Efficacy and safety of oral antivirals in individuals aged 80 years or older with mild-to-moderate COVID-19: preliminary report from an Italian Prescriber Center

Giuseppe Bruno; Serena Perelli; Massimo Giotta; Nicola Bartolomeo; Giuseppina De Vita; Giovanni Battista Buccoliero

doi:10.53854/liim-3004-9

Efficacy and safety of oral antivirals in individuals aged 80 years or older with mild-to-moderate COVID-19: preliminary report from an Italian Prescriber Center

Infez Med. 2022 Dec 1;30(4):547-554. doi: 10.53854/liim-3004-9. eCollection 2022.

Authors

Giuseppe Bruno¹, Serena Perelli¹, Massimo Giotta^{2

3}, Nicola Bartolomeo³, Giuseppina De Vita¹, Giovanni Battista Buccoliero¹

Affiliations

¹ Infectious Diseases Unit, San Giuseppe Moscati Hospital, Taranto, Azienda Sanitaria Locale Taranto, Italy.
² Complex Unit of Statistics and Epidemiology, Azienda Sanitaria Locale Taranto, Italy.
³ Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Italy.

Abstract

Introduction: Molnupiravir and Nirmatrelvir/ritonavir( r), have demonstrated to prevent the progression to severe COVID-19 in high-risk individuals. Real life data are lacking in the elderly.

Methods: All consecutive individuals aged ≥80 years with confirmed COVID-19 and mild-to-moderate illness who received an oral antiviral prescription between 11th January and 31^st May 2022 were included in this retrospective single-centre study. The aim was to assess safety and effectiveness of oral antivirals in individuals ≥80 years with mild to moderate COVID-19.

Results: A total of 168 subjects ≥80 years were included. Molnupiravir was prescribed in 147 (87.5%) subjects whereas Nirmatrelvir/r in 21 (12.5%); 16 (9.5%) experienced at least one adverse event. Overall, 21 (12.5%) hospitalizations and five deaths were reported at 28 days. At multivariate analysis male sex (OR=4.196, 95% CI=1.479-11.908; p=0.007), a moderate illness at time of prescription (OR=10.946, 95% CI=2.857-41.395; p=0.0005) and a greater number of days from the onset of symptoms to the therapy (OR=2.066, 95% CI=1.285-3.322; p=0.0027) were associated with hospitalization and/or death.

Conclusion: In this real-life setting, including older individuals' hospitalizations and mortality at 28 days remained low thanks to the prompt initiation of oral antiviral therapy. The use of oral antivirals can play a significant role in reducing healthcare costs and ensuring benefits among the elderly population.

Keywords: COVID-19; elderly; molnupiravir; nirmatrelvir.