Early Access to Oral Antivirals in High-Risk Outpatients: Good Weapons to Fight COVID-19
Introduction: Molnupiravir and Nirmatrelvir/r (NMV-r) have been proven to reduce severe Coronavirus Disease 2019 (COVID-19) in unvaccinated high-risk individuals. Data regarding their impact in fully vaccinated vulnerable subjects with mild-to-moderate COVID-19 are still limited, particularly in the...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-11-01
|
| Series: | Viruses |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1999-4915/14/11/2514 |
| _version_ | 1797463797036744704 |
|---|---|
| author | Giuseppe Bruno Massimo Giotta Serena Perelli Giuseppina De Vita Nicola Bartolomeo Giovanni Battista Buccoliero |
| author_facet | Giuseppe Bruno Massimo Giotta Serena Perelli Giuseppina De Vita Nicola Bartolomeo Giovanni Battista Buccoliero |
| author_sort | Giuseppe Bruno |
| collection | DOAJ |
| description | Introduction: Molnupiravir and Nirmatrelvir/r (NMV-r) have been proven to reduce severe Coronavirus Disease 2019 (COVID-19) in unvaccinated high-risk individuals. Data regarding their impact in fully vaccinated vulnerable subjects with mild-to-moderate COVID-19 are still limited, particularly in the era of Omicron and sub-variants. Methods: Our retrospective study aimed to compare the safety profile and effectiveness of the two antivirals in all consecutive high-risk outpatients between 11 January and 10 July 2022. A logistic regression model was carried out to assess factors associated with the composite outcome defined as all-cause hospitalization and/or death at 30 days. Results: A total of 719 individuals were included: 554 (77%) received Molnupiravir, whereas 165 (23%) were NMV-r users. Overall, 43 all-cause hospitalizations (5.9%) and 13 (1.8%) deaths were observed at 30 days. A composite outcome occurred in 47 (6.5%) individuals. At multivariate analysis, male sex [OR 3.785; <i>p</i> = 0.0021], age ≥ 75 [OR 2.647; <i>p</i> = 0.0124], moderate illness [OR 16.75; <i>p</i> < 0.001], and treatment discontinuation after medical decision [OR 8.148; <i>p</i> = 0.0123] remained independently associated with the composite outcome. Conclusions: No differences between the two antivirals were observed. In this real-life setting, the early use of both of the oral antivirals helped limit composite outcome at 30 days among subjects who were at high risk of disease progression. |
| first_indexed | 2024-03-09T17:55:49Z |
| format | Article |
| id | doaj.art-05767df805bf497ab48e74d763f88307 |
| institution | Directory Open Access Journal |
| issn | 1999-4915 |
| language | English |
| last_indexed | 2024-03-09T17:55:49Z |
| publishDate | 2022-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Viruses |
| spelling | doaj.art-05767df805bf497ab48e74d763f883072023-11-24T10:18:26ZengMDPI AGViruses1999-49152022-11-011411251410.3390/v14112514Early Access to Oral Antivirals in High-Risk Outpatients: Good Weapons to Fight COVID-19Giuseppe Bruno0Massimo Giotta1Serena Perelli2Giuseppina De Vita3Nicola Bartolomeo4Giovanni Battista Buccoliero5Infectious Diseases Unit, San Giuseppe Moscati Hospital, Azienda Sanitaria Locale Taranto, 74121 Taranto, ItalyComplex Unit of Statistics and Epidemiology, Azienda Sanitaria Locale Taranto, 74121 Taranto, ItalyInfectious Diseases Unit, San Giuseppe Moscati Hospital, Azienda Sanitaria Locale Taranto, 74121 Taranto, ItalyInfectious Diseases Unit, San Giuseppe Moscati Hospital, Azienda Sanitaria Locale Taranto, 74121 Taranto, ItalyInterdisciplinary Department of Medicine, University of Bari Aldo Moro, 70121 Bari, ItalyInfectious Diseases Unit, San Giuseppe Moscati Hospital, Azienda Sanitaria Locale Taranto, 74121 Taranto, ItalyIntroduction: Molnupiravir and Nirmatrelvir/r (NMV-r) have been proven to reduce severe Coronavirus Disease 2019 (COVID-19) in unvaccinated high-risk individuals. Data regarding their impact in fully vaccinated vulnerable subjects with mild-to-moderate COVID-19 are still limited, particularly in the era of Omicron and sub-variants. Methods: Our retrospective study aimed to compare the safety profile and effectiveness of the two antivirals in all consecutive high-risk outpatients between 11 January and 10 July 2022. A logistic regression model was carried out to assess factors associated with the composite outcome defined as all-cause hospitalization and/or death at 30 days. Results: A total of 719 individuals were included: 554 (77%) received Molnupiravir, whereas 165 (23%) were NMV-r users. Overall, 43 all-cause hospitalizations (5.9%) and 13 (1.8%) deaths were observed at 30 days. A composite outcome occurred in 47 (6.5%) individuals. At multivariate analysis, male sex [OR 3.785; <i>p</i> = 0.0021], age ≥ 75 [OR 2.647; <i>p</i> = 0.0124], moderate illness [OR 16.75; <i>p</i> < 0.001], and treatment discontinuation after medical decision [OR 8.148; <i>p</i> = 0.0123] remained independently associated with the composite outcome. Conclusions: No differences between the two antivirals were observed. In this real-life setting, the early use of both of the oral antivirals helped limit composite outcome at 30 days among subjects who were at high risk of disease progression.https://www.mdpi.com/1999-4915/14/11/2514COVID-19antiviralsSARS-CoV-2MolnupiravirNirmatrelvir |
| spellingShingle | Giuseppe Bruno Massimo Giotta Serena Perelli Giuseppina De Vita Nicola Bartolomeo Giovanni Battista Buccoliero Early Access to Oral Antivirals in High-Risk Outpatients: Good Weapons to Fight COVID-19 Viruses COVID-19 antivirals SARS-CoV-2 Molnupiravir Nirmatrelvir |
| title | Early Access to Oral Antivirals in High-Risk Outpatients: Good Weapons to Fight COVID-19 |
| title_full | Early Access to Oral Antivirals in High-Risk Outpatients: Good Weapons to Fight COVID-19 |
| title_fullStr | Early Access to Oral Antivirals in High-Risk Outpatients: Good Weapons to Fight COVID-19 |
| title_full_unstemmed | Early Access to Oral Antivirals in High-Risk Outpatients: Good Weapons to Fight COVID-19 |
| title_short | Early Access to Oral Antivirals in High-Risk Outpatients: Good Weapons to Fight COVID-19 |
| title_sort | early access to oral antivirals in high risk outpatients good weapons to fight covid 19 |
| topic | COVID-19 antivirals SARS-CoV-2 Molnupiravir Nirmatrelvir |
| url | https://www.mdpi.com/1999-4915/14/11/2514 |
| work_keys_str_mv | AT giuseppebruno earlyaccesstooralantiviralsinhighriskoutpatientsgoodweaponstofightcovid19 AT massimogiotta earlyaccesstooralantiviralsinhighriskoutpatientsgoodweaponstofightcovid19 AT serenaperelli earlyaccesstooralantiviralsinhighriskoutpatientsgoodweaponstofightcovid19 AT giuseppinadevita earlyaccesstooralantiviralsinhighriskoutpatientsgoodweaponstofightcovid19 AT nicolabartolomeo earlyaccesstooralantiviralsinhighriskoutpatientsgoodweaponstofightcovid19 AT giovannibattistabuccoliero earlyaccesstooralantiviralsinhighriskoutpatientsgoodweaponstofightcovid19 |