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547. Molnupiravir and Nirmatrelvir/Ritonavir Effectiveness in Reducing the Risk for COVID-19 Disease Progression and Death

Title: 547. Molnupiravir and Nirmatrelvir/Ritonavir Effectiveness in Reducing the Risk for COVID-19 Disease Progression and Death
Authors: Paraskevis, Dimitrios; Gkova, Mary; Mellou, Kassiani; Gkolfinopoulou, Kassiani; Kostaki, Evangelia Georgia; Loukides, Stylianos; Kotanidou, Anastasia; Skoutelis, Athanasios; Thiraios, Eleftherios; Saroglou, George; Zografopoulos, Dimitrios; Mossialos, Elias; Zaoutis, Theoklis; Gaga, Mina; Antoniadou, Anastasia; Tsiodras, Sotirios
Source: Open Forum Infectious Diseases ; volume 10, issue Supplement_2 ; ISSN 2328-8957
Publisher Information: Oxford University Press (OUP)
Publication Year: 2023
Description: Background Molnupiravir (M) and Nirmatrelvir/Ritonavir (N/R) have been authorized for use in COVID-19 patients at high risk for severe disease. We aimed to evaluate the effectiveness of M and N/R in highly vulnerable SARS-CoV-2 patients using a retrospective cohort study design. Methods The study population consisted of SARS-CoV-2 infected non-hospitalized patients in Greece, aged 65 years or older, that received M between February 2 and March 25, 2022 and N/R between March 26 and July 20, 2022. The impact of each drug was determined via comparisons with age-matched control groups of SARS-CoV-2-positive patients who did not receive oral antiviral therapy, using as outcome (i) hospital admission with COVID-19 within 10 days after tested positive, and (ii) death from COVID-19 within 35 days from positive test. Results Overall, 4,240 M and 13,861 N/R recipients were enrolled. Administration of M significantly reduced the risk of hospitalization (Odds Ratio [OR] = 0.40, p < 0.001) and death (OR=0.31, p < 0.001) among these patients based on data adjusted for age, previous SARS-CoV-2 infection, vaccination status, and time elapsed since the most recent vaccination. The reductions in risk were most profound among elderly patients (≥75 years old) and among those with high levels of drug adherence. Administration of N/R also resulted in significant reductions in the risk of hospitalization (OR = 0.31, p < 0.001) and death (OR=0.28, p < 0.001). Similar to M, the impact of N/R was more substantial among elderly patients and in those with high levels of drug adherence. Conclusion N/R and M use prevented hospital admissions and death in a large real-world study of highly vulnerable patient populations. Disclosures All Authors: No reported disclosures
Document Type: article in journal/newspaper
Language: English
DOI: 10.1093/ofid/ofad500.616
Availability: https://doi.org/10.1093/ofid/ofad500.616; https://academic.oup.com/ofid/article-pdf/10/Supplement_2/ofad500.616/53772056/ofad500.616.pdf
Rights: https://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.4EA90807
Database: BASE