Effectiveness and safety of molnupiravir among patients with mild to moderate COVID-19: a prospective, observational, cohort study
This study evaluates the effect of molnupiravir on clinical improvement, viral clearance and antibody responses of COVID-19 patients who previously developed immunity through vaccination or prior infection. This multi-center, prospective, observational study included all mild adult COVID-19 cases for whom molnupiravir was recommended during the study period. The primary outcome was hospitalization, death or new oxygen need due to COVID-19 within 28 days of follow-up. The effects of molnupiravir on viral clearance, serum biochemical tests and SARS-CoV-2 antibody levels were also assessed. A total of 844 patients (402 molnupiravir, 442 no molnupiravir) were included. The mean age was 66, 75% of them were vaccinated. The primary outcome occurred in 8 patients, with no significant difference different between propensity score-matched groups. Molnupiravir showed no effect on clinical improvement. Viral clearance was higher in the molnupiravir group on day 3, but higher in the untreated group by day 10. Serum SARS-CoV-2 antibody levels on day 28 were lower in the molnupiravir group. The effectiveness of molnupiravir in reducing hospitalization and death may be insufficient in previously immune COVID-19 patients. Additionally, molnupiravir may reduce day-28 serum SARS-CoV-2 antibody level.
Authors
- Mahir Kapmaz (ORCID: https://orcid.org/0000-0002-4115-3914)
- Sevim Meşe (ORCID: https://orcid.org/0000-0001-5944-0180)
- Seniha Başaran (ORCID: https://orcid.org/0000-0002-3402-2510)
- Mehtap Aydın (ORCID: https://orcid.org/0000-0003-4044-9366)
- Meryem Çalışkan
- hüsna çevik
- Belgin Coşkun (ORCID: https://orcid.org/0000-0002-9884-9859)
- Önder Ergönül (ORCID: https://orcid.org/0000-0003-1935-9235)
- Serap Şimşek Yavuz (ORCID: https://orcid.org/0000-0002-4675-169X)
- Neslihan UYAR (ORCID: https://orcid.org/0000-0002-3388-0177)
- Mert Ahmet Kuşkucu (ORCID: https://orcid.org/0000-0001-8735-5725)
- Aysun Benli (ORCID: https://orcid.org/0000-0003-0679-0990)
- Füsun Can (ORCID: https://orcid.org/0000-0002-6372-6680)
- Özlem Aydın (ORCID: https://orcid.org/0000-0003-0398-9216)
- Sezen Fansa (ORCID: https://orcid.org/0009-0009-0810-3067)
- Özlem Altuntaş-Aydın
- Rahmet Guner
- Ali Ağaçfidan
- Hasan Yağmur
- Mustafa Önel
- Nilsun Altunal
- Duygu Korkut Akyürek
- Elif Mukime Sarıcaoğlu
- Yeşim Tok
- Sezen Özge Özen
- Alpay Azap
- Gülsüm Öztürk-Emiral
- Elif Selcen Beng
- Müge Ayhan
- İlker İnanç-Balkan
- Fatma Zehra Güneşer
- Mihriban Aksoy
- Alper Gündüz
- Filiz Pehlivanoğlu
- Burcu Atasoy Bozan
- Melek-Nur Aslan
Institutions
- Üsküdar University (TR)
- Ministry of Health (TR)
- Koç University (TR)
- Ankara University (TR)
- Bilkent University (TR)
- University of Health Science (KH)
- Izmir Kâtip Çelebi University (TR)
- Fatih University (TR)
- Ministry of Health (BN)
- Ministry of Health (UA)
- Ümraniye Eğitim ve Araştırma Hastanesi (TR)
- Istanbul University-Cerrahpaşa (TR)
- Education Training And Research (US)
- İstanbul Kanuni Sultan Süleyman Eğitim ve Araştırma Hastanesi (TR)
- Ankara Bilkent City Hospital (TR)
- Istanbul University (TR)
Publication Details
- Journal
- Scientific Reports
- Published
- 2026-04-16
- DOI
- https://doi.org/10.1038/s41598-026-44971-x
- Primary Topic
- SARS-CoV-2 and COVID-19 Research
- Type
- article
- Field-Weighted Citation Impact
- 0.00