Study: Molnupiravir Reduces Mortality in Patients With COVID-19

In a large retrospective cohort study conducted in the Czech Republic during the COVID-19 Omicron variant outbreak, molnupiravir demonstrated effectiveness in reducing mortality among adult patients.

This study was prompted by the need to evaluate real-world effectiveness of molnupiravir during the ongoing pandemic, particularly as variants such as Omicron have introduced new challenges due to high transmissibility. While molnupiravir received emergency use authorization as an oral antiviral treatment for COVID-19, evidence of its impact on mortality in real-world settings remained limited. This research aimed to address this gap by leveraging population-wide data.

Researchers analyzed data from 74,541 adult patients diagnosed with SARS-CoV-2 infection between January 1 and December 31, 2022 who were treated with molnupiravir. The study used stratified Cox regression and Fine-Gray models to account for competing risks and adjust for potential confounders. Outcomes of interest included 30-day all-cause and 30-day COVID-19-related mortality.

Treatment with molnupiravir was associated with a significant reduction in 30-day all-cause mortality (adjusted hazard ratio [HR], 0.58; 95% CI, 0.53-0.64; P < .001) and 30-day COVID-19-related mortality (adjusted HR, 0.50; 95% CI, 0.42-0.58; P < .001). The beneficial effect of the treatment was significant regardless of sex, comorbidity burden (as measured by the DCCI score), hospitalization, COVID-19 vaccination status, and age.

“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,” the study authors concluded.

Reference

Pavlik T, Jarkovský J, Šanca O, et al. Real clinical effectiveness of molnupiravir against 30-day mortality among 74 541 SARS-CoV-2 positive patients. Open Forum Infect Dis. Published online November 20, 2024. https://doi.org/10.1093/ofid/ofae685