For non-hospitalized, unvaccinated adults with mild-to-moderate COVID-19 and at least one risk factor for severe disease, mol-nupiravir reduces the risk for hospitalization or death, according to a study published in the New England Journal of Medicine. In the phase III, double-blind, randomized trial, Carisa De Anda, PharmD, and colleagues started molnupiravir within 5 days of onset of COVID-19 signs or symptoms. Participants (N=1,433), who had at least one risk factor for severe disease, were randomly assigned to molnupiravir (N=716) or placebo (N=717) twice daily for 5 days. At the interim analysis, the superiority of molnupiravir was demonstrated; risk for hospitalization for any cause or death through day 29 was lower with molnupiravir than with placebo (7.3% vs 14.1%; difference, −6.8 percentage points). In an analysis of all participants, the percentage of patients who were hospitalized or died through day 29 was also lower in the molnupiravir group compared with the placebo group (6.8% vs 9.7%; difference, −3.0 percentage points). Subgroup analyses results were similar to the overall results. Through day 29, one death was reported in the molnupiravir group compared with nine in the placebo group.

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