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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...

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Autores principales: Bruno, Giuseppe, Giotta, Massimo, Perelli, Serena, De Vita, Giuseppina, Bartolomeo, Nicola, Buccoliero, Giovanni Battista
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9695104/
https://www.ncbi.nlm.nih.gov/pubmed/36423123
http://dx.doi.org/10.3390/v14112514
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author Bruno, Giuseppe
Giotta, Massimo
Perelli, Serena
De Vita, Giuseppina
Bartolomeo, Nicola
Buccoliero, Giovanni Battista
author_facet Bruno, Giuseppe
Giotta, Massimo
Perelli, Serena
De Vita, Giuseppina
Bartolomeo, Nicola
Buccoliero, Giovanni Battista
author_sort Bruno, Giuseppe
collection PubMed
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; p = 0.0021], age ≥ 75 [OR 2.647; p = 0.0124], moderate illness [OR 16.75; p < 0.001], and treatment discontinuation after medical decision [OR 8.148; p = 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.
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spelling pubmed-96951042022-11-26 Early Access to Oral Antivirals in High-Risk Outpatients: Good Weapons to Fight COVID-19 Bruno, Giuseppe Giotta, Massimo Perelli, Serena De Vita, Giuseppina Bartolomeo, Nicola Buccoliero, Giovanni Battista Viruses Article 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; p = 0.0021], age ≥ 75 [OR 2.647; p = 0.0124], moderate illness [OR 16.75; p < 0.001], and treatment discontinuation after medical decision [OR 8.148; p = 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. MDPI 2022-11-14 /pmc/articles/PMC9695104/ /pubmed/36423123 http://dx.doi.org/10.3390/v14112514 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Bruno, Giuseppe
Giotta, Massimo
Perelli, Serena
De Vita, Giuseppina
Bartolomeo, Nicola
Buccoliero, Giovanni Battista
Early Access to Oral Antivirals in High-Risk Outpatients: Good Weapons to Fight COVID-19
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 Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9695104/
https://www.ncbi.nlm.nih.gov/pubmed/36423123
http://dx.doi.org/10.3390/v14112514
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