Outcomes in COVID-19 molnupiravir studies
Outcomes in molnupiravir studies.
Potential risks of the mechanism of action include the creation of dangerous variants, and mutagenicity, carcinogenicity, teratogenicity, and embryotoxicity [Hadj Hassine , Swanstrom , Waters ] . There is substantial publication bias. Two trials (CTRI/2021/05/033864 and CTRI/2021/08/0354242) reported no significant efficacy, however the results have not been published. Multiple trials have not reported results and did not respond to requests
[Lawrence ] .
0
0.5
1
1.5+
All studies
33%
13
15,517
Improvement, Studies, Patients
Relative Risk
Mortality
43%
5
13,003
Ventilation
48%
2
11,102
Hospitalization
2%
7
13,445
Recovery
15%
5
906
Viral clearance
38%
6
12,550
RCTs
37%
10
4,415
RCT mortality
50%
3
1,901
Peer-reviewed
39%
5
3,678
Early
43%
9
4,714
Late
16%
4
10,803
Molnupiravir for COVID-19
c19early.com/m Aug 2022
Favors molnupiravir
Favors control
0
0.5
1
1.5+
ALL STUDIES
MORTALITY
VENTILATION
HOSPITALIZATION
RECOVERY
VIRAL CLEARANCE
RCTS
RCT MORTALITY
PEER-REVIEWED
All
Early
Late
Molnupiravir for COVID-19
C19EARLY.COM/M AUG 2022
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Fischer (RCT)
77%
0.23 [0.01-5.69]
death
0/140
1/62
Improvement, RR [CI]
Treatment
Control
Hetero (RCT)
70%
0.30 [0.13-0.70]
hosp.
7/371
23/370
Optimus (RCT)
58%
0.42 [0.31-0.58]
viral+
38/175
93/180
Khoo (RCT)
-33%
1.33 [0.55-3.26]
no recov.
8/12
3/6
Jayk Bernal (RCT)
89%
0.11 [0.01-0.86]
death
1/709
9/699
Tippabhotla (RCT)
46%
0.54 [0.22-1.34]
hosp.
7/610
13/610
Yip (PSW)
-12%
1.12 [0.68-1.82]
death/ICU
Flisiak
39%
0.61 [0.38-0.97]
death
20/203
63/387
Khoo (DB RCT)
67%
0.33 [0.01-8.08]
oxygen
0/90
1/90
Tau2 = 0.25, I2 = 71.9%, p = 0.016
Early treatment
43%
0.57 [0.36-0.90]
81/2,310
206/2,404
43% improvement
033864 (RCT)
0%
1.00 [0.50-2.00]
improv.
n/a
n/a
FUTILITY, PENDING1
Improvement, RR [CI]
Treatment
Control
035424 (RCT)
0%
1.00 [0.50-2.00]
improv.
n/a
n/a
FUTILITY, PENDING1
Arribas (DB RCT)
-282%
3.82 [0.50-29.1]
death
11/216
1/75
Wong (PSM)
45%
0.55 [0.47-0.63]
death
2,116 (n)
8,396 (n)
Tau2 = 0.18, I2 = 64.9%, p = 0.55
Late treatment
16%
0.84 [0.49-1.45]
11/2,332
1/8,471
16% improvement
All studies
33%
0.67 [0.49-0.89]
92/4,642
207/10,875
33% improvement
13 molnupiravir COVID-19 studies
c19early.com/m Aug 2022
Tau2 = 0.13, I2 = 68.2%, p = 0.0069
Effect extraction pre-specified
1 FUTILITY: terminated for futility, results pending
Favors molnupiravir
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Fischer (RCT)
77%
0.23 [0.01-5.69]
0/140
1/62
Improvement, RR [CI]
Treatment
Control
Jayk Bernal (RCT)
89%
0.11 [0.01-0.86]
1/709
9/699
Flisiak
39%
0.61 [0.38-0.97]
20/203
63/387
Tau2 = 0.32, I2 = 28.0%, p = 0.079
Early treatment
60%
0.40 [0.14-1.11]
21/1,052
73/1,148
60% improvement
Arribas (DB RCT)
-282%
3.82 [0.50-29.1]
11/216
1/75
Improvement, RR [CI]
Treatment
Control
Wong (PSM)
45%
0.55 [0.47-0.63]
2,116 (n)
8,396 (n)
Tau2 = 1.34, I2 = 71.3%, p = 0.92
Late treatment
-10%
1.10 [0.18-6.80]
11/2,332
1/8,471
-10% improvement
All studies
43%
0.57 [0.38-0.84]
32/3,384
74/9,619
43% improvement
5 molnupiravir COVID-19 mortality results
c19early.com/m Aug 2022
Tau2 = 0.06, I2 = 36.2%, p = 0.0051
Favors molnupiravir
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Flisiak
5%
0.95 [0.39-2.32]
7/203
14/387
Improvement, RR [CI]
Treatment
Control
Tau2 = 0.00, I2 = 0.0%, p = 0.92
Early treatment
5%
0.95 [0.39-2.32]
7/203
14/387
5% improvement
Wong (PSM)
69%
0.31 [0.16-0.61]
2,116 (n)
8,396 (n)
Improvement, RR [CI]
Treatment
Control
Tau2 = 0.00, I2 = 0.0%, p = 0.00064
Late treatment
69%
0.31 [0.16-0.61]
0/2,116
0/8,396
69% improvement
All studies
48%
0.52 [0.17-1.57]
7/2,319
14/8,783
48% improvement
2 molnupiravir COVID-19 mechanical ventilation results
c19early.com/m Aug 2022
Tau2 = 0.47, I2 = 74.4%, p = 0.25
Favors molnupiravir
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Fischer (RCT)
-33%
1.33 [0.14-12.5]
hosp.
3/140
1/62
Improvement, RR [CI]
Treatment
Control
Hetero (RCT)
70%
0.30 [0.13-0.70]
hosp.
7/371
23/370
Tippabhotla (RCT)
46%
0.54 [0.22-1.34]
hosp.
7/610
13/610
Yip (PSW)
-17%
1.17 [0.99-1.39]
hosp.
Flisiak
-1%
1.01 [0.71-1.43]
hosp. time
203 (n)
387 (n)
Khoo (DB RCT)
89%
0.11 [0.01-2.03]
hosp.
0/90
4/90
Tau2 = 0.13, I2 = 67.4%, p = 0.26
Early treatment
22%
0.78 [0.51-1.20]
17/1,414
41/1,519
22% improvement
Wong (PSM)
0%
1.00 [0.95-1.04]
hosp. time
2,116 (n)
8,396 (n)
Improvement, RR [CI]
Treatment
Control
Tau2 = 0.00, I2 = 0.0%, p = 0.86
Late treatment
0%
1.00 [0.95-1.04]
0/2,116
0/8,396
0% improvement
All studies
2%
0.98 [0.81-1.17]
17/3,530
41/9,915
2% improvement
7 molnupiravir COVID-19 hospitalization results
c19early.com/m Aug 2022
Tau2 = 0.02, I2 = 69.8%, p = 0.81
Favors molnupiravir
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Fischer (RCT)
77%
0.23 [0.01-5.69]
death
0/140
1/62
Improvement, RR [CI]
Treatment
Control
Hetero (RCT)
70%
0.30 [0.13-0.70]
hosp.
7/371
23/370
Jayk Bernal (RCT)
89%
0.11 [0.01-0.86]
death
1/709
9/699
Tippabhotla (RCT)
46%
0.54 [0.22-1.34]
hosp.
7/610
13/610
Yip (PSW)
-12%
1.12 [0.68-1.82]
death/ICU
Flisiak
39%
0.61 [0.38-0.97]
death
20/203
63/387
Khoo (DB RCT)
67%
0.33 [0.01-8.08]
oxygen
0/90
1/90
Tau2 = 0.25, I2 = 62.8%, p = 0.028
Early treatment
46%
0.54 [0.31-0.94]
35/2,123
110/2,218
46% improvement
Arribas (DB RCT)
-282%
3.82 [0.50-29.1]
death
11/216
1/75
Improvement, RR [CI]
Treatment
Control
Wong (PSM)
45%
0.55 [0.47-0.63]
death
2,116 (n)
8,396 (n)
Tau2 = 1.34, I2 = 71.3%, p = 0.92
Late treatment
-10%
1.10 [0.18-6.80]
11/2,332
1/8,471
-10% improvement
All studies
39%
0.61 [0.41-0.90]
46/4,455
111/10,689
39% improvement
9 molnupiravir COVID-19 serious outcomes
c19early.com/m Aug 2022
Tau2 = 0.16, I2 = 68.7%, p = 0.014
Effect extraction pre-specified (most serious outcome)
Favors molnupiravir
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Hetero (RCT)
33%
0.67 [0.54-0.82]
recov. time
371 (n)
370 (n)
Improvement, RR [CI]
Treatment
Control
Khoo (RCT)
-33%
1.33 [0.55-3.26]
no recov.
8/12
3/6
Tau2 = 0.13, I2 = 54.4%, p = 0.53
Early treatment
18%
0.82 [0.44-1.52]
8/383
3/376
18% improvement
033864 (RCT)
0%
1.00 [0.50-2.00]
improv.
n/a
n/a
FUTILITY, PENDING1
Improvement, RR [CI]
Treatment
Control
035424 (RCT)
0%
1.00 [0.50-2.00]
improv.
n/a
n/a
FUTILITY, PENDING1
Arribas (DB RCT)
1%
0.99 [0.68-1.45]
no recov.
72 (n)
75 (n)
Tau2 = 0.00, I2 = 0.0%, p = 0.97
Late treatment
1%
0.99 [0.74-1.34]
0/72
0/75
1% improvement
All studies
15%
0.85 [0.66-1.11]
8/455
3/451
15% improvement
5 molnupiravir COVID-19 recovery results
c19early.com/m Aug 2022
Tau2 = 0.03, I2 = 35.2%, p = 0.24
1 FUTILITY: terminated for futility, results pending
Favors molnupiravir
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Fischer (RCT)
49%
0.51 [0.22-1.18]
viral+
10/118
9/54
Improvement, RR [CI]
Treatment
Control
Optimus (RCT)
58%
0.42 [0.31-0.58]
viral+
38/175
93/180
Tippabhotla (RCT)
59%
0.41 [0.29-0.57]
viral+
42/610
103/610
Khoo (DB RCT)
23%
0.77 [0.58-1.09]
viral+
90 (n)
90 (n)
Tau2 = 0.09, I2 = 72.6%, p = 0.00035
Early treatment
49%
0.51 [0.36-0.74]
90/993
205/934
49% improvement
Arribas (DB RCT)
12%
0.88 [0.62-1.25]
viral+
26/52
34/60
Improvement, RR [CI]
Treatment
Control
Wong (PSM)
17%
0.83 [0.73-0.93]
viral+
2,115 (n)
8,396 (n)
Tau2 = 0.00, I2 = 0.0%, p = 0.0021
Late treatment
17%
0.83 [0.74-0.94]
26/2,167
34/8,456
17% improvement
All studies
38%
0.62 [0.46-0.84]
116/3,160
239/9,390
38% improvement
6 molnupiravir COVID-19 viral clearance results
c19early.com/m Aug 2022
Tau2 = 0.10, I2 = 82.7%, p = 0.0016
Favors molnupiravir
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Fischer (RCT)
77%
0.23 [0.01-5.69]
death
0/140
1/62
Improvement, RR [CI]
Treatment
Control
Hetero (RCT)
70%
0.30 [0.13-0.70]
hosp.
7/371
23/370
Optimus (RCT)
58%
0.42 [0.31-0.58]
viral+
38/175
93/180
Khoo (RCT)
-33%
1.33 [0.55-3.26]
no recov.
8/12
3/6
Jayk Bernal (RCT)
89%
0.11 [0.01-0.86]
death
1/709
9/699
Tippabhotla (RCT)
46%
0.54 [0.22-1.34]
hosp.
7/610
13/610
Khoo (DB RCT)
67%
0.33 [0.01-8.08]
oxygen
0/90
1/90
Tau2 = 0.11, I2 = 32.1%, p = 0.0009
Early treatment
54%
0.46 [0.30-0.73]
61/2,107
143/2,017
54% improvement
033864 (RCT)
0%
1.00 [0.50-2.00]
improv.
n/a
n/a
FUTILITY, PENDING1
Improvement, RR [CI]
Treatment
Control
035424 (RCT)
0%
1.00 [0.50-2.00]
improv.
n/a
n/a
FUTILITY, PENDING1
Arribas (DB RCT)
-282%
3.82 [0.50-29.1]
death
11/216
1/75
Tau2 = 0.00, I2 = 0.0%, p = 0.77
Late treatment
-8%
1.08 [0.67-1.73]
11/216
1/75
-8% improvement
All studies
37%
0.63 [0.40-1.00]
72/2,323
144/2,092
37% improvement
10 molnupiravir COVID-19 Randomized Controlled Trials
c19early.com/m Aug 2022
Tau2 = 0.24, I2 = 56.0%, p = 0.05
Effect extraction pre-specified
1 FUTILITY: terminated for futility, results pending
Favors molnupiravir
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Fischer (RCT)
77%
0.23 [0.01-5.69]
0/140
1/62
Improvement, RR [CI]
Treatment
Control
Jayk Bernal (RCT)
89%
0.11 [0.01-0.86]
1/709
9/699
Tau2 = 0.00, I2 = 0.0%, p = 0.024
Early treatment
86%
0.14 [0.02-0.78]
1/849
10/761
86% improvement
Arribas (DB RCT)
-282%
3.82 [0.50-29.1]
11/216
1/75
Improvement, RR [CI]
Treatment
Control
Tau2 = 0.00, I2 = 0.0%, p = 0.2
Late treatment
-282%
3.82 [0.50-29.1]
11/216
1/75
-282% improvement
All studies
50%
0.50 [0.05-5.45]
12/1,065
11/836
50% improvement
3 molnupiravir COVID-19 RCT mortality results
c19early.com/m Aug 2022
Tau2 = 2.97, I2 = 67.3%, p = 0.58
Favors molnupiravir
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Hetero (RCT)
70%
0.30 [0.13-0.70]
hosp.
7/371
23/370
Improvement, RR [CI]
Treatment
Control
Khoo (RCT)
-33%
1.33 [0.55-3.26]
no recov.
8/12
3/6
Jayk Bernal (RCT)
89%
0.11 [0.01-0.86]
death
1/709
9/699
Tippabhotla (RCT)
46%
0.54 [0.22-1.34]
hosp.
7/610
13/610
Tau2 = 0.46, I2 = 62.7%, p = 0.098
Early treatment
52%
0.48 [0.21-1.14]
23/1,702
48/1,685
52% improvement
Arribas (DB RCT)
-282%
3.82 [0.50-29.1]
death
11/216
1/75
Improvement, RR [CI]
Treatment
Control
Tau2 = 0.00, I2 = 0.0%, p = 0.2
Late treatment
-282%
3.82 [0.50-29.1]
11/216
1/75
-282% improvement
All studies
39%
0.61 [0.25-1.49]
34/1,918
49/1,760
39% improvement
5 molnupiravir COVID-19 peer reviewed trials
c19early.com/m Aug 2022
Tau2 = 0.61, I2 = 65.2%, p = 0.28
Effect extraction pre-specified (most serious outcome)
Favors molnupiravir
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Fischer (RCT)
77%
0.23 [0.01-5.69]
death
0/140
1/62
Improvement, RR [CI]
Treatment
Control
Fischer (RCT)
65%
0.35 [0.01-8.33]
death
0/55
1/62
Fischer (RCT)
67%
0.33 [0.01-8.03]
death
0/62
1/62
Fischer (RCT)
58%
0.42 [0.02-10.0]
death
0/23
1/62
Fischer (RCT)
-33%
1.33 [0.14-12.5]
hosp.
3/140
1/62
Fischer (RCT)
-13%
1.13 [0.07-17.6]
hosp.
1/55
1/62
Fischer (RCT)
-100%
2.00 [0.19-21.5]
hosp.
2/62
1/62
Fischer (RCT)
58%
0.42 [0.02-10.0]
hosp.
0/23
1/62
Fischer (RCT)
49%
0.51 [0.22-1.18]
viral+
10/118
9/54
Fischer (RCT)
89%
0.11 [0.01-0.86]
viral+
1/53
9/54
Fischer (RCT)
30%
0.70 [0.25-1.93]
viral+
5/43
9/54
Fischer (RCT)
-9%
1.09 [0.37-3.18]
viral+
4/22
9/54
Fischer (RCT)
92%
0.08 [0.01-0.62]
viral+
1/117
6/54
Fischer (RCT)
92%
0.08 [0.00-1.34]
viral+
0/53
6/54
Fischer (RCT)
91%
0.09 [0.00-1.48]
viral+
0/42
6/54
Fischer (RCT)
59%
0.41 [0.05-3.20]
viral+
1/22
6/54
Fischer (RCT)
30%
0.70 [0.37-1.36]
viral+
19/137
12/61
Fischer (RCT)
62%
0.38 [0.13-1.12]
viral+
4/53
12/61
Fischer (RCT)
-8%
1.08 [0.54-2.18]
viral+
13/61
12/61
Fischer (RCT)
56%
0.44 [0.11-1.83]
viral+
2/23
12/61
Hetero (RCT)
70%
0.30 [0.13-0.70]
hosp.
7/371
23/370
Hetero (RCT)
33%
0.67 [0.54-0.82]
recov. time
371 (n)
370 (n)
Optimus (RCT)
58%
0.42 [0.31-0.58]
viral+
38/175
93/180
Khoo (RCT)
-33%
1.33 [0.55-3.26]
no recov.
8/12
3/6
Khoo (RCT)
-100%
2.00 [0.28-14.2]
no recov.
4/12
1/6
Khoo (RCT)
-100%
2.00 [0.90-4.43]
no recov.
4/4
3/6
Khoo (RCT)
0%
1.00 [0.28-3.54]
no recov.
2/4
3/6
Khoo (RCT)
0%
1.00 [0.28-3.54]
no recov.
2/4
3/6
Khoo (RCT)
-50%
1.50 [0.13-17.7]
no recov.
1/4
1/6
Khoo (RCT)
-200%
3.00 [0.39-23.1]
no recov.
2/4
1/6
Khoo (RCT)
-50%
1.50 [0.13-17.7]
no recov.
1/4
1/6
Jayk Bernal (RCT)
89%
0.11 [0.01-0.86]
death
1/709
9/699
Jayk Bernal (RCT)
30%
0.70 [0.49-0.99]
death/hosp.
48/709
68/699
Jayk Bernal (RCT)
94%
0.06 [0.00-0.97]
death/hosp.
0/37
9/47
Jayk Bernal (RCT)
50%
0.50 [0.20-1.26]
death/hosp.
6/75
13/82
Jayk Bernal (RCT)
24%
0.76 [0.42-1.38]
death/hosp.
18/237
22/221
Jayk Bernal (RCT)
42%
0.58 [0.20-1.68]
death/hosp.
5/47
7/38
Tippabhotla (RCT)
46%
0.54 [0.22-1.34]
hosp.
7/610
13/610
Tippabhotla (RCT)
46%
0.54 [0.41-0.71]
no improv.
67/610
125/610
Tippabhotla (RCT)
52%
0.48 [0.42-0.54]
no improv.
199/610
417/610
Tippabhotla (RCT)
25%
0.75 [0.71-0.79]
no improv.
433/610
576/610
Tippabhotla (RCT)
59%
0.41 [0.29-0.57]
viral+
42/610
103/610
Tippabhotla (RCT)
81%
0.19 [0.15-0.24]
viral+
62/610
327/610
Tippabhotla (RCT)
78%
0.22 [0.19-0.27]
viral+
113/610
505/610
Yip (PSW)
-12%
1.12 [0.68-1.82]
death/ICU
Yip (PSW)
-17%
1.17 [0.99-1.39]
hosp.
Flisiak
39%
0.61 [0.38-0.97]
death
20/203
63/387
Flisiak
5%
0.95 [0.39-2.32]
ventilation
7/203
14/387
Flisiak
-1%
1.01 [0.71-1.43]
hosp. time
203 (n)
387 (n)
Khoo (DB RCT)
67%
0.33 [0.01-8.08]
oxygen
0/90
1/90
Khoo (DB RCT)
89%
0.11 [0.01-2.03]
hosp.
0/90
4/90
Khoo (DB RCT)
23%
0.77 [0.58-1.09]
viral+
90 (n)
90 (n)
033864 (RCT)
0%
1.00 [0.50-2.00]
improv.
n/a
n/a
FUTILITY, PENDING1
035424 (RCT)
0%
1.00 [0.50-2.00]
improv.
n/a
n/a
FUTILITY, PENDING1
Arribas (DB RCT)
-282%
3.82 [0.50-29.1]
death
11/216
1/75
Arribas (DB RCT)
-217%
3.17 [0.34-29.8]
death
3/71
1/75
Arribas (DB RCT)
-317%
4.17 [0.48-36.4]
death
4/72
1/75
Arribas (DB RCT)
-311%
4.11 [0.47-35.9]
death
4/73
1/75
Arribas (DB RCT)
1%
0.99 [0.68-1.45]
no recov.
72 (n)
75 (n)
Arribas (DB RCT)
12%
0.88 [0.61-1.28]
no recov.
73 (n)
75 (n)
Arribas (DB RCT)
-1%
1.01 [0.69-1.47]
no recov.
73 (n)
75 (n)
Arribas (DB RCT)
12%
0.88 [0.62-1.25]
viral+
26/52
34/60
Arribas (DB RCT)
-2%
1.02 [0.74-1.41]
viral+
29/50
34/60
Arribas (DB RCT)
21%
0.79 [0.56-1.13]
viral+
27/60
34/60
Arribas (DB RCT)
8%
0.92 [0.41-2.08]
viral+
9/53
10/54
Arribas (DB RCT)
-48%
1.48 [0.72-3.03]
viral+
14/51
10/54
Arribas (DB RCT)
21%
0.79 [0.34-1.84]
viral+
8/55
10/54
Wong (PSM)
45%
0.55 [0.47-0.63]
death
2,116 (n)
8,396 (n)
Wong (PSM)
69%
0.31 [0.16-0.61]
ventilation
2,116 (n)
8,396 (n)
Wong (PSM)
47%
0.53 [0.46-0.62]
death/ICU
2,116 (n)
8,396 (n)
Wong (PSM)
0%
1.00 [0.95-1.04]
hosp. time
2,116 (n)
8,396 (n)
Wong (PSM)
17%
0.83 [0.73-0.93]
viral+
2,115 (n)
8,396 (n)
molnupiravir COVID-19 outcomes
c19early.com/m Aug 2022
1 FUTILITY: terminated for futility, results pending
Favors molnupiravir
Favors control
Please send us corrections, updates, or comments. Vaccines and
treatments are both valuable and complementary. All practical, effective, and
safe means should be used. No treatment, vaccine, or intervention is 100%
available and effective for all current and future variants. Denying the
efficacy of any method increases mortality, morbidity, collateral damage, and
the risk of endemic status. We do not provide medical advice. Before taking
any medication, consult a qualified physician who can provide personalized
advice and details of risks and benefits based on your medical history and
situation.
FLCCC and
WCH
provide treatment protocols.
Thanks for your feedback! Please search before submitting papers and note
that studies are listed under the date they were first available, which may be
the date of an earlier preprint.
Submit