Did You Take the Popular Covid-19 Anti-viral Pill Molnupiravir?
Covid-19 antiviral drug Molnupiravir linked to unique SARS-CoV-2 mutations
Leading research teams from institutions like the Francis Crick Institute, University of Cambridge, Imperial College London, University of Liverpool, University of Cape Town, and UKHSA have detected a connection between the COVID-19 anti-viral drug, molnupiravir, and unique SARS-CoV-2 mutations.
Molnupiravir’s mechanism targets the virus’s genetic makeup, leading to mutations during its replication phase. These alterations often hinder or destroy the virus, decreasing its presence in patients. This drug gained rapid approval and usage in many nations during the pandemic’s peak.
New findings in Nature highlight the researchers’ efforts to trace SARS-CoV-2’s genetic changes using worldwide sequencing data. Their deep dive into 15 million virus sequences allowed them to pinpoint specific mutations across the virus’s lineage.
What stood out was a unique set of mutations in the data, distinct from usual COVID-19 mutations. These unusual mutations were prevalent among molnupiravir recipients. A noticeable spike in such mutations was observed in 2022, around the time molnupiravir was introduced.
The data also indicated a higher occurrence of these mutations among seniors and regions with extensive molnupiravir usage. In England, upon examining treatment records, researchers discovered that molnupiravir was implicated in a minimum of 30% of the cases.
Each mutation carries a unique genetic ‘signature’. The team observed a remarkable resemblance between these unusual mutations and those seen in molnupiravir’s clinical tests.
Furthermore, the appearance of mutation clusters hinted at potential transmission between individuals, even though no current major variants are associated with this signature.
The study underscores the challenges in gauging the ramifications of molnupiravir on viral evolution and public health. The backdrop of chronic COVID-19 cases, where molnupiravir is frequently administered, further complicates the matter.
Theo Sanderson, the study’s lead author from the Francis Crick Institute, emphasized the drug’s dual-edged nature. While it curtails the infection, it simultaneously enriches the virus’s genetic diversity.
“COVID-19 is still having a major effect on human health, and some people have difficulty clearing the virus, so it’s important we develop drugs which aim to cut short the length of infection. But our evidence shows that a specific antiviral drug, molnupiravir, also results in new mutations, increasing the genetic diversity in the surviving viral population.”
He asserted, “Our findings are useful for ongoing assessment of the risks and benefits of molnupiravir treatment. The possibility of persistent antiviral-induced mutations needs to be taken into account for the development of new drugs which work in a similar way. Our work shows that the unprecedented size of post-pandemic sequence datasets, collaboratively built by thousands of researchers and healthcare workers around the world, creates huge power to reveal insights into virus evolution that would not be possible from analysis of data from any individual country.”
Adding his perspective, Christopher Ruis of the University of Cambridge’s Medicine Department noted, “Molnupiravir is one of a number of drugs being used to fight COVID-19. It belongs to a class of drugs that can cause the virus to mutate so much that it is fatally weakened. But what we’ve found is that in some patients, this process doesn’t kill all the viruses, and some mutated viruses can spread. This is important to take into account when assessing the overall benefits and risks of molnupiravir and similar drugs.”
Source: 10.1038/s41586-023-06649-6
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