Molnupiravir use within 5 days of a positive SARS-CoV-2 test was associated with a reduction of postacute sequelae of SARS-CoV-2 (PASC) in a large VA study, researchers report. The reduction was evident in a large variety of patient types: people who had not received a COVID-19 vaccine, had received 1 or 2 vaccine doses, and had received a booster dose, and in those with primary SARS-CoV-2 infection and reinfection.
The cohort study included 229,286 participants who tested positive for SARS-CoV-2 between Jan. 5, 2022, and Jan. 15, 2023, had at least 1 risk factor for progression to severe COVID-19, and survived the first 30 days after testing positive. The risks of PASC (13 postacute sequelae that were defined in advance), postacute death, postacute hospital admission, and each individual postacute sequela for 11,472 participants treated with molnupiravir within 5 days of the positive test result and 217,814 on no COVID-19 antiviral or antibody treatment.
“Compared with no treatment, molnupiravir use within five days of a positive SARS-CoV-2 test result was associated with reduced risk of PASC (relative risk 0.86 (95% confidence interval 0.83 to 0.89); absolute risk reduction at 180 days 2.97% (95% confidence interval 2.31% to 3.60%)), post-acute death (hazard ratio 0.62 (0.52 to 0.74); 0.87% (0.62% to 1.13%)), and post-acute hospital admission (0.86 (0.80 to 0.93); 1.32% (0.72% to 1.92%)),” the authors report. “Molnupiravir was associated with reduced risk of eight of the 13 post-acute sequelae: dysrhythmia, pulmonary embolism, deep vein thrombosis, fatigue and malaise, liver disease, acute kidney injury, muscle pain, and neurocognitive impairment. Molnupiravir was also associated with reduced risk of PASC in people who had not received a covid-19 vaccine, had received at one or two vaccine doses, and had received a booster dose, and in people with primary SARS-CoV-2 infection and reinfection.”