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0 0.5 1 1.5 2+ Liver injury -241% Improvement Relative Risk Molnupiravir  Winyupakorn et al.  EARLY TREATMENT Is early treatment with molnupiravir beneficial for COVID-19? Prospective study of 300 patients in Thailand (Sep 2021 - Oct 2022) Winyupakorn et al., Research Square, Oct 2023 Favors molnupiravir Favors control

Liver injury in non-severe COVID-19 with various pandemic phases: a real-world study

Winyupakorn et al., Research Square, doi:10.21203/
Oct 2023  
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Prospective study of 300 patients with mild to moderate COVID-19 in Thailand, showing the highest risk of liver injury with molnupiravir treatment, OR 3.4 (p = 0.06).
Concerns have been raised that the mutagenic mechanism of action may create dangerous variants or cause cancer Hadj Hassine, Huntsman, Marikawa, Swanstrom, Waters, Zhou, Zibat. Multiple analyses have identified variants potentially created by molnupiravir Fountain-Jones, Kosakovsky Pond, Sanderson,
liver injury, 241.0% higher, OR 3.41, p = 0.06, treatment 22, control 278, adjusted per study, multivariable, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Winyupakorn et al., 31 Oct 2023, prospective, Thailand, preprint, 4 authors, study period September 2021 - October 2022.
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Liver injury in non-severe COVID-19 with various pandemic phases: a real-world study
Jirayuth Winyupakorn, Chunlanee Sangketchon, Watcharaporn Devakul Na Ayutthaya, Supatsri Sethasine
The using of a variety of anti-COVID-19 medicines connected to the degree of liver impairment in the short term was intriguing. To evaluate the dynamic course of liver injury in patients with mild to moderate COVID-19 within 10 days of admission. This was a prospective cohort study of 300 patients who were newly proven mild to moderate COVID-19 between September 2021 and October 2022. There were 188 patients in hospitel/ eld hospital (n = 188) and cohort wards (n = 112). One hundred and fteen patients (38.3%) suffered from liver injury (LI). The majority of Group LI participants (n = 104) received medication to treat the COVID-19 infection, including favipiravir (45%), remdesivir (17.4%), molnupiravir (11.3%), Andrographis paniculata (ADG) (8.7%), and favipiravir in combination with ivermectin (7.7%). When compared to no LI, molnupiravir medication was linked with the largest proportion of transaminase < 2 and 2-5 times the ULN [11.3% vs. 4.9%, p = 0.038; 15.2% vs. 4.9%, p = 0.013]. After 10 days, the majority of patients exhibited a transaminase decline. A less-than-critical level of liver damage was reported in mild to moderate COVID-19 that allows clinicians to administer a variety of standard medications during short periods of hospital stay.
We emphasized the real-world dynamics of LI in mild to moderate COVID-19, the less-than-critical state of liver impairment that enables physicians to give a variety of common drugs over the course of the entire hospitalization period. Declarations Data availability The data used in this work are available upon reasonable request from the corresponding author.
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