Evidence map›Paper›PMID 41514297›Full record

Observational studyVirology journal2026

Viral kinetics in adults with Covid-19 treated with nirmatrelvir-ritonavir or molnupiravir: a population-based, observational cohort study.

Marlene Prager, Dominik Ensle, Hubert Eser, Florentin Glötzl, Benjamin Riedl, Marton Szell, Arschang Valipour, Alexander Zoufaly, Christoph Wenisch, Doris Haider and 7 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Virology journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Marlene PragerDepartment of Clinical Pharmacology, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria.
Dominik EnsleMunicipal Department for Public Health Services of the City of Vienna, Vienna, Austria.
Hubert EserMunicipal Department for Information Technology of the City of Vienna, Vienna, Austria.
Florentin GlötzlInstitute for Ecological Economics, Department for Socioeconomics, Vienna University of Economics and Business, Vienna, Austria.
Benjamin RiedlDepartment of Research, Vienna Healthcare Group, Vienna, Austria.
Marton SzellDepartment of Internal Medicine 2, Emergency Department, Klinik Donaustadt, Vienna, Austria.
Arschang ValipourHealth Care Group Klinik Floridsdorf, Karl-Landsteiner Institute for Lung Research and Pulmonary Oncology Vienna, Vienna, Austria.
Alexander ZoufalyFourth Medical Department with Infectious Diseases and Tropical Medicine, Klinik Favoriten, Vienna, Austria.
Christoph WenischFourth Medical Department with Infectious Diseases and Tropical Medicine, Klinik Favoriten, Vienna, Austria.
Doris HaiderDepartment of Pharmacy, Klinik Favoriten, Vienna, Austria.
Heinz BurgmannDepartment of Internal Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria.
Florian ThalhammerDepartment of Urology, Medical University of Vienna, Vienna, Austria.
Florian GötzingerDivision of Paediatric Infectious Diseases, Department of Paediatrics and Adolescent Medicine, Klinik Ottakring, Vienna, Austria.
Bernd JilmaDepartment of Clinical Pharmacology, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria.
Ursula KarnthalerMunicipal Department for Public Health Services of the City of Vienna, Vienna, Austria.
Markus ZeitlingerDepartment of Clinical Pharmacology, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria. markus.zeitlinger@meduniwien.ac.at.
Anselm JordaDepartment of Clinical Pharmacology, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis research was motivated by the widespread use of oral antivirals during the Covid-19 pandemic and the remaining uncertainty regarding their effects on viral kinetics, which have rarely been studied in real-world population cohorts of this size.

methodsWe analysed 291,340 SARS-CoV-2 cycle threshold (CT) values from 113,399 non-hospitalized adult patients in Vienna (01/2022-05/2023), including 30,451 from 12,166 nirmatrelvir-ritonavir recipients, 27,959 from 10,752 molnupiravir recipients, and 232,930 from 90,481 untreated controls.

resultsBoth antivirals initially caused a rapid increase in mean CT values. After completion of the 5-day treatment course, CT values declined in both antiviral groups, which was not observed in untreated individuals.

conclusionsThese findings provide population-level evidence on post-treatment viral kinetics of oral antivirals during the Omicron wave.

Indexed as

Antiviral AgentsCOVID-19 Drug TreatmentRitonavirSARS-CoV-2AdultAzabicyclo CompoundsCohort StudiesCOVID-19CytidineDrug CombinationsFemaleHumansHydroxylaminesKineticsLeucineLopinavirAntiviral AgentsAzabicyclo CompoundsCytidineDrug CombinationsHydroxylaminesLeucineLopinavirmolnupiravirMorpholinesnirmatrelvir and ritonavir drug combinationProlinePyrrolidinonesRitonavirSulfidesCoronavirusLagevrioPaxlovidSARS-CoV-2Viral rebound

Identifiers

PMID41514297
PMCPMC12882270

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.