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0 0.5 1 1.5 2+ Combined death/ventilati.. -12% Improvement Relative Risk Hospitalization -17% Molnupiravir for COVID-19  Yip et al.  EARLY TREATMENT Is early treatment with molnupiravir beneficial for COVID-19? Retrospective 88,962 patients in China (February - March 2022) Higher hospitalization with molnupiravir (not stat. sig., p=0.062) c19early.org Yip et al., Clinical Infectious Diseases, May 2022 Favors molnupiravir Favors control

Impact of the use of oral antiviral agents on the risk of hospitalization in community COVID-19 patients

Yip et al., Clinical Infectious Diseases, doi:10.1093/cid/ciac687 (date from preprint)
May 2022  
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Propensity score weighted retrospective of 93,883 outpatients in Hong Kong, 5,808 treated with molnupiravir and 4,921 treated with paxlovid, showing higher hospitalization and higher combined mortality/mechanical ventilation/ICU admission with molnupiravir, without statistical significance; and lower hospitalization and combined mortality/mechanical ventilation/ICU admission with paxlovid, statistically significant only for hospitalization.
Concerns have been raised that the mutagenic mechanism of action may create dangerous variants or cause cancer Chamod, Hadj Hassine, Huntsman, Marikawa, Swanstrom, Waters, Zhou, Zibat. Multiple analyses have identified variants potentially created by molnupiravir Fountain-Jones, Kosakovsky Pond, Sanderson, twitter.com.
Study covers paxlovid and molnupiravir.
combined death/ventilation/ICU, 12.0% higher, HR 1.12, p = 0.66, treatment 53 of 5,808 (0.9%), control 151 of 83,154 (0.2%), propensity score weighting, Cox proportional hazards, day 30.
risk of hospitalization, 17.0% higher, HR 1.17, p = 0.06, treatment 437 of 5,808 (7.5%), control 1,322 of 83,154 (1.6%), propensity score weighting, Cox proportional hazards, day 30.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Yip et al., 24 May 2022, retrospective, placebo-controlled, China, peer-reviewed, 11 authors, study period 16 February, 2022 - 31 March, 2022. Contact: wonglaihung@cuhk.edu.hk.
This PaperMolnupiravirAll
PhD Terry Cheuk-Fung Yip, MD Chung-Yan Lui, BSc Mandy Sze-Man Lai, MD Wai-Sun Wong, MPhil Yee-Kit Tse, Hon-Ming Bosco, MD Ma, MD Elsie Hui, MFM Maria Kw Leung, Henry Lik-Yuen, MD Chan, MD Shu-Cheong Hui, Lai-Hung Grace, MBChB Wong
Impact of the use of oral antiviral agents on the risk of hospitalization in community COVID-19 patients
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