Early Use of Mulnupiravir Associated with Reduced Hospitalization and Death Among US Veterans
Started on Day 1 and Steroids Added Improved Outcomes
By Peter A. McCullough, MD, MPH
When both Paxlovid and Mulnupiravir were rolled out as EUA oral drugs to treat COVID-19 I accepted them clinically and placed them as antiviral options in the McCullough Protocol. One of the reasons for my early adoption was that I knew any novel drug advanced by Operation Warp Speed and endorsed by the CDC, FDA, and NIH would engage doctors who wanted to treat patients but were fearful of the stigmata associated with prescribing hydroxychloroquine or ivermectin. In the McCullough Protocol, no drug is necessary nor sufficient, thus any oral antiviral in combination with other medications would comprise a life saving “early treatment regimen” as compared to patients who received no medications at all.
Xie et al reported from the Veterans Administration automated database and found that among US veterans of whom were 92% men age 70 years, 46% former smokers, 63% vaxxed and boosted, that early use of the SARS-CoV-2 polymerase inhibitor, mulnupiravir, especially if started on Day 1, was associated with reduced risk of post-acute sequalae, hospitalization, and death after acute COVID-19. Of note, slightly more patients who received mulnupiravir had natural immunity (18%) and more received concurrent corticosteroids (14%). The authors did not account for other ambulatory drugs in the McCullough Protocol but I anticipate that mulnupiravir was associated with more extensive use of multidrug therapy shown to reduce hospitalization and death.
In summary, we use non-randomized analyses such as this not to make therapeutic claims on a specific drug, but to analyze overall patterns of care and in this case be reassured that early mulnupiravir as part of a multidrug regimen was associated with achieving the over-arching goal of reducing hospitalization and death. The only shortcoming is that not all high risk patients were given a chance with home therapy to survive free of these two outcomes
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Not sure I'd take anything new - since I will never trust big pharma again. Especially when the safe alternatives can be obtained. People just need to know where and how to get them.
Dr. McCullough's flexibility in including those drugs was a very wise strategy of his.