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Molnupiravir inhibits SARS-CoV-2 variants including Omicron in the hamster model

Rosenke et al., JCI Insight, doi:10.1172/jci.insight.160108
May 2022  
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Syrian hamster study showing efficacy of molnupiravir for multiple variants including omicron.
Potential risks of molnupiravir include the creation of dangerous variants, and mutagenicity, carcinogenicity, teratogenicity, and embryotoxicity1-10. Multiple analyses have identified variants potentially created by molnupiravir11-15.
Rosenke et al., 17 May 2022, United Kingdom, peer-reviewed, 11 authors. Contact: feldmannh@niaid.nih.gov, michael.jarvis@plymouth.ac.uk.
This PaperMolnupiravirAll
Molnupiravir inhibits SARS-CoV-2 variants including Omicron in the hamster model
Kyle Rosenke, Atsushi Okumura, Matthew C Lewis, Friederike Feldmann, Kimberly Meade-White, W Forrest Bohler, Amanda Griffin, Rebecca Rosenke, Carl Shaia, Michael A Jarvis, Heinz Feldmann
The recent emergence of the SARS-CoV-2 Omicron variant of concern (VOC) containing a heavily mutated spike protein capable of escaping preexisting immunity identifies a continued need for interventional measures. Molnupiravir (MK-4482), an orally administered nucleoside analog, has demonstrated efficacy against earlier SARS-CoV-2 lineages and was recently approved for SARS-CoV-2 infections in high-risk adults. Here we assessed the efficacy of MK-4482 against the earlier Alpha, Beta and Delta VOCs and Omicron in the hamster COVID-19 model. Omicron replication and associated lung disease in vehicle treated hamsters was reduced compared to the earlier VOCs. MK-4482 treatment inhibited virus replication in the lungs of Alpha, Beta and Delta VOC infected hamsters. Importantly, MK-4482 profoundly inhibited virus replication in the upper and lower respiratory tract of hamsters infected with the Omicron VOC. Consistent with its mutagenic mechanism, MK-4482 treatment had a more pronounced inhibitory effect on infectious titers compared to viral RNA genome load. Histopathologic analysis showed that MK-4482 treatment caused a concomitant reduction in the level of lung disease and viral antigen load in infected hamsters across all VOCs examined. Together, our data indicate the potential of MK-4482 as an effective antiviral against known SARS-CoV-2 VOCs, especially Omicron, and likely future SARS-CoV-2 variants.
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