COVID-19 enfeksi̇yonunda molnupiravi̇r tedavi̇si̇ alan hastalarin değerlendi̇ri̇lmesi̇
et al., Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, doi:10.34087/cbusbed.1423523, Mar 2024
Retrospective study of 78 hospitalized COVID-19 patients in Turkey showing no significant difference in mortality or discharge rates with molnupiravir treatment.
Potential risks of molnupiravir include the creation of dangerous variants, and mutagenicity, carcinogenicity, teratogenicity, and embryotoxicity1-15. Multiple analyses have identified variants potentially created by molnupiravir16-20.
Standard of Care (SOC) for COVID-19 in the study country,
China, is average with moderate efficacy for approved treatments21.
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risk of death, 50.0% higher, RR 1.50, p = 1.00, treatment 3 of 39 (7.7%), control 2 of 39 (5.1%).
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risk of ICU admission, no change, RR 1.00, p = 1.00, treatment 2 of 39 (5.1%), control 2 of 39 (5.1%).
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| Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates |
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Zibat et al., N4-hydroxycytidine, the active compound of Molnupiravir, promotes SARS-CoV-2 mutagenesis and escape from a neutralizing nanobody, iScience, doi:10.1016/j.isci.2023.107786.
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Marikawa et al., An active metabolite of the anti-COVID-19 drug molnupiravir impairs mouse preimplantation embryos at clinically relevant concentrations, Reproductive Toxicology, doi:10.1016/j.reprotox.2023.108475.
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Zhou et al., β-D-N4-hydroxycytidine Inhibits SARS-CoV-2 Through Lethal Mutagenesis But Is Also Mutagenic To Mammalian Cells, The Journal of Infectious Diseases, doi:10.1093/infdis/jiab247.
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Chamod et al., Molnupiravir Metabolite--N4-hydroxycytidine Causes Cytotoxicity and DNA Damage in Mammalian Cells in vitro: N4-hydroxycytidine Induced Cytotoxicity DNA Damage, Asian Medical Journal and Alternative Medicine, 23:3, asianmedjam.com/index.php/amjam/article/view/1448.
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Standing et al., Randomized controlled trial of molnupiravir SARS-CoV-2 viral and antibody response in at-risk adult outpatients, Nature Communications, doi:10.1038/s41467-024-45641-0.
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Mori et al., Reactive oxygen species-mediated cytotoxic and DNA-damaging mechanism of N4-hydroxycytidine, a metabolite of the COVID-19 therapeutic drug molnupiravir, Free Radical Research, doi:10.1080/10715762.2025.2469738.
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Özdemir et al., 25 Mar 2024, retrospective, China, peer-reviewed, 4 authors.
Contact: dr.yelizozdemir@hotmail.com, melis1084@yahoo.com, selma.tosun@yahoo.com, drhulyaozkan@gmail.com.
COVID-19 ENFEKSİYONUNDA MOLNUPiRAVİR TEDAVİSİ ALAN HASTALARIN DEĞERLENDİRİLMESİ
Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, doi:10.34087/cbusbed.1423523
Öz Amaç:
References
Bernal, Da Silva, Musungaie, Molnupiravir for oral treatment of covıd-19 in nonhospitalized patients, N Engl J Med
Butler, Hobbs, Gbinigie, Molnupiravir plus usual care versus usual care alone as early treatment for adults with COVID-19 at increased risk of adverse outcomes (PANORAMIC): an open-label, platform-adaptive randomised controlled trial, Lancet
Fischer, A phase 2a clinical trial of molnupiravir in patients with COVID-19 shows accelerated SARS-CoV-2 RNA clearance and elimination of infectious virus, Science translational medicine
Fischer, Eron, Jr, Holman, Cohen et al., A phase 2a clinical trial of molnupiravir in patients with COVID-19 shows accelerated SARS-CoV-2 RNA clearance and elimination of infectious virus, Sci Transl Med, doi:10.1126/scitranslmed.abl7430
Hotar, Omay, Bayrak, Kuruüzüm, Ünal, Pandeminin toplumsal yansımaları, İzmir İktisat Dergisi, doi:10.24988/ije.202035201
Huang, Wang, Li, Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China, Lancet
Johnson, Puenpatom, Moncada, Effect of molnupiravir on biomarkers, respiratory interventions, and medical services in COVID-19: a randomized, placebo-controlled trial, Ann Intern Med
Referanslar, None
Sağlık, Bakanlığı COVID-19 (SARS-CoV-2 Enfeksiyonu) Erişkin Hasta Tedavisi
Senderovich, Vinoraj, Stever, Waicus, Efficacy of COVID-19 treatments among geriatric patients: a systematic review, Ther Adv Infect Dis
Serdar, İlhanli, Kahraman, COVID-19'un zayıf halkası: Yaşlı nüfus, Türk Coğrafya Dergisi
Soysal, Koronavirüs salgını ve yaşlılık, Avrasya Sosyal ve Ekonomi Araştırmaları Dergisi
Tsai, Wu, Liu, Clinical effectiveness of oral antiviral agents in older patients with COVID-19 based on real-world data, J Med Virol
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"abstract": "<jats:p xml:lang=\"tr\">Özet
\nAmaç: Bu araştırmada COVID-19 tanısıyla hastanemizde yatırılarak takip edilen hastalarda molnupiravirin hastalık seyri üzerindeki etkisinin değerlendirilmesi amaçlanmıştır.
\nGereç ve yöntem: Retrospektif ve gözlemsel tasarımda olan bu çalışmada 01.11.2021-01.05.2022 tarihleri arasında COVID-19 tanısıyla hastanede yatan 78 hasta değerlendirilmiştir. Molnupiravir tedavisi için uygun olup tedavi verilen ve benzer özelliklerde olup tedavi verilmeyen hastaların verileri karşılaştırılmıştır. Hastaların yaş, cinsiyet, komorbid hastalıkları gibi sosyodemografik verileri, oksijen saturasyonları, toraks bilgisayarlı tomografideki akciğer tutulum oranları, steroid tedavisi alma durumları,takip ve tedavi sonuçları incelenmiştir.
\nBulgular: Çalışmaya alınan 78 hastanın 39’una molnupiravir tedavisi verilmiş olup, taburculuk ve mortalite oranı arasında gruplar arasında anlamlı fark saptanmamıştır (p=1). Geriatrik ve geriatrik olmayan hastaların verileri ayrıca karşılaştırılmış iki grup arasında mortalite ile cinsiyet, eşlik eden kronik hastalık varlığı, BT tutulumu, molnupiravir tedavisinin etkinliği açısından fark bulunmamıştır (p>0.05). 
\nSonuçlar: Çalışmamızda hastaneye yatarak takip edilen hastalarda MLP tedavisinin hastaneden taburculuk ve mortalite üzerinde olumlu veya olumsuz etkisi gösterilmemiştir. 
\nAnahtar kelimeler: COVID-19, Molnupiravir, Antiviral</jats:p>",
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