{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T09:27:42Z","timestamp":1781947662250,"version":"3.54.5"},"reference-count":35,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T00:00:00Z","timestamp":1728345600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["ascpt.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Pharma and Therapeutics"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:p>There had been concerns about the acute complications during or shortly after coronavirus disease 2019 (COVID\u201019) treatment with nirmatrelvir\/ritonavir (NMVr) and molnupiravir (MOL). This study aimed to compare the risks of selected acute safety events in patients treated with or without NMVr or MOL using the COVID\u201019 oral treatment safety assessment data, constructed through the linkage of nationwide databases: National COVID\u201019 registry, Real\u2010time Prescription Surveillance, and National Health Insurance data. We identified all adults diagnosed with COVID\u201019 between January and November 2022, and then constructed two cohorts by matching up to four patients without antiviral treatment records to NMVr or MOL users using propensity score matching. Outcomes of interest were incident\u2010selected cardiac (i.e., atrial fibrillation, other arrhythmia, bradycardia), neurological (i.e., seizure, neuropathy, encephalomyelitis), and miscellaneous (i.e., acute pancreatitis, acute liver injury, dysgeusia) events. A total of 739,935 NMVr users were matched with 2,951,690 comparators and 150,431 MOL users with 759,521 comparators. NMVr users were at lower risk for developing selected cardiac events (hazard ratio 0.74 [95% CI 0.65\u20130.87] for atrial fibrillation, 0.81 [0.65\u20130.99] for other arrhythmia, and 0.82 [0.70\u20130.96] for bradycardia) and dysgeusia (0.58 [0.45\u20130.74]). For MOL users, the risk was lower for atrial fibrillation (0.72 [0.53\u20130.96]) and dysgeusia (0.34 [0.18\u20130.65]). Overall, there were no increased risks of acute complications during and shortly after treatment with oral COVID\u201019 antivirals. Rather, the findings underscore their effectiveness in attenuating the risk of potential acute sequelae of COVID\u201019.<\/jats:p>","DOI":"10.1002\/cpt.3461","type":"journal-article","created":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T17:05:06Z","timestamp":1728407106000},"page":"445-453","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Selected Acute Safety Events Following the Use of Nirmatrelvir\/Ritonavir or Molnupiravir for <scp>COVID<\/scp>\u201019: A Nationwide Cohort Study in South Korea"],"prefix":"10.1002","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7253-6515","authenticated-orcid":false,"given":"Ju Hwan","family":"Kim","sequence":"first","affiliation":[{"name":"School of Pharmacy Sungkyunkwan University  Suwon Korea"},{"name":"Department of Biohealth Regulatory Science Sungkyunkwan University  Suwon Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahhyung","family":"Choi","sequence":"additional","affiliation":[{"name":"School of Pharmacy Sungkyunkwan University  Suwon Korea"},{"name":"Harvard\u2010MIT Center for Regulatory Science, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gihwan","family":"Bae","sequence":"additional","affiliation":[{"name":"Artificial Intelligence and Big\u2010Data Convergence Center, Gil Medical Center Gachon University College of Medicine  Incheon Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun\u2010Jeong","family":"Joo","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min Joo","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Catholic Kwandong University College of Medicine, International St. Mary's Hospital  Incheon Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyungmin","family":"Huh","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine Samsung Medical Center, Sungkyunkwan University School of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyungmin","family":"Lee","sequence":"additional","affiliation":[{"name":"Patient Management Team, Central Headquarters of COVID\u201019 Korea Disease Control and Prevention Agency  Cheongju Korea"},{"name":"Division of Immunization Korea Disease Control and Prevention Agency  Cheongju Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jungyeon","family":"Kim","sequence":"additional","affiliation":[{"name":"Patient Management Team, Central Headquarters of COVID\u201019 Korea Disease Control and Prevention Agency  Cheongju Korea"},{"name":"Division of Clinical Research, Center for Emerging Virus Research, National Institute of Infectious Disease Korea Disease Control and Prevention Agency  Cheongju Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong\u2010Hwi","family":"Kim","sequence":"additional","affiliation":[{"name":"Patient Management Team, Central Headquarters of COVID\u201019 Korea Disease Control and Prevention Agency  Cheongju Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min\u2010Gyu","family":"Yoo","sequence":"additional","affiliation":[{"name":"Patient Management Team, Central Headquarters of COVID\u201019 Korea Disease Control and Prevention Agency  Cheongju Korea"},{"name":"Division of Public Health Emergency Response Research, Bureau of Public Health Emergency Preparedness Korea Disease Control and Prevention Agency  Cheongju Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Il Uk","family":"Jo","sequence":"additional","affiliation":[{"name":"Big Data Management Division, Health Insurance Review &amp; Assessment Service  Wonju Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Poong Hoon","family":"Lee","sequence":"additional","affiliation":[{"name":"Big Data Management Division, Health Insurance Review &amp; Assessment Service  Wonju Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geun Woo","family":"Lee","sequence":"additional","affiliation":[{"name":"Big Data Management Division, Health Insurance Review &amp; Assessment Service  Wonju Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hee Sun","family":"Jung","sequence":"additional","affiliation":[{"name":"Big Data Management Division, Health Insurance Review &amp; Assessment Service  Wonju Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaehun","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine Korea University College of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1010-7525","authenticated-orcid":false,"given":"Ju\u2010Young","family":"Shin","sequence":"additional","affiliation":[{"name":"School of Pharmacy Sungkyunkwan University  Suwon Korea"},{"name":"Department of Biohealth Regulatory Science Sungkyunkwan University  Suwon Korea"},{"name":"Department of Clinical Research Design &amp; Evaluation, Samsung Advanced Institute for Health Sciences &amp; Technology (SAIHST) Sungkyunkwan University  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,8]]},"reference":[{"key":"e_1_2_10_1_1","unstructured":"World Health Organization.WHO Coronavirus (COVID\u201019) dashboard > Cases [Dashboard]<https:\/\/data.who.int\/dashboards\/covid19\/cases> (2023)."},{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m1985"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa1419"},{"key":"e_1_2_10_4_1","unstructured":"US Food & Drug Administration.FDA Approves First Oral Antiviral for Treatment of COVID\u201019 in Adults<https:\/\/www.fda.gov\/news\u2010events\/press\u2010announcements\/fda\u2010approves\u2010first\u2010oral\u2010antiviral\u2010treatment\u2010covid\u201019\u2010adults> (2023)."},{"key":"e_1_2_10_5_1","unstructured":"UK Medicines and Healthcare products Regulatory Agency.First oral antiviral for COVID\u201019 Lagevrio (molnupiravir) approved by MHRA [media release]<https:\/\/www.gov.uk> (2021)."},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2118542"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2116044"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(22)00644-2"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciac443"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)01586-0"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2204919"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiad324"},{"key":"e_1_2_10_13_1","doi-asserted-by":"crossref","DOI":"10.1177\/2050313X231168304","article-title":"Possible nirmatrelvir\/ritonavir\u2010induced bradycardia in a patient with asymptomatic COVID\u201019","volume":"11","author":"DeMarco E.","year":"2023","journal-title":"SAGE Open Med. 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