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0 0.5 1 1.5 2+ ICU admission -162% Improvement Relative Risk Progression 8% Hospitalization time 18% Time to viral- 21% Viral clearance, day 21 -23% Viral clearance, day 14 28% Viral clearance, day 10 38% Viral clearance, day 7 18% Viral clearance, day 5 12% Liu et al. Molnupiravir for COVID-19 EARLY TREATMENT Is early treatment with molnupiravir beneficial for COVID-19? Retrospective 42 patients in China (March - May 2022) Shorter hospitalization (p=0.14) and faster viral clearance (p=0.1), not stat. sig. Liu et al., Infectious Diseases and Therapy, doi:10.1007/s40121-022-00716-7 Favors molnupiravir Favors control
Disease Progression of Hospitalized Elderly Patients with Omicron BA.2 Treated with Molnupiravir
Liu et al., Infectious Diseases and Therapy, doi:10.1007/s40121-022-00716-7
Liu et al., Disease Progression of Hospitalized Elderly Patients with Omicron BA.2 Treated with Molnupiravir, Infectious Diseases and Therapy, doi:10.1007/s40121-022-00716-7
Oct 2022   Source   PDF  
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Retrospective 42 elderly patients in China showing faster viral clearance with molnupiravir.
Concerns have been raised that the mutagenic mechanism of action may create dangerous variants or cause cancer [Hadj Hassine, Swanstrom]. See [Fountain-Jones, Sanderson,] for analysis of variants potentially created by molnupiravir.
risk of ICU admission, 161.5% higher, RR 2.62, p = 1.00, treatment 1 of 26 (3.8%), control 0 of 16 (0.0%), continuity correction due to zero event (with reciprocal of the contrasting arm).
risk of progression, 7.7% lower, RR 0.92, p = 1.00, treatment 3 of 26 (11.5%), control 2 of 16 (12.5%), NNT 104, dyspnea or ICU.
hospitalization time, 17.9% lower, relative time 0.82, p = 0.14, treatment 26, control 16.
time to viral-, 21.4% lower, relative time 0.79, p = 0.10, treatment 26, control 16.
risk of no viral clearance, 23.1% higher, RR 1.23, p = 1.00, treatment 2 of 26 (7.7%), control 1 of 16 (6.2%), day 21.
risk of no viral clearance, 28.2% lower, RR 0.72, p = 0.51, treatment 7 of 26 (26.9%), control 6 of 16 (37.5%), NNT 9.5, day 14.
risk of no viral clearance, 38.5% lower, RR 0.62, p = 0.04, treatment 14 of 26 (53.8%), control 14 of 16 (87.5%), NNT 3.0, day 10.
risk of no viral clearance, 17.9% lower, RR 0.82, p = 0.22, treatment 20 of 26 (76.9%), control 15 of 16 (93.8%), NNT 5.9, day 7.
risk of no viral clearance, 11.5% lower, RR 0.88, p = 0.28, treatment 23 of 26 (88.5%), control 16 of 16 (100.0%), NNT 8.7, day 5.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Liu et al., 30 Oct 2022, retrospective, China, peer-reviewed, median age 84.0, 10 authors, study period 26 March, 2022 - 31 May, 2022.
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Disease Progression of Hospitalized Elderly Patients with Omicron BA.2 Treated with Molnupiravir
Yayun Liu, Lingling Ge, Shiyong Fan, Aijing Xu, Xinyu Wang, Xu Dong, Mingxiao Xu, Wenhan Fan, Wu Zhong, Xuesong Liang
Infectious Diseases and Therapy, doi:10.1007/s40121-022-00716-7
Introduction: The efficacy of molnupiravir (MLN) on Omicron sublineages is limited. We investigated the effectiveness of MLN in older adults diagnosed with Omicron BA.2. Methods: Data of elderly COVID-19 patients (over 60 years) admitted to Chinghai Hospital (Shanghai, China) from 26 March to 31 May 2022 were reviewed. Study outcomes were a composite of undetectable viral load (VL) and disease progression [all-cause mortality, initiation of oxygen supply through high-flow device or invasive mechanical ventilation (IMV), or intensive care unit (ICU) admission] and their individual outcomes. Results: A total of 42 elderly patients were enrolled: 26 of them received MLN, 17 (40.5%) were males, the median age was 84 years, and 12 were fully vaccinated (31.0%). Among these elderly COVID-19 patients, five (11.90%) experienced obvious dyspnea or were transferred to ICU [three MLN users (11.5%) versus two non-MLN users (12.5%)]. Compared with no MLN use, MLN use was associated with rapid undetectable VL. At day 10, MLN users achieved Yayun Liu, Lingling Ge, and Shiyong Fan are co-first authors.
Author Contributions. Yayun Liu recruited the patients and collected specimens, edited the clinical data and performed the data analysis; Lingling Ge edited the clinical data of enrolled patients; Shiyong Fan drafted the manuscript; Aijing Xu recruited the patients and treated the patients; Wang, Xu Dong, Mingxiao Xu and Wenhan Fan treated the patients; Wu Zhong conceived and designed the study; Xuesong Liang conceived and designed the study; checked the data analysis and drafted the manuscript; All authors have read and approved the final manuscript. Disclosures. Yayun Liu, Lingling Ge, Shiyong Fan, Aijing Xu, Xinyu Wang, XuDong, Mingxiao Xu, Wenhan Fan, Wu Zhong and Xuesong Liang declare that they have no competing interests. Compliance with Ethics Guidelines. This study was approved by the Ethics Committee of Changhai Hospital. (CHEC2022-111).Written informed consent was exempted from all the study participants. This study was performed in accordance with the Helsinki Declaration of 1964 and its later amendments. Data Availability. All data and analysis results are included in this article. The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. All authors have read and approved the final manuscript. Open Access. This article is licensed under a Creative Commons Attribution-Non-Commercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction..
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Wong, Au, Lau, Lau, Cowling et al., Real-world effectiveness of molnupiravir and nirmatrelvir/ritonavir against mortality, hospitalization, and in-hospital outcomes among community-dwelling, ambulatory COVID-19 patients during the BA.2.2 wave in Hong Kong: an observational study, doi:10.1101/2022.05.26.22275631
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