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Background <p>This research was motivated by the widespread use of oral antivirals during the Covid-19 pandemic and the remaining uncertainty regarding their effects on viral kinetics, which have rarely been studied in real-world population cohorts of this size.</p> Methods <p>We analysed 291,340 SARS-CoV-2 cycle threshold (CT) values from 113,399 non-hospitalized adult patients in Vienna (01/2022–05/2023), including 30,451 from 12,166 nirmatrelvir-ritonavir recipients, 27,959 from 10,752 molnupiravir recipients, and 232,930 from 90,481 untreated controls.</p> Results <p>Both antivirals initially caused a rapid increase in mean CT values. After completion of the 5-day treatment course, CT values declined in both antiviral groups, which was not observed in untreated individuals.</p> Conclusions <p>These findings provide population-level evidence on post-treatment viral kinetics of oral antivirals during the Omicron wave.</p>

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Viral kinetics in adults with Covid-19 treated with nirmatrelvir-ritonavir or molnupiravir: a population-based, observational cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月10日

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  • Marlene Prager,
  • Dominik Ensle,
  • Hubert Eser,
  • Florentin Glötzl,
  • Benjamin Riedl,
  • Marton Szell,
  • Arschang Valipour,
  • Alexander Zoufaly,
  • Christoph Wenisch,
  • Doris Haider,
  • Heinz Burgmann,
  • Florian Thalhammer,
  • Florian Götzinger,
  • Bernd Jilma,
  • Ursula Karnthaler,
  • Markus Zeitlinger,
  • Anselm Jorda

摘要

Background

This research was motivated by the widespread use of oral antivirals during the Covid-19 pandemic and the remaining uncertainty regarding their effects on viral kinetics, which have rarely been studied in real-world population cohorts of this size.

Methods

We analysed 291,340 SARS-CoV-2 cycle threshold (CT) values from 113,399 non-hospitalized adult patients in Vienna (01/2022–05/2023), including 30,451 from 12,166 nirmatrelvir-ritonavir recipients, 27,959 from 10,752 molnupiravir recipients, and 232,930 from 90,481 untreated controls.

Results

Both antivirals initially caused a rapid increase in mean CT values. After completion of the 5-day treatment course, CT values declined in both antiviral groups, which was not observed in untreated individuals.

Conclusions

These findings provide population-level evidence on post-treatment viral kinetics of oral antivirals during the Omicron wave.