our findings [ 21 , 22 ]. Despite this, the study by Flisiak et al did not take into account subjects’ vaccination status and previous SARS-CoV-2 infection, and Radcliff’s paper did not offer data regarding adherence to molnupiravir treatment.…”

Recent review of COVID-19 management: diagnosis, treatment and vaccination

“…When compared to non-receptors, receiving molnupiravir or nirmatrelvir–ritonavir was linked to considerably lower odds of all-cause death and the overall disease progression outcome, as well as a decreased need for oxygen therapy [ 64 ]. The reduction in the mortality rate was greatly visible in patients with higher risk of hospitalization, such as those above 80 years in age [ 65 ]. In the same study, 890 patients were administered Paxlovid, the results indicates that this drug was also efficient in lowering the mortality rate [ 64 ].…”

Застосування молнупіравіру при COVID-19 у період домінування штаму «омікрон» SARS-CoV-2

“…У дослідженні R. Flisiak та співавторів (2022) оцінювали ефективність молнупіравіру у пацієнтів, госпіталізованих з приводу COVID-19, у реальній клінічній практиці під час хвилі зараження штамом «омікрон» SARS-CoV-2 [7].…”