Efficacy of Sotrovimab (SOT), Molnupiravir (MOL), and Nirmatrelvir/Ritponavir (N/R) and Tolerability of Molnupiravir in Outpatients at High Risk for Severe COVID-19
Author:
Kauer Victoria1, Totschnig David1ORCID, Waldenberger Ferdinand2, Augustin Max13, Karolyi Mario1, Nägeli Michelle1ORCID, Wenisch Christoph1, Zoufaly Alexander14
Affiliation:
1. Vienna Healthcare Group, Department of Medicine IV, Klinik Favoriten, Kundratstraße 3, 1100 Vienna, Austria 2. ASBÖ Arbeiter-Samariter-Bund Floridsdorf-Donaustadt, 1150 Vienna, Austria 3. Department I of Internal Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany 4. Faculty of Medicine, Sigmund Freud University, 1200 Vienna, Austria
Abstract
Objective: The main goal of this study was to assess the potential clinical impact of an outpatient administration of available antivirals including SOT, N/R, and MOL to COVID-19 patients at high risk for disease progression. Methods: We conducted a retrospective analysis on 2606 outpatient individuals with mild to moderate COVID-19 at risk for disease progression, hospitalization, or death. After receiving either SOT (420/2606), MOL (1788/2606), or N/R (398/2606), patients were followed-up with regarding primary (hospitalization rate) and secondary (treatment and side effects) outcomes by phone. Result: A total of 2606 patients were treated at the outpatient clinic (SOT: 420; N/R: 398; MOL: 1788). 3.2% of the SOT patients (1 ICU admission), 0.8% of the MOL patients (2 ICU admissions), and none of the N/R patients were hospitalized. 14.3% of the N/R patients reported strong to severe side effects, exceeding SOT (2.6%) and MOL (5%) patients. A reduction in COVID symptoms after the treatment was experienced by 43% of patients in both the SOT and MOL groups and by 67% of patients in the N/R group, respectively. Women had a higher chance of symptom improvement with MOL (OR 1.2, 95%CI 1.0–1.5). Conclusion: All antiviral treatment options effectively prevented hospitalization in high-risk COVID-19 patients and were well tolerated. Side effects were pronounced in patients with N/R.
Funder
COVIM Federal Ministry of Education and Research Germany
Subject
Virology,Infectious Diseases
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1. Engineered Therapeutic Antibody Against SARS-CoV-2;Current Clinical Microbiology Reports;2023-11-14 2. Molnupiravir/sotrovimab;Reactions Weekly;2023-07-22
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