Frontiers in Pharmacology (Jun 2022)

Antiviral Efficacy and Safety of Molnupiravir Against Omicron Variant Infection: A Randomized Controlled Clinical Trial

  • Rongrong Zou,
  • Ling Peng,
  • Dan Shu,
  • Lei Zhao,
  • Jianfeng Lan,
  • Guoyu Tan,
  • Jinghan Peng,
  • Xiangyi Yang,
  • Miaona Liu,
  • Chenhui Zhang,
  • Jing Yuan,
  • Huxiang Wang,
  • Song Li,
  • Hongzhou Lu,
  • Wu Zhong,
  • Yingxia Liu

DOI
https://doi.org/10.3389/fphar.2022.939573
Journal volume & issue
Vol. 13

Abstract

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Background: The rapid worldwide spread of the Omicron variant of SARS-CoV-2 has unleashed a new wave of COVID-19 outbreaks. The efficacy of molnupiravir, an approved drug, is still unknown in patients infected with the Omicron variant.Objective: Evaluated the antiviral efficacy and safety of molnupiravir in patients infected with SARS-CoV-2 Omicron variant, with symptom duration within 5 days.Methods: We conducted a randomized, controlled trial involving patients with mild or moderate COVID-19. Patients were randomized to orally receive molnupiravir (800 mg) plus basic treatment or only basic treatment for 5 days (BID). The antiviral efficacy of the drug was evaluated using reverse transcriptase polymerase chain reaction.Results: Results showed that the time of viral RNA clearance (primary endpoint) was significantly decreased in the molnupiravir group (median, 9 days) compared to the control group (median, 10 days) (Log-Rank p = 0.0092). Of patients receiving molnupiravir, 18.42% achieved viral RNA clearance on day 5 of treatment, compared to the control group (0%) (p = 0.0092). On day 7, 40.79%, and 6.45% of patients in the molnupiravir and control groups, respectively, achieved viral RNA clearance (p = 0.0004). In addition, molnupiravir has a good safety profile, and no serious adverse events were reported.Conclusion: Molnupiravir significantly accelerated the SARS-CoV-2 Omicron RNA clearance in patients with COVID-19.Clinical Trial Registration: [chictr.org.cn], identifier [ChiCTR2200056817].

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