Molnupiravir's real-world effectiveness in COVID-19 non-hospitalized patients at high risk of severe disease: a single-center study

ObjectiveTo assess the real-world effectiveness of molnupiravir (MOL) in reducing the need for hospitalization in at-risk, non-hospitalized patients with confirmed COVID-19. MethodsA single-center, non-randomized, observational retrospective study of non-hospitalized patients with confirmed COVID-19 treated at the Clinic for Infectious and Tropical Diseases, University Clinical Center in Belgrade, Serbia. ResultsBetween December 15th, 2021, and February 15th, 2022, 320 patients were eligible for inclusion in the study. Of these, 165 received treatment with molnupiravir (51.6%), while both groups were similar in gender and age distribution. The treatment group had a higher proportion of vaccination (75.2% vs. 51%, p<0.001) but was similar to the control group in terms of multiple comorbidity predomination (65.5% vs. 65.2%, p 0.956). The majority of patients who received MOL didnt require hospitalization (92.7 vs. 24.5%, p<0.001) and needed oxygen supplementation less frequently than those in the control group (0.6% vs. 31%, p<0.001). During the follow-up period of 12.12{+/-}3.5 days, none of the patients on MOL were admitted to the Intensive Care Unit (vs. 10.3%, p<0.001). Molnupiravir significantly reduced the risk of hospitalization by 97.9% (HR 0.021, p<0.001). ConclussionOur study has proven the effectiveness of molnupiravir in preventing hospitalization in a population at risk for developing severe forms of COVID-19.