Clinical outcomes among COVID-19 patients initiated on molnupiravir in Denmark: A national registry study

TY - JOUR

T1 - Clinical outcomes among COVID-19 patients initiated on molnupiravir in Denmark

T2 - A national registry study

AU - Larsen, Carsten S.

AU - Westergaard, Caroline L.

AU - Stærke, Nina B.

AU - Arnet, Urs

AU - Liu, Gui

AU - Kantsø, Line R.

AU - Kjellberg, Jakob

PY - 2025/2

Y1 - 2025/2

N2 - Background: Molnupiravir (MOV) is an orally bioavailable ribonucleoside with antiviral activity against all tested SARS-CoV-2 variants. We describe the demographic, clinical, and treatment characteristics of non-hospitalized Danish patients treated with MOV and their clinical outcomes following MOV initiation. Method: Among all adults (>18 years) who received MOV between 16 December 2021 and 30 April 2022 in an outpatient setting in Denmark, we summarized their demographic and clinical characteristics at baseline and post-MOV outcomes using descriptive statistics. Outcomes were emergent hospitalization and all-cause mortality during the 28 days after MOV initiation. We estimated the odds ratios (OR) of outcomes by time from positive test to treatment using logistic regression. Results: We identified 3691 MOV-treated patients, of whom 45.8% were male and mean age was 70.1 years. Most patients (76.2%) initiated MOV within 0–2 days after a positive SARS-CoV-2 test and 16.8% within 3–5 days. Over a 28-day period, rates for all-cause, respiratory- or COVID-19-related, and COVID-19-related hospitalization were 4.8%, 2.6% and 1.5%, respectively. All-cause mortality was 1.6%. Initiation of MOV 3–5 days after a positive SARS-CoV-2 test compared to 1–2 days was associated with an increased risk of all-cause (OR 1.85, 95% CI 1.29–2.67) and respiratory or COVID-19-related (OR 1.78, 95% CI 1.07–2.94) hospitalization, and all-cause mortality (OR 2.90, 95% CI 1.64–5.15). Conclusion: MOV was primarily prescribed to vaccinated elderly persons with multiple comorbidities. The all-cause hospitalization and mortality rates in this population were low. Early initiation of MOV reduced the risk of hospitalization and death compared with late initiation.

AB - Background: Molnupiravir (MOV) is an orally bioavailable ribonucleoside with antiviral activity against all tested SARS-CoV-2 variants. We describe the demographic, clinical, and treatment characteristics of non-hospitalized Danish patients treated with MOV and their clinical outcomes following MOV initiation. Method: Among all adults (>18 years) who received MOV between 16 December 2021 and 30 April 2022 in an outpatient setting in Denmark, we summarized their demographic and clinical characteristics at baseline and post-MOV outcomes using descriptive statistics. Outcomes were emergent hospitalization and all-cause mortality during the 28 days after MOV initiation. We estimated the odds ratios (OR) of outcomes by time from positive test to treatment using logistic regression. Results: We identified 3691 MOV-treated patients, of whom 45.8% were male and mean age was 70.1 years. Most patients (76.2%) initiated MOV within 0–2 days after a positive SARS-CoV-2 test and 16.8% within 3–5 days. Over a 28-day period, rates for all-cause, respiratory- or COVID-19-related, and COVID-19-related hospitalization were 4.8%, 2.6% and 1.5%, respectively. All-cause mortality was 1.6%. Initiation of MOV 3–5 days after a positive SARS-CoV-2 test compared to 1–2 days was associated with an increased risk of all-cause (OR 1.85, 95% CI 1.29–2.67) and respiratory or COVID-19-related (OR 1.78, 95% CI 1.07–2.94) hospitalization, and all-cause mortality (OR 2.90, 95% CI 1.64–5.15). Conclusion: MOV was primarily prescribed to vaccinated elderly persons with multiple comorbidities. The all-cause hospitalization and mortality rates in this population were low. Early initiation of MOV reduced the risk of hospitalization and death compared with late initiation.

KW - COVID-19

KW - hospitalization

KW - molnupiravir

KW - mortality

KW - SARS-CoV-2

UR - http://www.scopus.com/inward/record.url?scp=85215609507&partnerID=8YFLogxK

U2 - 10.1177/13596535241313244

DO - 10.1177/13596535241313244

M3 - Journal article

C2 - 39836400

AN - SCOPUS:85215609507

SN - 1359-6535

VL - 30

JO - Antiviral Therapy

JF - Antiviral Therapy

IS - 1

ER -