{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:56:18Z","timestamp":1777928178845,"version":"3.51.4"},"reference-count":23,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T00:00:00Z","timestamp":1654041600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["OMICS: A Journal of Integrative Biology"],"published-print":{"date-parts":[[2022,6,1]]},"abstract":"<jats:p>The long view on living with COVID-19 as an endemic disease calls for expanding the planetary health intervention toolbox. We will need a battery of vaccines, small molecule oral antiviral drugs, and biomarkers to forecast antiviral drug efficacy and safety. In this context, theranostics refers to fusion of therapeutics and diagnostics. We examine here emerging pathways to theranostics innovation for COVID-19 oral antiviral drugs, with molnupiravir as a case study. With new virus variants (1) variations in the molnupiravir efficacy target, viral RNA-dependent RNA polymerase, (2) variability in pharmacokinetics and exposure to molnupiravir active moiety in fluids on virus entry points to the host (e.g., saliva, tears, and nasal secretions), (3) variability in transformation from prodrug molnupiravir to its active form, and (4) variability in putative adverse effects on human\/host cells, all warrant attention for prospects and challenges vis \u00e0 vis theranostics innovation for COVID-19 oral antivirals. The emerging lessons from molnupiravar are of interest to future design of COVID-19 theranostic research with other oral antiviral medications. Regulatory agencies, the pharmaceutical industry, research funders, governments, and ministries of health around the world have important stewardship roles to advance the subpopulation level analyses of clinical trial data on oral antiviral drugs for COVID-19. This would remedy the current lag in clinically relevant multiomics theranostics for oral antivirals in the battle against COVID-19.<\/jats:p>","DOI":"10.1089\/omi.2022.0045","type":"journal-article","created":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T13:54:26Z","timestamp":1652795666000},"page":"324-328","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["The Long View on COVID-19 Theranostics and Oral Antivirals: Living with Endemic Disease and Lessons from Molnupiravir"],"prefix":"10.1177","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2183-6830","authenticated-orcid":false,"given":"Anmar","family":"Al-Taie","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy and Faculty of Pharmacy, Istinye University, Istanbul, Turkey."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fatma Rana","family":"Denkdemir","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Toxicology, Faculty of Pharmacy, Istinye University, Istanbul, Turkey."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zaineb","family":"Sharief","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Toxicology, Faculty of Pharmacy, Istinye University, Istanbul, Turkey."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayse Seyma","family":"Buyuk","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Toxicology, Faculty of Pharmacy, Istinye University, Istanbul, Turkey."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Semra","family":"\u015earda\u015f","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Toxicology, Faculty of Pharmacy, Istinye University, Istanbul, Turkey."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,6,13]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/d41586-022-00220-5"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.virusres.2022.198765"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2022.835136"},{"key":"e_1_3_3_5_1","first-page":"Dis","article-title":"Availability of oral antivirals against SARS-CoV-2 infection and the requirement for an ethical prescribing approach","author":"Dal-R\u00e9 R","year":"2022","unstructured":"Dal-R\u00e9 R, , Becker SL, , Bottieau E, et al. (2022). Availability of oral antivirals against SARS-CoV-2 infection and the requirement for an ethical prescribing approach. Lancet Infect. Dis.","journal-title":"Lancet Infect"},{"key":"e_1_3_3_6_1","first-page":"e32","article-title":"Molnupiravir for Covid-19 in nonhospitalized patients","volume":"386","author":"De Anda C","year":"2022","unstructured":"De Anda C, , Johnson MG, , and Pedley A. (2022). Molnupiravir for Covid-19 in nonhospitalized patients. N Engl J Med, 386, e32.","journal-title":"N Engl J Med"},{"key":"e_1_3_3_7_1","article-title":"Assessment report","author":"EMA","year":"2022","unstructured":"EMA. (2022). Assessment report. Use of molnupiravir for the treatment of COVID-19. January 27, 2022. https:\/\/www.ema.europa.eu\/en\/documents\/referral\/lagevrio-also-known-molnupiravir-mk-4482-covid-19-article-53-procedure-assessment-report_en.pdf. 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Molnupiravir: A lethal mutagenic drug against rapidly mutating severe acute respiratory syndrome coronavirus 2\u2014A narrative review. J Med, Virol, 1\u201311.","journal-title":"J Med"},{"key":"e_1_3_3_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1957.72980250010016"},{"key":"e_1_3_3_17_1","first-page":"ciac180","article-title":"Molnupiravir and nirmatrelvir-ritonavir: oral COVID antiviral drugs","author":"Saravolatz LD","year":"2022","unstructured":"Saravolatz LD, , Depcinski S, , and Sharma M. (2022). Molnupiravir and nirmatrelvir-ritonavir: oral COVID antiviral drugs. 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