tetano
Editor, Senior Moderator
Clin Exp Med
. 2022 Dec 5.
doi: 10.1007/s10238-022-00949-3. Online ahead of print.
Real-world clinical outcomes of treatment with molnupiravir for patients with mild-to-moderate coronavirus disease 2019 during the Omicron variant pandemic
Yasuhito Suzuki[SUP] 1 [/SUP], Yoko Shibata[SUP] 2 [/SUP], Hiroyuki Minemura[SUP] 1 [/SUP], Takefumi Nikaido[SUP] 1 [/SUP], Yoshinori Tanino[SUP] 1 [/SUP], Atsuro Fukuhara[SUP] 1 3 [/SUP], Ryuzo Kanno[SUP] 4 [/SUP], Hiroyuki Saito[SUP] 5 [/SUP], Shuzo Suzuki[SUP] 5 [/SUP], Yayoi Inokoshi[SUP] 6 [/SUP], Eiichiro Sando[SUP] 7 [/SUP], Hirofumi Sakuma[SUP] 8 [/SUP], Tatsuho Kobayashi[SUP] 9 [/SUP], Hiroaki Kume[SUP] 10 [/SUP], Masahiro Kamimoto[SUP] 11 [/SUP], Hideko Aoki[SUP] 12 [/SUP], Akira Takama[SUP] 13 [/SUP], Taku Iizuka[SUP] 14 [/SUP], Takamichi Kamiyama[SUP] 15 [/SUP], Masaru Nakayama[SUP] 16 [/SUP], Kiyoshi Saito[SUP] 17 [/SUP], Koichi Tanigawa[SUP] 18 [/SUP], Masahiko Sato[SUP] 19 [/SUP], Yuichi Waragai[SUP] 19 [/SUP], Toshiyuki Kambe[SUP] 20 [/SUP], Norio Kanzaki[SUP] 21 [/SUP], Teruhisa Azuma[SUP] 22 [/SUP], Hiromasa Okamoto[SUP] 23 [/SUP], Keiji Sakamoto[SUP] 24 [/SUP], Yuichi Nakamura[SUP] 24 [/SUP], Hiroshi Ohtani[SUP] 25 [/SUP], Mitsuru Waragai[SUP] 26 [/SUP], Shinsaku Maeda[SUP] 27 [/SUP], Tokiya Ishida[SUP] 28 [/SUP], Keishi Sugino[SUP] 29 [/SUP], Wataru Abe[SUP] 30 [/SUP], Yasuhiko Tsukada[SUP] 31 [/SUP], Tomoyoshi Lee[SUP] 1 [/SUP], Ryuki Yamada[SUP] 1 10 [/SUP], Riko Sato[SUP] 1 [/SUP], Takumi Onuma[SUP] 1 [/SUP], Hikaru Tomita[SUP] 1 [/SUP], Mikako Saito[SUP] 1 [/SUP], Natsumi Watanabe[SUP] 1 [/SUP], Mami Rikimaru[SUP] 1 [/SUP], Takaya Kawamata[SUP] 1 [/SUP], Julia Morimoto[SUP] 1 [/SUP], Ryuichi Togawa[SUP] 1 [/SUP], Yuki Sato[SUP] 1 10 [/SUP], Junpei Saito[SUP] 1 [/SUP], Kenya Kanazawa[SUP] 1 [/SUP], Sugihiro Hamaguchi[SUP] 32 [/SUP], Ken Iseki[SUP] 31 [/SUP]
Affiliations
Abstract
It is unclear whether molnupiravir has a beneficial effect on vaccinated patients infected with the Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We here evaluated the efficacy of molnupiravir in patients with mild-to-moderate coronavirus disease 2019 (COVID-19) during the Omicron variant surge in Fukushima Prefecture, Japan. We enrolled patients with mild-to-moderate COVID-19 who were admitted to hospitals between January and April, 2022. Clinical deterioration after admission was compared between molnupiravir users (n = 230) and non-users (n = 690) after 1:3 propensity score matching. Additionally, we performed forward stepwise multivariate logistic regression analysis to evaluate the association between clinical deterioration after admission and molnupiravir treatment in the 1:3 propensity score-matched subjects. The characteristics of participants in both groups were balanced as indicated by covariates with a standardized mean difference of < 0.1. Regarding comorbidities, there was no imbalance between the two groups, except for the presence of hypertension, dyslipidemia, diabetes mellitus, and cardiac disease. The clinical deterioration rate was significantly lower in the molnupiravir users compared to the non-users (3.90% vs 8.40%; P = 0.034). Multivariate logistic regression analysis demonstrated that receiving molnupiravir was a factor for preventing deterioration (odds ratio 0.448; 95% confidence interval 0.206-0.973; P = 0.042), independent of other covariates. This real-world study demonstrates that molnupiravir contributes to the prevention of deterioration in COVID-19 patients after hospitalization during the Omicron variant phase.
Keywords: COVID-19; Effectiveness; Molnupiravir; Omicron variant; Real-world.
. 2022 Dec 5.
doi: 10.1007/s10238-022-00949-3. Online ahead of print.
Real-world clinical outcomes of treatment with molnupiravir for patients with mild-to-moderate coronavirus disease 2019 during the Omicron variant pandemic
Yasuhito Suzuki[SUP] 1 [/SUP], Yoko Shibata[SUP] 2 [/SUP], Hiroyuki Minemura[SUP] 1 [/SUP], Takefumi Nikaido[SUP] 1 [/SUP], Yoshinori Tanino[SUP] 1 [/SUP], Atsuro Fukuhara[SUP] 1 3 [/SUP], Ryuzo Kanno[SUP] 4 [/SUP], Hiroyuki Saito[SUP] 5 [/SUP], Shuzo Suzuki[SUP] 5 [/SUP], Yayoi Inokoshi[SUP] 6 [/SUP], Eiichiro Sando[SUP] 7 [/SUP], Hirofumi Sakuma[SUP] 8 [/SUP], Tatsuho Kobayashi[SUP] 9 [/SUP], Hiroaki Kume[SUP] 10 [/SUP], Masahiro Kamimoto[SUP] 11 [/SUP], Hideko Aoki[SUP] 12 [/SUP], Akira Takama[SUP] 13 [/SUP], Taku Iizuka[SUP] 14 [/SUP], Takamichi Kamiyama[SUP] 15 [/SUP], Masaru Nakayama[SUP] 16 [/SUP], Kiyoshi Saito[SUP] 17 [/SUP], Koichi Tanigawa[SUP] 18 [/SUP], Masahiko Sato[SUP] 19 [/SUP], Yuichi Waragai[SUP] 19 [/SUP], Toshiyuki Kambe[SUP] 20 [/SUP], Norio Kanzaki[SUP] 21 [/SUP], Teruhisa Azuma[SUP] 22 [/SUP], Hiromasa Okamoto[SUP] 23 [/SUP], Keiji Sakamoto[SUP] 24 [/SUP], Yuichi Nakamura[SUP] 24 [/SUP], Hiroshi Ohtani[SUP] 25 [/SUP], Mitsuru Waragai[SUP] 26 [/SUP], Shinsaku Maeda[SUP] 27 [/SUP], Tokiya Ishida[SUP] 28 [/SUP], Keishi Sugino[SUP] 29 [/SUP], Wataru Abe[SUP] 30 [/SUP], Yasuhiko Tsukada[SUP] 31 [/SUP], Tomoyoshi Lee[SUP] 1 [/SUP], Ryuki Yamada[SUP] 1 10 [/SUP], Riko Sato[SUP] 1 [/SUP], Takumi Onuma[SUP] 1 [/SUP], Hikaru Tomita[SUP] 1 [/SUP], Mikako Saito[SUP] 1 [/SUP], Natsumi Watanabe[SUP] 1 [/SUP], Mami Rikimaru[SUP] 1 [/SUP], Takaya Kawamata[SUP] 1 [/SUP], Julia Morimoto[SUP] 1 [/SUP], Ryuichi Togawa[SUP] 1 [/SUP], Yuki Sato[SUP] 1 10 [/SUP], Junpei Saito[SUP] 1 [/SUP], Kenya Kanazawa[SUP] 1 [/SUP], Sugihiro Hamaguchi[SUP] 32 [/SUP], Ken Iseki[SUP] 31 [/SUP]
Affiliations
- PMID: 36469171
- DOI: 10.1007/s10238-022-00949-3
Abstract
It is unclear whether molnupiravir has a beneficial effect on vaccinated patients infected with the Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We here evaluated the efficacy of molnupiravir in patients with mild-to-moderate coronavirus disease 2019 (COVID-19) during the Omicron variant surge in Fukushima Prefecture, Japan. We enrolled patients with mild-to-moderate COVID-19 who were admitted to hospitals between January and April, 2022. Clinical deterioration after admission was compared between molnupiravir users (n = 230) and non-users (n = 690) after 1:3 propensity score matching. Additionally, we performed forward stepwise multivariate logistic regression analysis to evaluate the association between clinical deterioration after admission and molnupiravir treatment in the 1:3 propensity score-matched subjects. The characteristics of participants in both groups were balanced as indicated by covariates with a standardized mean difference of < 0.1. Regarding comorbidities, there was no imbalance between the two groups, except for the presence of hypertension, dyslipidemia, diabetes mellitus, and cardiac disease. The clinical deterioration rate was significantly lower in the molnupiravir users compared to the non-users (3.90% vs 8.40%; P = 0.034). Multivariate logistic regression analysis demonstrated that receiving molnupiravir was a factor for preventing deterioration (odds ratio 0.448; 95% confidence interval 0.206-0.973; P = 0.042), independent of other covariates. This real-world study demonstrates that molnupiravir contributes to the prevention of deterioration in COVID-19 patients after hospitalization during the Omicron variant phase.
Keywords: COVID-19; Effectiveness; Molnupiravir; Omicron variant; Real-world.