Molnupiravir and nirmatrelvir-ritonavir reduce mortality risk during post-acute COVID-19 phase
et al., Journal of Infection, doi:10.1016/j.jinf.2023.02.029, Feb 2023
Retrospective 30,040 hospitalized patients in Hong Kong, showing lower mortality 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.
Study covers molnupiravir and paxlovid.
|
risk of death, 11.0% lower, HR 0.89, p = 0.02, treatment 704 of 6,153 (11.4%), control 2,541 of 17,283 (14.7%), adjusted per study, multivariable, Cox proportional hazards.
|
|
risk of hospitalization, 1.0% lower, HR 0.99, p = 0.76, treatment 2,298 of 6,153 (37.3%), control 2,541 of 17,283 (14.7%), adjusted per study, multivariable, Cox proportional hazards.
|
|
risk of progression, 4.0% higher, HR 1.04, p = 0.18, treatment 2,300 of 6,153 (37.4%), control 2,541 of 17,283 (14.7%), adjusted per study, A&E admission, multivariable, Cox proportional hazards.
|
| Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates |
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Wan et al., 22 Feb 2023, retrospective, China, peer-reviewed, 13 authors, study period 26 February, 2022 - 30 September, 2022.
Contact: ewchan@hku.hk, wongick@hku.hk.
Molnupiravir and nirmatrelvir-ritonavir reduce mortality risk during post-acute COVID-19 phase
Journal of Infection, doi:10.1016/j.jinf.2023.02.029
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Ethics approval This study was approved by the Central Institutional Review Board of the Hospital Authority of Hong Kong (CIRB-2021-005-4) and the DH Ethics Committee (LM171/2021).
Data sharing Data will not be made available to others because the data custodians have not given permission.
Sources of funding
References
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Wan, Mok, Yan, Wang, Zhang et al., Vaccine effectiveness of BNT162b2 and CoronaVac against SARS-CoV-2 Omicron BA.2 infection, hospitalisation, severe complications, cardiovascular disease and mortality in patients with diabetes mellitus: A case control study, Journal of Infection
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Yip, Lui, Lai, Wong, Tse et al., Impact of the Use of Oral Antiviral Agents on the Risk of Hospitalization in Community Coronavirus Disease, Clinical Infectious Diseases
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Late treatment
is less effective
is less effective
wan