80岁以上和80岁以下新冠肺炎患者莫努匹拉韦的可接受性和安全性比较

Aging and health research Pub Date : 2023-06-01 DOI:10.1016/j.ahr.2023.100130

Kohei Fujita , Osamu Kanai , Hiroaki Hata , Kenjiro Ishigami , Kazutaka Nanba , Naoki Esaka , Koichi Seta , Tadashi Mio , Takao Odagaki

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引用次数: 2

摘要

背景Molnupiravir被广泛用于2019冠状病毒病（新冠肺炎）的治疗；然而，在现实世界的临床实践中，它在≥80岁的老年患者中的可接受性和安全性尚不清楚。方法我们进行了一项单中心回顾性研究，并根据以下标准评估新冠肺炎患者接受莫努匹拉韦治疗的结果：（a）莫努匹拉韦停药率；（B）不良事件的类型、频率和严重程度；（C）结果7名患者（46.1%）年龄≥80岁（老年患者），55名患者（53.9%）年龄<；80岁（年轻患者）。老年和年轻患者在共存疾病和新冠肺炎疫苗接种史方面没有显著差异。根据日本厚生劳动省的分类，老年患者患中度疾病（中度1和2）的可能性明显高于年轻患者。在治疗期间，8.5%的老年患者和1.8%的年轻患者停止服用莫努匹拉韦，但差异不显著。在39/102例（38.2%）患者中观察到不良事件。最常见的不良事件是腹泻（9.8%）、共存疾病恶化（6.9%）、骨髓抑制（6.9%，）、肝功能紊乱（5.9%）和食欲不振（4.9%）。大多数不良事件为轻微不良事件，从1级到3级不等。全因死亡率为10.8%，未观察到与莫努匹拉韦相关的死亡。结论莫努匹拉韦治疗年龄≥80岁的老年新冠肺炎患者是可接受的、安全的。

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Comparison of the acceptability and safety of molnupiravir in COVID-19 patients aged over and under 80 years

Background

Molnupiravir is being widely used as a treatment for coronavirus disease 2019 (COVID-19); however, its acceptability and safety in older patients aged ≥ 80 years in real-world clinical practice is not well understood.

Methods

We conducted a single-centre retrospective study and assessed the outcome of patients with COVID-19 treated with molnupiravir according to the following criteria: (A) discontinuation rate of molnupiravir; (B) type, frequency, and severity of adverse events; (C) all-cause mortality within 30 days of the diagnosis of COVID-19.

Results

Forty-seven patients (46.1%) were aged ≥ 80 years (older patients) and 55 (53.9%) were aged < 80 years (younger patients). There were no significant differences in coexisting diseases and history of vaccination for COVID-19 between older and younger patients. Older patients were significantly more likely to have moderate disease (moderate 1 and 2) according to the Japanese Ministry of Health, Labour and Welfare classification than younger patients. During treatment, 8.5% of older patients and 1.8% of younger patients stopped taking molnupiravir, but the difference was not significant. Adverse events were observed in 39/102 (38.2%) patients. The most common adverse events were diarrhoea (9.8%), exacerbation of coexisting diseases (6.9%), bone marrow suppression (6.9%), liver dysfunction (5.9%), and loss of appetite (4.9%). Most adverse events were minor, ranging from grades 1 to 3. The all-cause mortality rate was 10.8%, and no molnupiravir-related deaths were observed.