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Real-world effectiveness of molnupiravir and nirmatrelvir/ritonavir as treatments for COVID-19 in patients at high risk

Paraskevis, Dimitrios, Gkova, Maria, Mellou, Kassiani, Gerolymatos, Gerasimos, Psalida, Naya, Gkolfinopoulou, Kassiani, Kostaki, Evangelia-Georgia, Loukides, Stylianos, Kotanidou, Anastasia, Skoutelis, Athanasios, Thiraios, Eleftherios, Saroglou, Georgios, Zografopoulos, Dimitrios, Filippou, Dimitrios, Mossialos, Elias ORCID: 0000-0001-8664-9297, Zaoutis, Theoklis, Gaga, Mina, Tsiodras, Sotirios and Antoniadou, Anastasia (2023) Real-world effectiveness of molnupiravir and nirmatrelvir/ritonavir as treatments for COVID-19 in patients at high risk. Journal of Infectious Diseases, 228 (12). 1667 - 1674. ISSN 0022-1899

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Identification Number: 10.1093/infdis/jiad324


Background Using a retrospective cohort study design, we aimed to evaluate the effectiveness of molnupiravir and nirmatrelvir/ritonavir in patients with SARS-CoV-2 who were highly vulnerable. Methods The impact of each drug was determined via comparisons with age-matched control groups of patients positive for SARS-CoV-2 who did not receive oral antiviral therapy. Results Administration of molnupiravir significantly reduced the risk of hospitalization (odds ratio [OR], 0.40; P < .001) and death (OR, 0.31; P < .001) among these patients based on data adjusted for age, previous SARS-CoV-2 infection, vaccination status, and time elapsed since the most recent vaccination. The reductions in risk were most profound among elderly patients (≥75 years old) and among those with high levels of drug adherence. Administration of nirmatrelvir/ritonavir also resulted in significant reductions in the risk of hospitalization (OR, 0.31; P < .001) and death (OR, 0.28; P < .001). Similar to molnupiravir, the impact of nirmatrelvir/ritonavir was more substantial among elderly patients and in those with high levels of drug adherence. Conclusions Collectively, these real-world findings suggest that although the risks of hospitalization and death due to COVID-19 have been reduced, antivirals can provide additional benefits to members of highly vulnerable patient populations.

Item Type: Article
Official URL:
Additional Information: © 2023 The Author(s)
Divisions: Health Policy
Subjects: R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
H Social Sciences > HV Social pathology. Social and public welfare. Criminology
Date Deposited: 15 Jan 2024 11:51
Last Modified: 18 Jul 2024 16:03

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