Page 37 - JCTR-10-1

Journal of Clinical and Translational Research 2024; 10(1): 33-51

Journal of Clinical and Translational Research

Journal homepage: http://www.jctres.com/en/home

ORIGINAL ARTICLE

Effect of combination of molnupiravir with clarithromycin on blood

biomarkers in patients with mild-to-moderate COVID-19

Kenji Gonda 1,2,3 *, Takeshi Hai , Kouichi Suzuki , Kazuki Morooka , Akihiko Ozaki , Koji Kono , Seiich Takenoshita 5
2
3,4
1,2
4
1
2
1 Department of Breast and Thyroid Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki City, Fukushima, 972-8322, Japan, Department of
Gastrointestinal Tract Surgery, Fukushima Medical University, 1-Hikarigaoka, Fukushima City, Fukushima, 960-1295, Japan, Department of
3
Bioregulation and Pharmacological Medicine, Fukushima Medical University, 1-Hikarigaoka, Fukushima City, Fukushima, 960-1295, Japan, Daido
4
Central Hospital, 1-1-37 Asato, Naha City, Okinawa 902-0067, Japan, Department of Drug Research for Astatine-221 Targeted Alfa Therapy,
5
Fukushima Medical University, 1 Hikarigaoka, Fukushima City, Fukushima, 960-1295, Japan
ARTICLE INFO ABSTRACT
Article history: Background: Molnupiravir is a type of medication used to treat coronavirus disease 2019 (COVID-19).
Received: June 07, 2023 However, no evidence regarding the therapeutic effect of molnupiravir combined with clarithromycin
Accepted: December 19, 2023 (CAM) on blood biomarkers is available.
Published: February 1, 2024 Methods: Of the 156 rehabilitation patients, 124 patients with mild-to-moderate COVID-19 were
treated with molnupiravir. Among these 124 patients, 54 were treated with CAM. The remaining
Keywords: 28 rehabilitation patients were negative for COVID-19. Blood biomarkers were assessed after
COVID-19 administration of molnupiravir in patients receiving molnupiravir plus CAM or molnupiravir alone.
Molnupiravir Results: Among the measured blood biomarkers, lactate dehydrogenase, potassium, white blood
Clarithromycin cells, C-reacted protein, neutron–lymphocyte ratio, fibrin degradation product, and prothrombin
IgA time–international normalized ratio values were significantly higher (P < 0.05) in the molnupiravir
alone group than in the molnupiravir plus CAM group, and lymphocytes were significantly lower
*Corresponding author: (P < 0.05) on day 5 after admission. In the molnupiravir plus CAM group, immunoglobulin (Ig) A
Kenji Gonda levels increased and soluble interleukin 2-receptor levels (sIL2R) decreased (P < 0.05) on day 14
Department of Breast and Thyroid Surgery, after admission. In addition, COVID-19-negative patients had higher IgA levels and lower sIL2R
Jyoban Hospital of Tokiwa Foundation, Iwaki levels compared to infected patients (P < 0.05). The concomitant administration of molnupiravir plus
City, Fukushima 972-8322, Japan. CAM resulted in fewer sequelae after 12 months, and the incidence of venous thromboembolism was
Email: gondake@fmu.ac.jp significantly reduced (P < 0.05).
Conclusion: In patients with mild-to-moderate COVID-19, concomitant administration of
© 2024 Author(s). This is an Open-Access molnupiravir plus CAM showed several non-worsening blood biomarkers, elevated immune activity,
article distributed under the terms of the and reduced post-infection sequelae.
Creative Commons Attribution-Noncommercial Relevance for Patients: After administration of molnupiravir to patients with mild-to-moderate
License, permitting all non-commercial use,
distribution, and reproduction in any medium, COVID-19, administration of CAM to patients suffering from secondary macrolide-sensitive bacterial
provided the original work is properly cited. infection was compared with administration of molnupiravir alone. D-dimer, IgA, and sIL2R are
potential predictive factors of disease severity in critically ill patients with COVID-19.

1. Introduction
Sudden deterioration and death of patients suffering from mild-to-moderate coronavirus
disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2
(SARS-CoV-2), is common on the clinical scene. In some cases, patients become severely
ill without being aware of it and suffer from oxygen deficiency. It is necessary to prevent
deterioration of COVID-19, tested positive by means of SARS-CoV-2 antigen test or

DOI: https://doi.org/10.36922/jctr.00075