COVID-19 Drug Molnupiravir Exacerbate the COVID-19 Pandemic?

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COVID-19 Drug Molnupiravir Exacerbate the COVID-19 Pandemic?

Molnupiravir, a COVID-19 Drug, Appears to Drive Virus Mutations or Exacerbate the Pandemic, According to Nature.

Molnupiravir, an oral antiviral drug for COVID-19, operates by disrupting the virus’s genome, inducing random mutations during replication to weaken the virus and prevent further reproduction, ultimately clearing the infection. It has received approvals for COVID-19 treatment in several countries, including the UK, the US, and Japan, and has been in use since its market authorization at the end of 2021.

However, concerns have emerged that if Molnupiravir fails to completely eliminate the virus, it could potentially lead to the emergence of new mutant strains.

On September 25, 2023, researchers from the University of Cambridge and the Francis Crick Institute in the UK published a study titled “A molnupiravir-associated mutational signature in global SARS-CoV-2 genomes” in the journal “Nature.”

The study reveals that the antiviral drug Molnupiravir may be accelerating mutations in the SARS-CoV-2 virus, increasing its genetic diversity. Analysis of treatment data in the UK indicates that at least 30% of mutated viruses are associated with Molnupiravir usage. Some individuals treated with Molnupiravir have been found to produce new mutant viruses that not only survive but also transmit.

COVID-19 Drug Molnupiravir Exacerbate the COVID-19 Pandemic?

From the outset, some researchers had concerns about the mechanism of action of Molnupiravir. One concern was that the drug might not only induce mutations in the coronavirus but also cause mutations in the DNA of individuals undergoing treatment. Another concern was that mutant viruses could continue to thrive and propagate within the human body, potentially becoming more transmissible or virulent than before.

Inside the body, Molnupiravir is transformed into a molecule that can disrupt the virus’s genome, introducing nucleotide mutations in its RNA, randomly changing some Cs to Ts and some Gs to As. With these changes, the virus’s offspring become weaker as it replicates, reducing the rate of viral replication and eliminating the virus within the body.

However, in certain cases, some mutant viruses may not be killed off rapidly enough, potentially leading to the spread of new mutant viruses.

In this study, researchers sequenced the virus repository of the Global Initiative on Sharing Avian Influenza Data (GISAID) and collaborated with the International Nucleotide Sequence Database Collaboration (INSDC) to analyze over 15 million global sequences of the SARS-CoV-2 virus genome, identifying mutations at each point in the virus’s evolutionary history.

COVID-19 Drug Molnupiravir Exacerbate the COVID-19 Pandemic?

Researchers found that since 2022, some mutation patterns have been markedly different from the typical patterns, and they are closely associated with individuals taking Molnupiravir. As Molnupiravir was introduced, specific mutations increased in frequency, whereas the number of such mutations in sequences from countries where Molnupiravir was not approved remained low.

To confirm this association, researchers analyzed treatment data from the UK and found that at least 31% of mutant viruses were linked to Molnupiravir use.

Through mutation feature tracking, specific mutation features closely matched those observed in Molnupiravir clinical trials.

Furthermore, some individuals treated with Molnupiravir were found to produce new mutant viruses that not only survive but also transmit.

Researchers emphasized that the COVID-19 virus continues to have a significant impact on human health, with some individuals struggling to clear the virus. Therefore, the development of drugs aimed at reducing the duration of infection remains crucial. However, this study suggests that the antiviral drug Molnupiravir may also lead to new mutations, increasing the genetic diversity within the population of surviving viruses.

Researchers stressed that when developing new drugs with similar modes of action, the potential for sustained antiviral-induced mutations should be considered.

Furthermore, as early as December 2022, researchers at the Royal Hobart Hospital in Australia published a study on the preprint platform medRxiv titled “Antiviral treatments lead to the rapid accrual of hundreds of SARS-CoV-2 mutations in immunocompromised patients,” suggesting that the use of Molnupiravir in treatment may lead to the emergence of new mutations and prolong the pandemic.

COVID-19 Drug Molnupiravir Exacerbate the COVID-19 Pandemic?

In conclusion, research indicates that the antiviral drug Molnupiravir may contribute to new mutations, increasing the genetic diversity of the virus, raising questions about its continued use.