Impact of the use of oral antiviral agents on the risk of hospitalization in community COVID-19 patients
Yip et al.,
Impact of the use of oral antiviral agents on the risk of hospitalization in community COVID-19 patients,
Clinical Infectious Diseases, doi:10.1093/cid/ciac687 (date from earlier preprint)
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 [Hadj Hassine, Swanstrom]. See [Fountain-Jones, Sanderson, ] for analysis of variants potentially created by 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.
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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.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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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.
Abstract: Page 1 of 21
COVID-19 oral antivirals and hospitalisation
Yip, et al.
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Impact of the use of oral antiviral agents on the risk of hospitalisation in community
COVID-19 patients
Running title: COVID-19 oral antivirals and hospitalisation risk in community
Terry Cheuk-Fung Yip*1,2,3, Grace Chung-Yan Lui*1,2,4, Mandy Sze-Man Lai1,2, Vincent WaiSun Wong 1,2,3, Yee-Kit Tse1,2,3, Bosco Hon-Ming Ma1, Elsie Hui1, Maria KW Leung6, Henry
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Lik-Yuen Chan2,5,7, David Shu-Cheong Hui1,2,4, Grace Lai-Hung Wong1,2,3
1Department of Medicine and Therapeutics, 2Medical Data Analytics Centre (MDAC), 3Institute
er
r
of Digestive Disease, 4Stanley Ho Centre for Emerging Infectious Diseases, Jockey Club School
of Public Health & Primary Care, and Faculty of Medicine5, The Chinese University of Hong
Kong; Hong Kong
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6Department of Family Medicine, Prince of Wales Hospital, Hospital Authority, Hong Kong
7Department of Internal Medicine, Union Hospital, Hong Kong
*TCF Yip and GCY Lui contributed equally to this study.
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Keywords: SARS-CoV-2, hospital admission, death, molnupiravir, nirmatrelvir/ritonavir
Abbreviations: CDARS = Clinical Data Analysis and Reporting System, CI = confidence
tn
interval, DM = diabetes mellitus, ICD-9-CM = International Classification of Diseases, Ninth
Revision, Clinical Modification, IMV = invasive mechanical ventilation, HR = hazard ratio, ICU
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= intensive care unit, SARS-CoV-2 = severe acute respiratory syndrome coronavirus 2.
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Text word count:
3,441
No. of tables:
3
No. of figures:
2
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Summary word count:
Co-correspondence:
Pr
1. Grace Lai-Hung Wong, MBChB(Hons, CUHK), MD(CUHK), FRCP(Lond, Edin), FHKCP,
FHKAM(Medicine)
1
This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=4112160
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COVID-19 oral antivirals and hospitalisation
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2. David Shu-Cheong Hui, MBBS (UNSW); MD(UNSW); FRACP; FRCP (Lond, Glasg, Edin);
FHKCP; FHKAM(Medicine)
Department of Medicine and Therapeutics, 9/F Prince of Wales Hospital, Shatin, Hong Kong.
Telephone: 852-2632-3538, Fax:852-2637-3852, Email: wonglaihung@cuhk.edu.hk
Declaration of Interests
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Terry Yip has served as an advisory committee member and a speaker for Gilead Sciences.
Grace Lui has served as an advisory committee member for Gilead, Merck and GSK, speaker for
er
r
Merck and Gilead, and received research grant from Gilead, Merck and GSK.
Vincent Wong has served as a consultant or advisory committee member for AbbVie,
Boehringer Ingelheim, Echosens, Gilead Sciences, Intercept, Inventiva, Merck, Novo Nordisk,
pe
Pfizer, ProSciento, Sagimet Biosciences and TARGET PharmaSolutions; and a speaker for
Abbott, AbbVie, Echosens, Gilead Sciences and Novo Nordisk. He has received a research grant
from Gilead Sciences, and is a cofounder of Illuminatio Medical Technology Limited.
ot
Henry Chan has served as an Independent Non-Executive Director for Shanghai Henlius Biotech
Inc; as an advisory board member for Aligos, Aptorum, Arbutus, Hepion, Janssen, Gilead,
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Glaxo-Smith-Kline, Roche, Vaccitech, Virion Therapeutics, and Vir Biotechnology; and as a
speaker for Gilead, Roche, and Viatris.
rin
Grace Wong has served as an advisory committee member for Gilead Sciences and Janssen, and
as a speaker for Abbott, Abbvie, Ascletis, Bristol-Myers Squibb, Echosens, Gilead Sciences,
ep
Janssen and Roche. She has also received a research grant from Gilead..
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