{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T02:19:56Z","timestamp":1778638796248,"version":"3.51.4"},"reference-count":36,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T00:00:00Z","timestamp":1677110400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Department of Microbiology, University of Hong Kong"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>While molnupiravir (MOV) and nirmatrelvir\u2013ritonavir (NMV-r) were developed for treatment of mild to moderate COVID-19 infection, there has been a lack of data on the efficacy among unvaccinated adult patients with chronic respiratory diseases, including asthma, chronic obstructive pulmonary disease (COPD) and bronchiectasis. A territory-wide retrospective cohort study was conducted in Hong Kong to investigate the efficacy of MOV and NMV-r against severe outcomes of COVID-19 in unvaccinated adult patients with chronic respiratory diseases. A total of 3267 patients were included. NMV-r was effective in preventing respiratory failure (66.6%; 95% CI, 25.6\u201385.0%, p = 0.007), severe respiratory failure (77.0%; 95% CI, 6.9\u201394.3%, p = 0.039) with statistical significance, and COVID-19 related hospitalization (43.9%; 95% CI, \u22121.7\u201369.0%, p = 0.057) and in-hospital mortality (62.7%; 95% CI, \u22120.6\u201386.2, p = 0.051) with borderline statistical significance. MOV was effective in preventing COVID-19 related severe respiratory failure (48.2%; 95% CI 0.5\u201373.0, p = 0.048) and in-hospital mortality (58.3%; 95% CI 22.9\u201377.4, p = 0.005) but not hospitalization (p = 0.16) and respiratory failure (p = 0.10). In summary, both NMV-r and MOV are effective for reducing severe outcomes in unvaccinated COVID-19 patients with chronic respiratory diseases.<\/jats:p>","DOI":"10.3390\/v15030610","type":"journal-article","created":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T03:25:56Z","timestamp":1677122756000},"page":"610","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Real-World Study on Effectiveness of Molnupiravir and Nirmatrelvir\u2013Ritonavir in Unvaccinated Patients with Chronic Respiratory Diseases with Confirmed SARS-CoV-2 Infection Managed in Out-Patient Setting"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5611-1637","authenticated-orcid":false,"given":"Wang Chun","family":"Kwok","sequence":"first","affiliation":[{"name":"Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Man Fung","family":"Tsoi","sequence":"additional","affiliation":[{"name":"Centre for Epidemiology Versus Arthritis, The University of Manchester, Manchester M139PT, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sze Him Isaac","family":"Leung","sequence":"additional","affiliation":[{"name":"Department of Statistics, The Chinese University of Hong Kong, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chung Ki","family":"Tsui","sequence":"additional","affiliation":[{"name":"Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6057-8168","authenticated-orcid":false,"given":"Terence Chi Chun","family":"Tam","sequence":"additional","affiliation":[{"name":"Department of Medicine, Queen Mary Hospital, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4499-5284","authenticated-orcid":false,"given":"James Chung Man","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0004-2660","authenticated-orcid":false,"given":"David Chi Leung","family":"Lam","sequence":"additional","affiliation":[{"name":"Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary Sau Man","family":"Ip","sequence":"additional","affiliation":[{"name":"Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8811-1308","authenticated-orcid":false,"given":"Pak Leung","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Carol Yu Centre for Infection, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1056\/NEJMoa2116044","article-title":"Molnupiravir for oral treatment of Covid-19 in nonhospitalized patients","volume":"386","author":"Musungaie","year":"2022","journal-title":"N. 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