Frontiers in Transplantation (Jul 2024)

Remdesivir and molnupiravir had comparable efficacy in lung transplant recipients with mild-to-moderate COVID-19: a single center experience

  • Deepika Razia,
  • Deepika Razia,
  • Devika Sindu,
  • Lauren Cherrier,
  • Lauren Cherrier,
  • Katherine Grief,
  • Rajat Walia,
  • Rajat Walia,
  • Sofya Tokman,
  • Sofya Tokman

DOI
https://doi.org/10.3389/frtra.2024.1408289
Journal volume & issue
Vol. 3

Abstract

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IntroductionRemdesivir (REM) and molnupiravir (MOL) are commonly used to treat lung transplant recipients (LTRs) with COVID-19; however, the clinical efficacy of these medications is yet to be compared. In this retrospective cohort study, we compared the clinical outcomes between LTRs with mild-to-moderate COVID-19 treated with REM and those treated with MOL.Methods and ResultsBetween March 2020 and August 2022, 195 LTRs developed COVID-19 at our center. After excluding 82 who presented with severe disease requiring hospitalization, the remaining 113 were included in the analysis: 54 did not receive antiviral treatment, 30 were treated with REM, and 29 were treated with MOL. Adjusted multivariable logistic regression analysis showed similar rates of hospitalization (adjusted odds ratio (aOR) 1.169, [95% confidence interval (95% CI) 0.105–12.997, p = 0.899], ICU admission (aOR 0.822, 95% CI 0.042–16.220, p = 0.898), mechanical ventilation (aOR 0.903, 95% CI 0.015–55.124, p = 0.961), and COVID-19-related mortality (aOR 0.822, 95% CI 0.042–16.220, p = 0.898) between LTRs treated with REM and those treated with MOL for mild-to-moderate COVID-19, irrespective of SARS-CoV-2 strain.ConclusionMOL may be a suitable alternative to REM to treat LTRs with mild-to-moderate COVID-19, and the choice of antiviral therapy can be driven by practical considerations such as route of administration and drug availability.

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