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Real-world Effectiveness of Molnupiravir and Nirmatrelvir/Ritonavir as Treatments for COVID-19 in Patients at High Risk

Title: Real-world Effectiveness of Molnupiravir and Nirmatrelvir/Ritonavir as Treatments for COVID-19 in Patients at High Risk
Authors: Paraskevis, Dimitrios; Gkova, Maria; Mellou, Kassiani; Gerolymatos, Gerasimos; Psalida, Naya; Gkolfinopoulou, Kassiani; Kostaki, Evangelia-Georgia; Loukides, Stylianos; Kotanidou, Anastasia; Skoutelis, Athanasios; Thiraios, Eleftherios; Saroglou, Georgios; Zografopoulos, Dimitrios; Filippou, Dimitrios; Mossialos, Elias; Zaoutis, Theoklis; Gaga, Mina; Tsiodras, Sotirios; Antoniadou, Anastasia
Contributors: National Public Health Organization, Greece
Source: The Journal of Infectious Diseases ; volume 228, issue 12, page 1667-1674 ; ISSN 0022-1899 1537-6613
Publisher Information: Oxford University Press (OUP)
Publication Year: 2023
Description: Background Using a retrospective cohort study design, we aimed to evaluate the effectiveness of molnupiravir and nirmatrelvir/ritonavir in patients with SARS-CoV-2 who were highly vulnerable. Methods The impact of each drug was determined via comparisons with age-matched control groups of patients positive for SARS-CoV-2 who did not receive oral antiviral therapy. Results Administration of molnupiravir significantly reduced the risk of hospitalization (odds ratio [OR], 0.40; P < .001) and death (OR, 0.31; P < .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 nirmatrelvir/ritonavir also resulted in significant reductions in the risk of hospitalization (OR, 0.31; P < .001) and death (OR, 0.28; P < .001). Similar to molnupiravir, the impact of nirmatrelvir/ritonavir was more substantial among elderly patients and in those with high levels of drug adherence. Conclusions Collectively, these real-world findings suggest that although the risks of hospitalization and death due to COVID-19 have been reduced, antivirals can provide additional benefits to members of highly vulnerable patient populations.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1093/infdis/jiad324
DOI: 10.1093/infdis/jiad324/51401782/jiad324.pdf
Availability: https://doi.org/10.1093/infdis/jiad324; https://academic.oup.com/jid/advance-article-pdf/doi/10.1093/infdis/jiad324/51401782/jiad324.pdf; https://academic.oup.com/jid/article-pdf/228/12/1667/54717230/jiad324.pdf
Rights: https://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.8BB5DC28
Database: BASE