In short Article

Antiviral drugs for COVID-19


In the course of the COVID-19 pandemic, three antiviral drugs have been developed, which use different mechanisms to inhibit the replication of the virus. Molnupiravir and remdesivir are polymerase inhibitors, while nirmatrelvir is a protease inhibitor. Randomised studies have shown that these antiviral drugs, provided they are administered within 5 to 7 days after the first COVID-19 symptoms have appeared, significantly reduce the risk of hospitalisation and mortality in unvaccinated patients at elevated risk of a severe disease course. 

  • Administering the polymerase inhibitors molnupiravir or remdesivir or the protease inhibitor nirmatrelvir to unvaccinated patients in the early stages of COVID-19 can reduce the numbers of hospitalisations and deaths.
  • No published studies have compared the effectiveness of these antiviral drugs. An indirect comparison is impossible since the placebo-controlled studies differ too much from each other. 
  • For now, the applications for these antiviral drugs appear to be limited. There are theoretical arguments for using them in immunocompromised patients as an alternative to monoclonal antibodies.

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Authors

  • Leo M.L. Stolk, dr