Two new drugs have been developed for acute COVID infection. The new drugs are Molnupiravir (Lagevrio) and Paxlovid. In clinical trials, people most at risk from the serious effects of COVID were far less likely to die or be admitted to the hospital if they took a course of either of these pills in the five days after symptoms first appeared. In early November 2021, the United Kingdom became the first country to approve Molnupiravir. The approval was based on evidence that the drug halves the risk of hospitalization in people with mild or moderate forms of COVID. Paxlovid appears to reduce the risk of hospitalization by almost 90%. In theory, the drugs should be effective against known COVID variants, including the Delta variant.

Reduced risk of hospital admission

Previous antiviral options against COVID were expensive and had to be given in a hospital. The benefit of the new drugs is that they can be taken at home as pills. Both drugs are very effective when they are given soon after the onset of a COVID infection. However, the results from clinical trials are at an early stage. We still need to find out if specific types of patients (such as older adults, children, or those with pre-existing conditions) benefit more or less from these two drugs. Also, researchers will look at if the drugs are influenced by race, as well as the impact of cost and access. We also do not know if these drugs prevent spread of the virus or prevent illness from developing among those who have been exposed to the virus.

More needs to be known about safety

Most importantly, we need to find out more about the safety of these drugs. So far, they seem to have been well tolerated by study participants. Potential side effects were minor. However, we do not know about potential risks for pregnant women. Another concern is whether the virus will become resistant to the drugs over time.

For poorer countries, giving antiviral drugs early in the course of an infection means that they will need a larger supply of COVID-19 tests. Wealthy countries are already placing large orders for the drugs, raising concerns of limited access in other parts of the world.


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