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Record W4392106105 · doi:10.1038/s41467-024-45641-0

Randomized controlled trial of molnupiravir SARS-CoV-2 viral and antibody response in at-risk adult outpatients

2024· article· en· W4392106105 on OpenAlexaff
Joseph F. Standing, Laura Buggiotti, José Afonso Guerra‐Assunção, Maximillian Woodall, Samuel Ellis, Akosua Adom Agyeman, Charles M. Miller, Mercy Okechukwu, Emily Kirkpatrick, Amy Jacobs, Charlotte A. Williams, Sunando Roy, Luz M. Martin-Bernal, Rachel Williams, Claire M. Smith, Theo Sanderson, Fiona Ashford, Beena Emmanuel, Zaheer Afzal, Adrian Shields, Alex Richter, Jienchi Dorward, Oghenekome Gbinigie, Oliver van Hecke, Mark Lown, Nick Francis, Bhautesh Jani, Duncan Richards, Najib M. Rahman, Ly‐Mee Yu, Nicholas Thomas, Nigel Hart, Philip Evans, Monique Andersson, Gail Hayward, Kerenza Hood, Jonathan S. Nguyen‐Van‐Tam, Paul Little, Richard Hobbs, Saye Khoo, Christopher Butler, David M. Lowe, Judith Breuer, Julie Allen, Nadua Bayzid, Julianne R. Brown, Doug Burns, Elizabeth Hadley, J. A. Hatcher, Timothy D. McHugh, Chris Thalasselis, Mia Tomlinson, Francis Yongblah

Bibliographic record

VenueNature Communications · 2024
Typearticle
Languageen
FieldMedicine
TopicSARS-CoV-2 and COVID-19 Research
Canadian institutionsInstitute of Infection and Immunity
FundersBiotechnology and Biological Sciences Research CouncilMarie CurieMedical Research CouncilNational Institute for Health and Care ResearchFrancis Crick InstituteWellcome Trust
KeywordsViral loadAntibodyPersistence (discontinuity)MedicineRandomized controlled trialVirologyVirusSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2)ImmunologyBiologyInternal medicineCoronavirus disease 2019 (COVID-19)Disease

Abstract

fetched live from OpenAlex

Viral clearance, antibody response and the mutagenic effect of molnupiravir has not been elucidated in at-risk populations. Non-hospitalised participants within 5 days of SARS-CoV-2 symptoms randomised to receive molnupiravir (n = 253) or Usual Care (n = 324) were recruited to study viral and antibody dynamics and the effect of molnupiravir on viral whole genome sequence from 1437 viral genomes. Molnupiravir accelerates viral load decline, but virus is detectable by Day 5 in most cases. At Day 14 (9 days post-treatment), molnupiravir is associated with significantly higher viral persistence and significantly lower anti-SARS-CoV-2 spike antibody titres compared to Usual Care. Serial sequencing reveals increased mutagenesis with molnupiravir treatment. Persistence of detectable viral RNA at Day 14 in the molnupiravir group is associated with higher transition mutations following treatment cessation. Viral viability at Day 14 is similar in both groups with post-molnupiravir treated samples cultured up to 9 days post cessation of treatment. The current 5-day molnupiravir course is too short. Longer courses should be tested to reduce the risk of potentially transmissible molnupiravir-mutated variants being generated. Trial registration: ISRCTN30448031.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.003
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Randomized trial · Consensus signal: Randomized trial
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.014
Threshold uncertainty score0.046

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0010.003
Meta-epidemiology (narrow)0.0020.001
Meta-epidemiology (broad)0.0040.001
Bibliometrics0.0000.000
Science and technology studies0.0010.001
Scholarly communication0.0010.001
Open science0.0010.000
Research integrity0.0030.003
Insufficient payload (model declined to judge)0.0140.001

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.031
GPT teacher head0.406
Teacher spread0.375 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designRandomized trial
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations44
Published2024
Admission routes1
Has abstractyes

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