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All Studies   All Outcomes    Recent:   

Molnupiravir and nirmatrelvir-ritonavir reduce mortality risk during post-acute COVID-19 phase

Wan et al., Journal of Infection, doi:10.1016/j.jinf.2023.02.029
Feb 2023  
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Mortality 11% Improvement Relative Risk Hospitalization 1% Progression -4% Molnupiravir for COVID-19  Wan et al.  LATE TREATMENT Is late treatment with molnupiravir beneficial for COVID-19? Retrospective 23,436 patients in China (February - September 2022) Lower mortality with molnupiravir (p=0.016) c19early.org Wan et al., J. Infection, February 2023 Favorsmolnupiravir Favorscontrol 0 0.5 1 1.5 2+
Retrospective 30,040 hospitalized patients in Hong Kong, showing lower mortality with molnupiravir treatment.
Concerns have been raised that the mutagenic mechanism of action may create dangerous variants or cause cancer1-9. Multiple analyses have identified variants potentially created by molnupiravir10-13.
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
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.
This PaperMolnupiravirAll
Molnupiravir and nirmatrelvir-ritonavir reduce mortality risk during post-acute COVID-19 phase
Eric Yuk Fai Wan, MPH Boyuan Wang, BSc Sukriti Mathur, Cheyenne I Ying Chan, Vincent Ka Chun Yan, Francisco Tsz Tsun Lai, Celine Sze Ling Chui, PhD Xue Li, Carlos King Ho Wong, Chak Philip Hei Li, Chak Sing Lau, Prof Ian Chi Kei Wong, Dr Esther Wai Yin Chan
Journal of Infection, doi:10.1016/j.jinf.2023.02.029
This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
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
Agarwal, Rochwerg, Lamontagne, Siemieniuk, Agoritsas et al., A living WHO guideline on drugs for covid-19, BMJ
Evans, Qi, Adebayo, Underwood, Coulson et al., among higher-risk patients with COVID-19 in Wales: a retrospective cohort study
Ledford, Long-COVID treatments: why the world is still waiting, Nature
Wan, Chui, Lai, Chan, Li et al., Bell's palsy following vaccination with mRNA (BNT162b2) and inactivated (CoronaVac) SARS-CoV-2 vaccines: a case series and nested casecontrol study, The Lancet Infectious Diseases
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
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
Wan, Wang, Chui, Mok, Xu et al., Safety of an inactivated, wholevirion COVID-19 vaccine (CoronaVac) in people aged 60 years or older in Hong Kong: a modified selfcontrolled case series, The Lancet Healthy Longevity
Wong, Au, Lau, Lau, Cowling et al., Real-world effectiveness of molnupiravir and nirmatrelvir plus ritonavir against mortality, hospitalisation, and in-hospital outcomes among community-dwelling, ambulatory patients with confirmed SARS-CoV-2 infection during the omicron wave in Hong Kong: a, Beta-blockers
Yan, Wan, Ye, Mok, Lai et al., Effectiveness of BNT162b2 and CoronaVac vaccinations against mortality and severe complications after SARS-CoV-2 Omicron BA. 2 infection: a case-control study, Emerging Microbes & Infections
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
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