Real-world effectiveness of early molnupiravir or nirmatrelvir–ritonavir in hospitalised patients with COVID-19 without supplemental oxygen requirement on admission during Hong Kong's omicron BA.2 wave: a retrospective cohort study

  1. Carlos K H Wong
  2. Ivan C H Au
  3. Kristy T K Lau
  4. Eric H Y Lau
  5. Benjamin J Cowling
  6. Gabriel M Leung

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Abstract

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  1. Version published to 10.1016/s1473-3099(22)00507-2
  2. Version published to 10.1101/2022.05.19.22275291v2 on medRxiv
  3. ScreenIT

    SciScore for 10.1101/2022.05.19.22275291: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: This study was approved by the institutional review board of the University of Hong Kong / Hospital Authority Hong Kong West Cluster (reference no. UW 20-493).
    Consent: Given the extraordinary nature of the COVID-19 pandemic, individual patient-informed consent was not required for this retrospective cohort study using anonymized data.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    All statistical analyses were performed using Stata version 17 (StataCorp LP, College Station, TX).
    StataCorp
    suggested: (Stata, RRID:SCR_012763)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Nevertheless, several limitations of our study should be acknowledged. Firstly, we cannot exclude the possibility of selection bias or confounding by indication in this observational study, despite our population-based cohort was fully representative of the local COVID-19 patient population who did not require supplemental oxygen on admission. Besides, the clinical profile of our patients who would be deemed at risk of progression to severe COVID-19 might be different from those in the major trials of molnupiravir and nirmatrelvir/ritonavir, for instance, their dominant risk factor was overweight or obesity 22,23, whilst ours was old age. Secondly, since the Ct value was no longer adopted as one of the discharge criteria during our study period, patients might have already been deemed clinically stable for discharge before reaching the specific cutoff. Accordingly, further studies are needed to confirm our findings on viral load reduction and length of hospital stay associated with oral antiviral use. Results from ongoing trials (namely PANORAMIC and RECOVERY) and observational studies are awaiting 35-39, and further research is needed to explore the safety and effectiveness of oral antivirals in different patient populations (especially by COVID-19 vaccination status and VOC), drug combinations, and other healthcare settings such as nursing homes or residential care facilities. As proposed by the medical and research community, logistics and distribution issues should be ade...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  4. Version published to 10.1101/2022.05.19.22275291v1 on medRxiv