Pfizer’s Covid-19 antiviral Paxlovid and Merck’s coronavirus pill molnupiravir appear to guard against hospitalizations and death even when people aren’t experiencing severe symptoms, a new study found, as the White House continues efforts to make these medications more widely available as Covid cases surge.
Among those with non-severe Covid who took Paxlovid, there were 46 fewer admissions to the hospital per 1,000 patients, while there were 16 fewer admissions per 1,000 patients who took molnupiravir compared to placebo groups, researchers found in a systematic review published in Canadian Medical Association Journal, though many of the studies researchers analyzed were conducted before the emergence of the highly transmissible omicron variant.
Those figures suggest both pills—which were authorized by the Food and Drug Administration for emergency use authorization last year for some with mild to moderate coronavirus infections at risk of developing severe Covid—“probably” reduce the risk of hospitalization and death in patients with mild coronavirus infections, while Pfizer’s Paxlovid is likely more effective at reducing hospitalizations, researchers said.
Both treatments also most likely reduced deaths in those with mild cases compared to placebo groups, researchers concluded.
Remdesivir, meanwhile, the first antiviral Covid treatment approved by the FDA for those 12 and older hospitalized with Covid, may reduce the risk of hospitalization in non-severe cases but likely doesn’t prevent deaths.
The study addresses a big “gap in evidence,” since antiviral drugs may be “most useful” for those with non-severe cases, said study co-author Tyler Pitre, with the division of internal medicine at McMaster University in Ontario.
Covid cases and hospitalizations are on the rise in the U.S. and around the world as the extremely contagious omicron BA.5 subvariant continues to spread. The U.S. averaged 125,827 new infections per day in the week ending July 20, up from a low in mid-April of roughly 30,558 daily cases, according to the Centers for Disease Control. Daily new hospital admissions for the week ending July 19 topped 6,000, up from an average of 1,428 per day in early April, though hospitalizations remain much lower than during the January coronavirus surge.
Most research to date has focused on how Covid treatments combat severe illness in patients who have been hospitalized, and no studies to date have analyzed the evidence on oral antiviral treatments’ effectiveness against non-severe Covid, according to researchers. Pfizer’s antiviral pill is authorized for those 12 years and older in high-risk cases, while Merck’s treatment is only authorized for adults because it may impact bone and cartilage growth. The White House has been attempting to ensure more Americans can access Covid antiviral treatments, and in particular, Pfizer’s oral pill Paxlovid. The Biden Administration has pledged to buy 20 million courses of the treatment. It has also set up “Test-to-Treat” sites around the country where people can receive a coronavirus test and oral antiviral pills in one visit. After the program received some criticism from experts who argued it had not significantly improved access to the pills, the FDA earlier this month authorized pharmacists to prescribe Paxlovid to coronavirus patients 12 years and older who are at a high risk of developing severe Covid, after reviewing patients’ health records and medication lists. Pharmacists had been pushing for this authority to help speed up access to the drug.
President Joe Biden—who is experiencing mild symptoms after testing positive for Covid on Thursday and who is at a higher risk of developing severe illness because of his age—is currently taking Paxlovid, according to the White House.