Publication date: Dec 01, 2024
We examined the clinical effectiveness of molnupiravir in reducing deaths in a real-world cohort of adult patients with COVID-19 during the Omicron outbreak. This was a population-wide retrospective cohort study in the Czech Republic. We analyzed all 74 541 patients with an officially registered diagnosis of SARS-CoV-2 infection between 1 January and 31 December 2022, aged 18 years or older, treated with molnupiravir. The primary outcome was 30-day all-cause mortality; the secondary outcome was 30-day COVID-19-related mortality. Hazard ratios (HRs) were estimated using stratified Cox regression and the Fine-Gray model. The use of molnupiravir in adult SARS-CoV-2 positive patients was associated with a lower risk of both 30-day all-cause mortality: adjusted HR 0. 58 (95% confidence interval, 0. 53-0. 64; P < .001) and 30-day COVID-19-related mortality: adjusted HR 0. 50 (95% confidence interval, 0. 42-0. 58; P < .001). The effect of molnupiravir was highly significant regardless of sex, Deyo-Charlson Comorbidity Index score, hospitalization status, COVID-19 vaccination status, and patients older than age 65 years. In this cohort study, early initiation of molnupiravir was associated with a significant reduction in 30-day all-cause and COVID-19-related mortality in adult SARS-CoV-2 positive patients.
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| Concepts | Keywords |
|---|---|
| Czech | 30-day all-cause mortality |
| December | COVID-19 |
| Drugs | COVID-19-related mortality |
| Hospitalization | molnupiravir |
| SARS-CoV-2 infection |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | COVID-19 |
| pathway | REACTOME | SARS-CoV-2 Infection |
| disease | MESH | Comorbidity |
| disease | MESH | Infectious Diseases |
| pathway | REACTOME | Reproduction |
| pathway | REACTOME | Translation |
| disease | IDO | site |
| drug | DRUGBANK | Coenzyme M |
| drug | DRUGBANK | Ritonavir |
| disease | MESH | death |
| drug | DRUGBANK | Gold |
| drug | DRUGBANK | Trestolone |
| disease | MESH | drug interactions |
| disease | MESH | contraindications |
| disease | MESH | infection |
| disease | MESH | death cause |
| disease | MESH | liver diseases |
| disease | MESH | hypertension |
| disease | MESH | hepatitis |
| disease | MESH | diabetes mellitus |
| disease | IDO | immunodeficiency |
| disease | MESH | lung disease |
| drug | DRUGBANK | Oxygen |
| disease | MESH | reinfections |
| drug | DRUGBANK | Isoxaflutole |
| drug | DRUGBANK | Dextromethorphan |
| drug | DRUGBANK | Ranitidine |
| disease | IDO | algorithm |
| disease | MESH | Heart failure |
| disease | IDO | history |
| disease | IDO | symptom |
| disease | MESH | chronic diseases |
| disease | IDO | role |
| drug | DRUGBANK | Fluvoxamine |
| disease | MESH | influenza |
| disease | MESH | sepsis |
| disease | IDO | country |