We read with great interest the recent article published in the Journal of Infection investigating the effectiveness of molnupiravir, nirmatrelvir–ritonavir, and sotrovimab in preventing hospital admission or death among COVID-19 patients.
1We noticed that despite the use of broad-spectrum antivirals (e.g. remdesivir), monoclonal antibodies, corticosteroids, hydroxychloroquine
- Evans A.
- Qi C.
- Adebayo J.O.
- Underwood J.
- Coulson J.
- Bailey R.
- et al.
Real-world effectiveness of molnupiravir, nirmatrelvir-ritonavir, and sotrovimab on preventing hospital admission among higher-risk patients with COVID-19 in Wales: a retrospective cohort study.
J Infect. 2023; https://doi.org/10.1016/j.jinf.2023.02.012
2being attempted, only limited effectiveness was achieved in reducing mortality, along with financial and logistical limitations, preventing their widespread use. Hence, the pertinent question on whether the short-term evidence on the effectiveness of COVID-19 oral antivirals in reducing risk of mortality and hospitalizations holds true even in the post-acute phase, especially in a largely vaccinated global population in an Omicron-dominant setting, remains to be explored.
- Agarwal A.
- Rochwerg B.
- Lamontagne F.
- Siemieniuk R.A.C.
- Agoritsas T.
- Askie L.
- et al.
A living WHO guideline on drugs for covid-19.
BMJ. 2020; 370: m3379
3Thus, by examining two cohorts of hospitalized patients from Hong Kong prescribed with either molnupiravir or nirmatrelvir–ritonavir, this longitudinal study aims to assess the benefits of both drugs in reducing all-cause mortality in COVID-19 vaccine recipients compared to non-recipients in an in-patient setting in the post-acute phase of infection.
- Ledford H.
Long-COVID treatments: why the world is still waiting.
Nature. 2022; 608 (PubMed PMID: 35945375. Epub 2022/08/10. eng.): 258-260
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- Real-world effectiveness of molnupiravir, nirmatrelvir-ritonavir, and sotrovimab on preventing hospital admission among higher-risk patients with COVID-19 in Wales: a retrospective cohort study.J Infect. 2023; https://doi.org/10.1016/j.jinf.2023.02.012
- A living WHO guideline on drugs for covid-19.BMJ. 2020; 370: m3379
- Long-COVID treatments: why the world is still waiting.Nature. 2022; 608 (PubMed PMID: 35945375. Epub 2022/08/10. eng.): 258-260
- Safety of an inactivated, whole-virion COVID-19 vaccine (CoronaVac) in people aged 60 years or older in Hong Kong: a modified self-controlled case series.Lancet Healthy Longev. 2022; 3: e491-e500
- Bell's palsy following vaccination with mRNA (BNT162b2) and inactivated (CoronaVac) SARS-CoV-2 vaccines: a case series and nested case-control study.Lancet Infect Dis. 2022; 22: 64-72
- Vaccine effectiveness of BNT162b2 and CoronaVac against SARS-CoV-2 Omicron BA.2 infection, hospitalisation, severe complications, cardiovascular disease and mortality in patients with diabetes mellitus: a case control study.J Infect. 2022; 85: e140-e144
- Effectiveness of BNT162b2 and CoronaVac vaccinations against mortality and severe complications after SARS-CoV-2 Omicron BA. 2 infection: a case-control study.Emerg Microbes Infect. 2022; 11: 2304-2314
- Vaccine effectiveness of BNT162b2 and CoronaVac against SARS-CoV-2 Omicron BA. 2 infection, hospitalisation, severe complications, cardiovascular disease and mortality in patients with diabetes mellitus: a case control study.J Infect. 2022; 5: e140-e144
- Impact of the use of oral antiviral agents on the risk of hospitalization in community coronavirus disease 2019 patients (COVID-19).Clin Infect Dis. 2022; 76: e26-e33
- Real-world effectiveness of molnupiravir and nirmatrelvir plus ritonavir against mortality, hospitalisation, and in-hospital outcomes among community-dwelling, ambulatory patients with confirmed SARS-CoV-2 infection during the omicron wave in Hong Kong: an observational study.Lancet. 2022; 400: 1213-1222
Published online: February 21, 2023
Accepted: February 18, 2023
☆Eric Yuk Fai Wan, Boyuan Wang, and Sukriti Mathur are co-first authors and contributed equally.
© 2023 The British Infection Association. Published by Elsevier Ltd. All rights reserved.