Lupia Tommaso, Corcione Silvia, Shbaklo Nour, Boglione Lucio, Torresan Stefano, Pinna Simone Mornese, Rizzello Barbara, Bosio Roberta, Fornari Valentina, Brusa Maria Teresa, Borrè Silvio, De Rosa Francesco Giuseppe
Unit of Infectious Diseases, Cardinal Massaia, 14100 Asti, Italy.
Department of Medical Sciences, Infectious Diseases, University of Turin, 10126 Turin, Italy.
Antibiotics (Basel). 2022 Nov 3;11(11):1541. doi: 10.3390/antibiotics11111541.
Real-life experience of molnupiravir treatment is lacking, especially in people hospitalized for underlying diseases not related to COVID-19. We conducted a retrospective analysis regarding molnupiravir therapy in patients with SARS-CoV-2 infection admitted for underlying diseases not associated with COVID-19. Forty-four patients were included. The median age was 79 years (interquartile range [IQR]: 51-93 years), and most males were 57,4%. The median Charlson Comorbidity Index and 4C score were, respectively, 5 (IQR: 3-10) and 9.9 (IQR: 4-12). Moreover, 77.5% of the patients had at least two doses of the anti-SARS-CoV-2 vaccine, although 10.6% had not received any SARS-CoV-2 vaccine. Frequent comorbidities were cardiovascular diseases (68.1%), and diabetes (31.9%), and most admissions were for the acute chronic heart (20.4%) or liver (8.5%) failure. After molnupiravir started, 8 (18.1%) patients developed acute respiratory failure, and five (11.4%) patients died during hospitalisation. Moreover, molnupiravir treatment does not result in a statistically significant change in laboratory markers except for an increase in the monocyte count ( = 0.048, Z = 1.978). Molnupiravir treatment in our analysis was safe and well tolerated. In addition, no patients' characteristics were found significantly related to hospital mortality or an increase in oxygen support. The efficacy of the molecule remains controversial in large clinical studies, and further studies, including larger populations, are required to fill the gap in this issue.
莫努匹拉韦治疗的实际经验尚缺,尤其是在因与新冠病毒无关的基础疾病而住院的患者中。我们对因与新冠病毒无关的基础疾病而入院的新冠病毒感染患者的莫努匹拉韦治疗进行了回顾性分析。纳入了44例患者。中位年龄为79岁(四分位间距[IQR]:51 - 93岁),大多数为男性,占57.4%。查尔森合并症指数中位数和4C评分分别为5(IQR:3 - 10)和9.9(IQR:4 - 12)。此外,77.5%的患者至少接种了两剂抗新冠病毒疫苗,尽管10.6%的患者未接种任何新冠病毒疫苗。常见合并症为心血管疾病(68.1%)和糖尿病(31.9%),大多数入院是因为急性慢性心力衰竭(20.4%)或肝衰竭(8.5%)。开始使用莫努匹拉韦后,8例(18.1%)患者出现急性呼吸衰竭,5例(11.4%)患者在住院期间死亡。此外,除单核细胞计数增加外(P = 0.048,Z = 1.978),莫努匹拉韦治疗在实验室指标方面未导致具有统计学意义的变化。在我们的分析中,莫努匹拉韦治疗安全且耐受性良好。此外,未发现患者特征与医院死亡率或氧气支持增加有显著相关性。在大型临床研究中,该药物的疗效仍存在争议,需要进一步开展包括更大规模人群的研究来填补这一问题的空白。