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Gonda et al. | Journal of Clinical and Translational Research 2024; 10(1): 33-51 35

Figure 1. CONSORT flow chart detailing patient enrollment allocation, follow-up, and analysis. Out of the 156 rehabilitation patients, 124 patients
with mild-to-moderate COVID-19 received molnupiravir (800 mg twice daily for 5 days), and 54 of this subset of patients received clarithromycin
(400 mg twice daily for 3 days). The remaining 28 patients were negative for COVID-19 despite being isolated from other COVID-19-positive patients
and were not administered drugs.
Abbreviations: CT: Computed tomography, LDH: Lactate dehydrogenase, WBC: White blood cells, Hb: Hemoglobin, PLT: Platelet, CRP: C-reacted
protein, NLR: Neutron–lymphocyte ratio, FDP: Fibrin degradation product, PT-INR: Prothrombin time–International Normalized Ratio, CPK:
Creatinine phosphor kinase, BNP: Brain natriuretic peptide, Ig; Immunoglobulin, sIL2R: Soluble interleukin 2 receptor.

2.3. Statistics analysis On Okinawa Island, the rollout of Pfizer-BioNTech COVID-19
mRNA vaccines began in December 2021. More than 90% of the
Student’s t-test was used for statistical data analysis. A P < 0.05
was considered significant. Data are presented as SD±. Cox patients had received at least one vaccine shot within 6 months before
admission, and none of them received vaccine during hospitalization.
proportional hazard models were utilized to assess the impact of However, only 89.3% of the uninfected rehabilitation patients had
risk factors. SAS software version 9.2 (SAS Institute Inc., Cary, been vaccinated (Supplementary Data 4).
NC, USA) was used for statistical analysis.

3. Results 3.2. Dynamics of blood biomarkers during disease progression
in molnupiravir alone group, molnupiravir plus clarithromycin
3.1. Baseline characteristics of COVID-19 patients treated with group, and uninfected group
molnupiravir plus clarithromycin and molnupiravir alone and LDH, potassium, WBC, CRP, NLR, FDP, and PT-INR
uninfected patients
values were significantly higher (P < 0.05) in the molnupiravir
Between the molnupiravir plus CAM group and molnupiravir alone group than in the molnupiravir plus CAM combination
alone group, significant differences were observed in baseline group on day 5, and lymphocyte count was significantly lower
th
symptoms of fever, cough and sputa, shortness of breath, (P < 0.05). On the 14 day, WBC, CRP, neutrophils, and NLR
chest tightness, and dyspnea, and in baseline comorbidity of were all significantly high (P < 0.05), and lymphocyte count was
respiratory diseases (P < 0.05). Some baseline symptoms were significantly low (P < 0.05).
significantly different between uninfected rehabilitation patients In the molnupiravir alone group, LDH, potassium, WBC,
and those receiving molnupiravir plus CAM or molnupiravir CRP, neutrophils, NLR, fibrinogen, FDP, PT-INR, and CPK
alone. However, there was no significant difference in baseline significantly increased on day 5 after admission (P < 0.05) and
comorbidity (Supplementary Data 4). total cholesterol, triglyceride, uric acid, PLT, and lymphocytes
DOI: https://doi.org/10.36922/jctr.00075