Prevention is better than healing. Clinical and economic implications of oral antiviral agents in COVID-19: a prospective study

COVID-19 represents a threat for frailty patients. This study compares molnupiravir and nirmatrelvir for fragile COVID- 19 patients' efficacy, safety, and cost. An observational, prospective study allowed us to evaluate molnupiravir’s efficacy and safety in real life, compare it to a subgroup of patients treated with nirmatrelvir-ritonavir, and analyze its cost-effectiveness. From January to December 2022, 435 patients (225 males, 220 females; median age 72 years), were enrolled; 24 patients were unvaccinated, and 280 patients had ≥2 risk factors. Molnupiravir performed better clinically and economically. Compared to literature data, in these patients, hospitalization was 2.5% vs. 6.8% (P