Table 2.
Real-world evidence for use of oral antivirals in the treatment of mild to moderate COVID-19 disease in hospitalized patients
| Study design and setting | Sample size | Characteristics of antiviral users | Major findings |
| Molnupiravir | |||
| Suzuki et al.[37] Retrospective cohort 23 hospitals in Fukushima, Japan Jan to Apr 2022 |
230 molnupiravir users 690 nonusers matched by PS |
Age 64.1 ± 20.0 Male 53.0% ≥2 doses of vaccine 82.2% Hypertension 55.3% Diabetes 26.1% Cardiac disease 18.3% |
Clinical deteriorationa 3.9 vs. 8.4% (P = 0.034), adjusted OR 0.45 (95% CI 0.21–0.97) |
| Wai et al.[12] Retrospective inpatient cohort Hong Kong Feb to Mar 2022 |
799 molnupiravir users 20057 nonusers |
Age >60 years: 98.2% Male 50.6% Diabetes 15.2% Stroke 8.1% |
All-cause mortality HR 0.31 (95% CI 0.24–0.40) 28-day hospital readmission OR 0.71 (95% CI 0.52–0.97) |
| Wong et al.[38] Retrospective cohort study Hospitalized adults in Hong Kong Feb to May 2022 |
1856 molnupiravir users 1856 nonusers matched by PS |
Age 80.3 ± 13.0 Male 49.2% ≥2 doses of mRNA or ≥3 doses of inactivated vaccine 6.2% Charlson's comorbidity index 5.8 ± 1.9 |
All-cause mortality 8.1 vs. 15.9%, HR 0.48 (95% CI 0.40–0.59) Composite disease progressionb 16.5 vs. 25.9%, HR 0.60 (95% CI 0.52–0.69) |
| Nirmatrelvir-ritonavir | |||
| Wai et al.[12] Retrospective inpatient cohort Hong Kong Feb to Mar 2022 |
282 Nirmatrelvir-ritonavir users 20057 nonusers |
Age >60 years: 99.3% Male 52.1% Stroke 9.2% Diabetes 7.4% |
All-cause mortality HR 0.10 (95% CI 0.05–0.21) 28-day hospital readmission OR 0.47 (95% CI 0.24–0.93) |
| Wong et al.[38] Retrospective cohort study in Hong Kong Hospitalized adults Feb to May 2022 |
890 nirmatrelvir-ritonavir users 890 nonusers matched by PS |
Age 77.2 ± 14.1 Male 50.0% ≥2 doses of mRNA or ≥3 doses of inactivated vaccine 10.5% Charlson's comorbidity index 5.1 ± 1.7 |
All-cause mortality 3.6 vs. 10.3%, HR 0.34 (95% CI 0.23–0.50) Composite disease progressionb 11.3 vs. 19.4%, HR 0.57 (95% CI 0.45–0.72) |
CI, confidence interval; HR, hazard ratio; OR, odds ratio; PS, propensity score.
a
Worsened respiratory condition requiring escalation of treatment or respiratory support.
b
All-cause mortality, invasive mechanical ventilation, intensive care admission or oxygen therapy.