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An oral pill for COVID-19?

By LAI S. REYES, The Philippine STAR Published Aug 24, 2021 6:00 am

COVID-19 can be greedy. Not only does it take a big bite out of your budget, it also zaps the joy out of life, as youll be isolated from your loved ones once the symptoms have progressed not knowing if and when youll ever see them again.

Such is the case of my friend Raquel Rocky Avelino, a working mom, who was rushed to Amang Rodriguez Hospital in Marikina City last week due to high fever and shortness of breath.

According to her daughter Pearl Anne, her mom waited for 12 hours gasping for air alone in a wheelchair outside the ER before she was brought to the isolation room. There, Rocky spent another 13 hours before she got admitted to the COVID ward and was finally administered supplemental oxygen.

Ive never been so helpless and scared in my whole life, Rocky replied when I checked on her via Messenger. COVID-19 is real. People die by the minute. Ive seen patients mostly seniors being revived and declared dead. I would just close my eyes, say a prayer, and think of the happier days spent with family and friends.

Thank goodness, my friend is now out of danger.

MSD in the Philippines announced the clinical trial of Molnupiravir, an antiviral pill, which is being evaluated for treatment of COVID-19.

Get vaccinated, Rocky advised. I wouldnt be here fighting for dear life had I gotten that jab. And please dont wait for the symptoms to progress (before getting medical help) and endanger the rest of your family members.

If only there was a magic pill that could address the virus early on, patients would be spared from the physical, emotional and financial burden of the coronavirus.

Antiviral pill

Despite the governments vaccination efforts, COVID-19 and its variants continue to be a significant health threat.

Global pharmaceutical company MSD, with the support of its partners, recognizes the need to help manage COVID-19 in the earliest stages of infection and prevent the hospitalization of patients.

In a virtual media forum, MSD in the Philippines announced the clinical trial of Molnupiravir, an antiviral pill, which is being evaluated for treatment of COVID-19. Molnupiravir is being developed in collaboration with Ridgeback Biotherapeutics.

  A frontrunner in the effort to develop a treatment for COVID-19 is a twice-a-day drug called Molnupiravir. Photo by Merck & Company / AFP-JIJI

Resource speakers were Dr. Mary Ann Galang-Escalona, country medical lead of MSD in the Philippines; Dr. Virginia Delos Reyes, principal investigator at the Lung Center of the Philippines; Dr. Joel Santiaguel, principal investigator at Quirino Memorial Medical Center; and Dr. Loysa Orense, administrator and project lead of BantAI COVID.

Dubbed MOVe-Out, the global clinical trial has begun enrolling patients around the globe, the Philippines included. The trial aims to evaluate the 800-mg. dose of Molnupiravir taken twice daily for five days in non-hospitalized patients with confirmed COVID-19 or early symptoms.

Once the drug gets approved, it may be able to address mild to moderate COVID-19 cases and prevent them from becoming severe.

Molnupiravir is an investigational oral antiviral, explains Dr. Mary Ann Galang, country medical lead of MSD in the Philippines. It is not a repurposed drug and its mechanism of action is to insert itself into the SARS-COVID-2 virus.

If youre given Molnupiravir early in the course of the disease, for example, five days or less from the onset of symptoms, Molnupiravir may be able to cause viral error catastrophe.

Viral error catastrophe is that phenomenon wherein the drug (Molnupiravir) inserts itself into the body of the virus, explains Dr. Galang. What happens after is that the copies that the virus will make will be defective. Meaning, they will not be able to cause infections further in the body. Patients could potentially reduce the risk of developing complications and undergoing hospitalization.


Once the drug gets approved, it may be able to address mild to moderate COVID-19 cases and prevent them from becoming severe.

By then, the hospitals and medical frontliners will not get overburdened by the severe cases getting into the ICU, adds Dr. Galang.

Clinical trial

The clinical trial looks at the trial drug, Molnupiravir, and finds out if its effective or safe as a treatment for patients with mild to moderate COVID-19, without the need for hospitalization, explains Dr. Virginia Delos Reyes, principal investigator at the Lung Center of the Philippines. These trials are important because they provide the basis for the development and marketing of drugs.

The Lung Center of the Philippines and Quirino Medical Center are the clinical trial sites for Molnupiravir in the country. Both hospitals have designated a medical team that oversees the clinical trials and provides round-the-clock medical support to all participants.

Who are eligible for Molnupiravir clinical trials? Not everyone who wants to join the trial is eligible.

Clinical trials follow the inclusion and exclusion criteria. This is done to ensure that the investigation treatment is given to patients who are most likely to respond to it, explains Dr. Delos Reyes.

Filipino patients 18 years old and above who have tested positive for COVID-19 in the past five days are eligible. They should also have at least one of the following symptoms, have not been admitted to the hospital in the next 48 hours, and those with comorbidities, adds Dr. Joel Santiaguel, principal investigator at Quirino Memorial Medical Center.

During the course of the trial, patients are carefully monitored and encouraged to share any new or worsening side effects that they may experience. The patients can choose to discontinue his/ her participation in this trial at any time for any reason, notes Dr. Santiaguel.


BantAI COVID, Molnupiravir MOVe-Out trials community partner, provides patient referrals for this trial. BantAI COVID is an organized end-to-end management system for COVID that covers contract tracing, monitoring, triaging, telemedicine and referral to help facilities, says Dr. Loysa Orense, administrator and project lead of BantAI COVID.

It is a multi-platform system that has real-time data with analytics of the COVID situation using artificial intelligence (AI) that has serviced more than 200,000 patients currently in Quezon City.

We screen patients based on the same guidelines shared by Dr. Santiaguel, notes Dr. Orense. Patients with severe and critical symptoms are excluded. This means that the respiratory rate should not be above 30 per minute, the heart rate should be less than 125 beats per minute, and the oxygen saturation should be 93 or more.

BantAI COVID has brought to the table the importance and viability of technology, specifically Artificial Intelligence, in this COVID fight.

Being a pioneering effort in Quezon City and in the Philippines, we offer this as part of the solution to improve our statistics in saving lives. We are very hopeful and optimistic that this trial will be successful. And that Molnupiravir will be available within the year for all our patients in the community, enthuses Dr. Orense.

Lung Center of the Philippines started the trials on 15 patients last May 17. As for QMMC, Dr. Santiaguel says they need to recruit 10 patients since theyve just started.

We invite doctors to refer your COVID-10 patients to us to be part of this trial, or the patients themselves can contact us, adds. Dr. Galang.

Patients who are willing to volunteer as participants in the clinical trial may contact the study investigators Dr. Virginia Delos Reyes of the Lung Center of the Philippines at 0917-8999610; and Dr. Joel Santiaguel of QMMC at 0917-8413314. For inquiries, visit https://msdcovidresearch.com/