Mild Covid cases can be managed at home, Molnupiravir no magic drug, says AIIMS doc

PTI, Jan 10, 2022, 7:29 PM IST

Amajority of Covid patients during this Omicron-driven surge of infections have so far shown mild symptoms that can be managed at home with symptomatic treatment, an AIIMS doctor said on Monday and stressed that antiviral pill Molnupiravir is no magic drug for the disease.

There is no specific drug against COVID-19 as of now and the treatment still remains symptomatic, said Dr Neeraj Nischal, an additional professor in the Department of Medicine at AIIMS.

All that is needed is close supervision of patients, especially those who are at risk such as the elderly with comorbidities and those who are still not vaccinated, he said.

Dr Nischal said, ”Pandemic does not mean that unless your doctor prescribes multiple drugs or fancy pills you are not going to get okay. At the end of the day, patience, a positivity of mind and paracetamol will see a majority of patients through.” ”A majority of the infected patients during the third wave of Covid so far have shown mild symptoms which can be easily managed at home with symptomatic treatment,” he said.

About the recently approved drug Molnupiravir, the doctor said it is being touted as a magic pill, which is not the case.

”Data of this particular molecule is not that robust as is being claimed. Most importantly, the population in which the trial was conducted and the type of virus variant prevalent at that time is entirely different from today’s scenarios, Dr Nischal said.

A large portion of the population is now vaccinated and the prevalent coronavirus variant is Omicron.

Molnupiravir works by inducing mutation in the virus by substituting one of the components that is also present in human genetic material. ”So, apart from theoretical possibility of selecting a mutant virus which could be more dangerous, it can also affect rapidly dividing cells of human beings like cells of reproductive organs in male, foetus in pregnant women, bone and cartilage of young adults and children,” the doctor explained.

People must remember that this drug has been given restricted emergency use authorisation in a very selective group of patients who are at risk of developing serious disease and have no other therapeutic options, he said.

”So efforts should be made to restrict the use of this drug as the known and unknown harm is much more than the limited benefit it may offer. It should not become an over-the-counter medicine and should be prescribed with due diligence.” Indian Council of Medical Research Director-General Dr Balram Bhargava had last week said Molnupiravir has major safety concerns and has not been included in the national protocol for the treatment of COVID-19.

Another drug that is being prescribed to patients is a cocktail of monoclonal antibodies (casirivimab and imdevimab). It must be remembered that this is not effective against Omicron and its use in the previously infected/vaccinated population is also not clear, Dr Nischal said.

So, in the present context it should not be used irrationally, he underlined.

One should keep faith in their immune response which can be boosted by a healthy lifestyle, vaccination and following covid appropriate behaviour, Dr Nischal said.

Amajority of Covid patients during this Omicron-driven surge of infections have so far shown mild symptoms that can be managed at home with symptomatic treatment, an AIIMS doctor said on Monday and stressed that antiviral pill Molnupiravir is no magic drug for the disease.

There is no specific drug against COVID-19 as of now and the treatment still remains symptomatic, said Dr Neeraj Nischal, an additional professor in the Department of Medicine at AIIMS.

All that is needed is close supervision of patients, especially those who are at risk such as the elderly with comorbidities and those who are still not vaccinated, he said.

Dr Nischal said, ”Pandemic does not mean that unless your doctor prescribes multiple drugs or fancy pills you are not going to get okay. At the end of the day, patience, a positivity of mind and paracetamol will see a majority of patients through.” ”A majority of the infected patients during the third wave of Covid so far have shown mild symptoms which can be easily managed at home with symptomatic treatment,” he said.

About the recently approved drug Molnupiravir, the doctor said it is being touted as a magic pill, which is not the case.

”Data of this particular molecule is not that robust as is being claimed. Most importantly, the population in which the trial was conducted and the type of virus variant prevalent at that time is entirely different from today’s scenarios, Dr Nischal said.

A large portion of the population is now vaccinated and the prevalent coronavirus variant is Omicron.

Molnupiravir works by inducing mutation in the virus by substituting one of the components that is also present in human genetic material. ”So, apart from theoretical possibility of selecting a mutant virus which could be more dangerous, it can also affect rapidly dividing cells of human beings like cells of reproductive organs in male, foetus in pregnant women, bone and cartilage of young adults and children,” the doctor explained.

People must remember that this drug has been given restricted emergency use authorisation in a very selective group of patients who are at risk of developing serious disease and have no other therapeutic options, he said.

”So efforts should be made to restrict the use of this drug as the known and unknown harm is much more than the limited benefit it may offer. It should not become an over-the-counter medicine and should be prescribed with due diligence.” Indian Council of Medical Research Director-General Dr Balram Bhargava had last week said Molnupiravir has major safety concerns and has not been included in the national protocol for the treatment of COVID-19.

Another drug that is being prescribed to patients is a cocktail of monoclonal antibodies (casirivimab and imdevimab). It must be remembered that this is not effective against Omicron and its use in the previously infected/vaccinated population is also not clear, Dr Nischal said.

So, in the present context it should not be used irrationally, he underlined.

One should keep faith in their immune response which can be boosted by a healthy lifestyle, vaccination and following covid appropriate behaviour, Dr Nischal said.