A study survey on molnupiravir treatment in COVID-19 patients at home in Ninh Thuan province, Vietnam

T. Le-Huy, M.G. Balzanelli, P. Thai-Phuong, T. Tran Thai, H. Nguyen Vu Ngoc, L. Tran Phuc, T. Le Quoc, T. Nguyen Thanh, T. Nai Thanh, T. Le Van, L.P. Thi Bich, R. Lazzaro, P. Distratis, G. Dipalma, R. Morolla, A.M. Inchingolo, L. Dongiovanni, F. Triggiano, L. Santacroce, R. Del Prete, M. Serafini, A. Palermo, K. Cao Diem Nguyen, F. Inchingolo, C. Gargiulo Isacco

Ninh Thuan General Hospital, Ninh Thuan City, Ninh Thuan Province, Vietnam. francesco.inchingolo@uniba.it

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• Infectious Diseases

OBJECTIVE: Molnupiravir (MOV) is an oral antiviral drug that received use authorization in Vietnam for the treatment of mild COVID-19 (F0). There was a need to develop alternative approaches that allowed patients to access medication, decongest hospitals, clinics, and facilities, and protect people from infection. During the COVID-19 crisis, the Ninh Thuan Health Authorities implemented the home delivery of medication by community health workers. This study conducted in collaboration with two important Italian entities [the Aldo Moro University of Bari City and the 118 Department of Territorial Emergency System (118 SET) of Taranto City] aimed to evaluate the implementation of home delivery F0 treatment package assessing the rate of infection recovering during the coronavirus pandemic in Ninh Thuan province, Vietnam.

PATIENTS AND METHODS: A convergent mixed methods research, based on a longitudinal study with quantitative research and qualitative assessments, evaluated four implementation outcomes: the feasibility, fidelity, coverage, sustainability, and effectiveness of the initiative. Data sources included routinely collected data, a telephonic survey of patients, an analysis of set-up and recurrent costs, as well as descriptive exploratory qualitative and quantitative analysis.

RESULTS: After taking the MOV for 5 days, only 35 out of the initial 400 F0 patients remained positive, while 365 patients (91.2%) were negative (CT≥30). Whilst, the successful rate after using the drug during the course accounted for 99.85% and 100% after the entire treatment course, without any death. After 5 days of taking the drug, a positive test result (CT<30) was associated with age group ≥60 (OR=2.7) and comorbidities (OR=3.0) (p<0.05) compared to negative and positive results (CT≥30). Negative factors impacting F0 at home include a shortage of healthcare workers, inadequate supply of thermometers and SpO2 meters, and insufficient financial support for healthcare workers.

CONCLUSIONS: MOV caused a reduction in the risk of hospitalization or death in mild COVID-19 patients, and molnupiravir was also found to be well tolerated and safe without any major adverse events during the administration period.

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