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<p>This study evaluates the effect of molnupiravir on clinical improvement, viral clearance and antibody responses of COVID-19 patients who previously developed immunity through vaccination or prior infection. This multi-center, prospective, observational study included all mild adult COVID-19 cases for whom molnupiravir was recommended during the study period. The primary outcome was hospitalization, death or new oxygen need due to COVID-19 within 28&#xa0;days of follow-up. The effects of molnupiravir on viral clearance, serum biochemical tests and SARS-CoV-2 antibody levels were also assessed. A total of 844 patients (402 molnupiravir, 442 no molnupiravir) were included. The mean age was 66, 75% of them were vaccinated. The primary outcome occurred in 8 patients, with no significant difference different between propensity score-matched groups. Molnupiravir showed no effect on clinical improvement. Viral clearance was higher in the molnupiravir group on day 3, but higher in the untreated group by day 10. Serum SARS-CoV-2 antibody levels on day 28 were lower in the molnupiravir group. The effectiveness of molnupiravir in reducing hospitalization and death may be insufficient in previously immune COVID-19 patients. Additionally, molnupiravir may reduce day-28 serum SARS-CoV-2 antibody level.</p>

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Effectiveness and safety of molnupiravir among patients with mild to moderate COVID-19: a prospective, observational, cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月16日

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  • Serap Şimşek-Yavuz,
  • Alpay Azap,
  • Gülsüm Öztürk-Emiral,
  • Hüsna Çevik,
  • Rahmet Güner,
  • Müge Ayhan,
  • Belgin Coşkun,
  • Aysun Benli,
  • Yeşim Tok,
  • Mustafa Önel,
  • İlker İnanç-Balkan,
  • Sezen Fansa,
  • Fatma Zehra Güneşer,
  • Mahir Kapmaz,
  • Nilsun Altunal,
  • Elif Selcen Beng,
  • Özlem Aydın,
  • Sezen Özge Özen,
  • Seniha Başaran,
  • Hasan Yağmur,
  • Meryem Çalışkan,
  • Melek-Nur Aslan,
  • Neslihan Uyar,
  • Burcu Atasoy Bozan,
  • Mihriban Aksoy,
  • Mehtap Aydın,
  • Duygu Korkut Akyürek,
  • Elif Mukime Sarıcaoğlu,
  • Önder Ergönül,
  • Sevim Meşe,
  • Füsun Can,
  • Mert Ahmet Kuşkucu,
  • Ali Ağaçfidan,
  • Filiz Pehlivanoğlu,
  • Özlem Altuntaş-Aydın,
  • Alper Gündüz

摘要

This study evaluates the effect of molnupiravir on clinical improvement, viral clearance and antibody responses of COVID-19 patients who previously developed immunity through vaccination or prior infection. This multi-center, prospective, observational study included all mild adult COVID-19 cases for whom molnupiravir was recommended during the study period. The primary outcome was hospitalization, death or new oxygen need due to COVID-19 within 28 days of follow-up. The effects of molnupiravir on viral clearance, serum biochemical tests and SARS-CoV-2 antibody levels were also assessed. A total of 844 patients (402 molnupiravir, 442 no molnupiravir) were included. The mean age was 66, 75% of them were vaccinated. The primary outcome occurred in 8 patients, with no significant difference different between propensity score-matched groups. Molnupiravir showed no effect on clinical improvement. Viral clearance was higher in the molnupiravir group on day 3, but higher in the untreated group by day 10. Serum SARS-CoV-2 antibody levels on day 28 were lower in the molnupiravir group. The effectiveness of molnupiravir in reducing hospitalization and death may be insufficient in previously immune COVID-19 patients. Additionally, molnupiravir may reduce day-28 serum SARS-CoV-2 antibody level.