Abstract
Background: The initiation of antiviral treatment for coronavirus disease 2019 (COVID-19) is based on the patient's risk of developing severe symptoms. Molnupiravir and remdesivir are new antiviral agents with limited data in real-world practice, especially in Thailand.
Objectives: This study aimed to evaluate the treatment outcomes, adverse drug reactions (ADRs), and factors associated with treatment failure in mild-moderate symptoms of adult COVID-19 who received molnupiravir or three days- intravenous remdesivir at the initiation of treatment.
Methods: This retrospective study was conducted at King Chulalongkorn Memorial Hospital, Thai Red Cross Society. The inclusion criteria were mild-moderate symptoms of COVID-19 patients 18 years and over, received care during April 2022, and received five days of molnupiravir or three days of intravenous remdesivir at the initiation of treatment. Factors associated with treatment failure were analyzed by logistic regression with statistical significance at P < 0.05.
Results: Of 182 patients, 105 (57.7%) received remdesivir, and 77 (42.3%) received molnupiravir. Treatment failure was found in 6 cases (7.8%) of the molnupiravir group and 24 cases (22.9%) of the remdesivir group with statistical significance (P = 0.007). By day 10, 30 patients (39.0%) in the molnupiravir group and 75 patients (71.4%) in the remdesivir group had clinically resolved, respectively (P < 0.001).Male gender (aOR = 3.375), and pneumonia (aOR = 2.495) were associated with treatment failure. No deaths or rehospitalization within 30 days after antiviral therapy were observed in this study. ADRs included headaches or dizziness with remdesivir (3.8%) and diarrhea with molnupiravir (5.2%).
Conclusion: Molnupiravir and three-days intravenous remdesivir are still recommended treatments for mild to moderate COVID-19 patients at risk of developing severe symptoms. Both antiviral agents are safe with few and mildly ADRs. This study suggests closely monitoring COVID-19 patients with pneumonia.
DOI
10.56808/2673-060X.5566
Recommended Citation
Kittikasemsook, Sarawut; Torvorapanit, Pattama; and Nakaranurack, Chotirat
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"Treatment outcomes and factors associated with treatment failure among mild-moderate COVID-19 patients receiving five-Days oral molnupiravir vs three-days intravenous remdesivir in a real-world practice,"
Chulalongkorn Medical Journal: Vol. 70:
Iss.
1, Article 4.
DOI: https://doi.org/10.56808/2673-060X.5566
Available at:
https://digital.car.chula.ac.th/clmjournal/vol70/iss1/4