The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in December 2019, which rapidly spread and has resulted in a global pandemic with approximately 4 million deaths to date. Oral antiviral agents are urgently needed to treat coronavirus disease 2019 (COVID-19) caused by this virus and to prevent its rampant spread and progression.

Molnupiravir (EIDD-2801) – a prodrug of beta-d-N4-hydroxycytidine and an inhibitor of RNA-dependent RNA polymerase, has recently shown significant activity against SARS-CoV-2. Animal trials have illustrated the therapeutic efficacy of this agent.

Two phase-I trials confirmed that oral molnupiravir is safe and well-tolerated at therapeutic doses. After five-days of the oral regimen, elimination of nasopharyngeal virus could be achieved in patients with early and mild COVID-19 – as revealed by two phase-II trials. In addition, two phase-II/III trials – NCT04575597 and NCT04575584, are ongoing.

It was recently disclosed that molnupiravir significantly reduced the risk of hospitalization or death in adults experiencing mild-to-moderate COVID-19. This drug is a direct-acting agent with favorable safety and tolerability profile, and is efficacious in reducing the nasopharyngeal viral load in COVID-19 patients. Clinical applications of molnupiravir for early COVID-19 treatment in patients with mild or moderate symptoms could be beneficial and can aid in preventing SARS-CoV-2 transmission.

Source: Antibiotics. 2021 Oct 23;10(11):1294. doi: 10.3390/antibiotics10111294.