In a new WHO guideline, the antiviral drug molnupiravir is conditionally recommended for patients with non-severe COVID-19 who are at the highest risk of hospitalization.
Patients who are at the highest risk of hospitalization typically include those who are unvaccinated, older people, and those with weak immune systems or chronic diseases.
However, the panel says that young and healthy patients, including children, and pregnant and breastfeeding women should not be given the drug due to potential harms.
Molnupiravir is an antiviral medicine that works by stopping coronavirus from growing and spreading. Used as early as possible after infection, it can help prevent more severe symptoms from developing.
Today’s recommendation is based on new data from six clinical trials involving 4,796 patients. This is the largest dataset on this drug so far.
Evidence from these trials showed that molnupiravir reduces the risk of hospital admission (43 fewer admissions per 1,000 patients at highest risk) and time to symptom resolution (average 3.4 fewer days), while low certainty evidence suggests a small effect on mortality (6 fewer deaths per 1,000 patients).
The team makes no recommendation for patients with a severe or critical illness as there are no trial data on molnupiravir for this population.
In the same guideline update, the panel recommends a treatment combining two antibodies (casirivimab and imdevimab) to be used in people who are confirmed not to have the omicron variant, as new evidence demonstrates a lack of effectiveness against the omicron variant.
Today’s guidance adds to previous recommendations for the use of Baricitinib, interleukin-6 receptor blockers, and systemic corticosteroids for patients with severe or critical COVID-19.
For the use of sotrovimab for patients with non-severe COVID-19 and against the use of convalescent plasma, ivermectin, and hydroxychloroquine in patients with COVID-19 regardless of disease severity.
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The study is published in The BMJ.
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