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莫努匹韦治疗在医疗机构 COVID-19 患者中的获益。

The Benefits of Molnupiravir Treatment in Healthcare Facilities Patients with COVID-19.

机构信息

Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, 220, Taiwan.

The Graduate Institute of Medicine, Yuan-Ze University, Taoyuan City, Taiwan.

出版信息

Drug Des Devel Ther. 2023 Jan 19;17:87-92. doi: 10.2147/DDDT.S392708. eCollection 2023.

Abstract

BACKGROUND

Molnupiravir (MOL) is an oral antiviral medication that has recently been treated for COVID-19.

OBJECTIVELY

We perform a prospective and observational study to elucidate the efficacy and safety of MOL in healthcare patients with COVID-19.

MATERIALS AND METHODS

A observational, non-randomized study of patients diagnosed with COVID-19 in 46 healthcare facilities and treated with MOL started within 5 days after the onset of signs or symptoms. We recorded data for all patients, including demographic data, clinical features, and symptoms. Treatment response was classified into cure, stable, hospitalization and death. Multivariate analysis was performed with stepwise logistic regression for hospitalization and death risk factors.

RESULTS

In total, 856 patients were diagnosed as having COVID-19 and treated with MOL during the study period. Of those, 496 patients (57.9%) were cured, 256 patients (29.9%) in stable condition, 104 patients (12.2%) hospitalized, and 22 patients (2.6%) died, respectively. There was significant effectiveness (87.8%) in COVID-19 patients using MOL. Multivariate analysis was performed to confirm the risk factors for hospitalization and death and included elder age (>80 years old) (odds ratio (OR) 2.2, 95% confidence interval (CI): 1.1-6.9), old cerebrovascular accident (CVA) (OR=4.1, 95% CI: 1.3-9.9), the presence of diabetes mellitus (DM) (OR=2.6, 95% CI: 1.2-9.1) and chronic respiratory diseases (OR=2.4, 95% (CI): 1.3-8.1).

LIMITATIONS

This is an observational study, neither randomized study nor control group study.

CONCLUSION

Initial treatment with MOL has the treatment benefits and is well tolerated for patients with COVID-19 in healthcare facilities. Older age, old CVA, DM, and chronic respiratory diseases were independent risk factors for hospitalization and mortality. The results demonstrate there are important clinical benefits of MOL beyond the reduction in hospitalization or death for these patients with more comorbidities in Taiwan.

摘要

背景

莫努匹韦(MOL)是一种口服抗病毒药物,最近被用于治疗 COVID-19。

目的

我们进行了一项前瞻性和观察性研究,以阐明 MOL 在 COVID-19 医护患者中的疗效和安全性。

材料和方法

对 46 家医疗机构中确诊为 COVID-19 并在症状出现后 5 天内开始使用 MOL 治疗的患者进行观察性、非随机研究。我们记录了所有患者的人口统计学数据、临床特征和症状。治疗反应分为治愈、稳定、住院和死亡。采用逐步逻辑回归对住院和死亡的危险因素进行多变量分析。

结果

在研究期间,共有 856 例患者被诊断为 COVID-19 并接受 MOL 治疗。其中,496 例(57.9%)治愈,256 例(29.9%)病情稳定,104 例(12.2%)住院,22 例(2.6%)死亡。COVID-19 患者使用 MOL 的疗效显著(87.8%)。进行多变量分析以确认住院和死亡的危险因素,包括年龄较大(>80 岁)(比值比(OR)2.2,95%置信区间(CI):1.1-6.9)、陈旧性脑血管意外(CVA)(OR=4.1,95%CI:1.3-9.9)、糖尿病(DM)(OR=2.6,95%CI:1.2-9.1)和慢性呼吸系统疾病(OR=2.4,95%CI:1.3-8.1)。

局限性

这是一项观察性研究,既不是随机研究也不是对照研究。

结论

初始使用 MOL 治疗对医疗机构中的 COVID-19 患者具有治疗益处且耐受性良好。年龄较大、陈旧性 CVA、DM 和慢性呼吸系统疾病是住院和死亡的独立危险因素。结果表明,对于台湾这些合并症较多的患者,MOL 除了降低住院率或死亡率外,还有重要的临床获益。

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