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. There is substantial positive publication bias. Two trials (CTRI/2021/05/033864 and CTRI/2021/08/0354242) have reported no significant efficacy, however the results have not been published.
0
0.5
1
1.5+
All studies
32%
11
14,747
Improvement, Studies, Patients
Relative Risk
Mortality
46%
4
12,413
Ventilation
69%
1
10,512
Hospitalization
2%
5
12,675
Recovery
15%
5
906
Viral clearance
41%
5
12,370
RCTs
36%
9
4,235
RCT mortality
50%
3
1,901
Peer-reviewed
39%
5
3,678
Early
44%
7
3,944
Late
16%
4
10,803
Molnupiravir for COVID-19
c19mp.com Jul 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
C19MP.COM JUL 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
Tau2 = 0.36, I2 = 78.7%, p = 0.048
Early treatment
44%
0.56 [0.31-1.00]
61/2,017
142/1,927
44% 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
32%
0.68 [0.48-0.95]
72/4,349
143/10,398
32% improvement
11 molnupiravir COVID-19 studies
c19mp.com Jul 2022
Tau2 = 0.16, I2 = 73.4%, p = 0.025
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
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
46%
0.54 [0.17-1.74]
12/3,181
11/9,232
46% improvement
4 molnupiravir COVID-19 mortality results
c19mp.com Jul 2022
Tau2 = 0.71, I2 = 51.0%, p = 0.31
Favors molnupiravir
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
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
69%
0.31 [0.16-0.61]
0/2,116
0/8,396
69% improvement
1 molnupiravir COVID-19 mechanical ventilation result
c19mp.com Jul 2022
Tau2 = 0.00, I2 = 0.0%, p = 0.00064
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.
Tau2 = 0.45, I2 = 76.0%, p = 0.34
Early treatment
33%
0.67 [0.30-1.51]
17/1,121
37/1,042
33% 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 [0.79-1.20]
17/3,237
37/9,438
2% improvement
5 molnupiravir COVID-19 hospitalization results
c19mp.com Jul 2022
Tau2 = 0.02, I2 = 77.3%, p = 0.82
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
Tau2 = 0.53, I2 = 71.9%, p = 0.079
Early treatment
53%
0.47 [0.20-1.09]
15/1,830
46/1,741
53% 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
40%
0.60 [0.36-1.00]
26/4,162
47/10,212
40% improvement
7 molnupiravir COVID-19 serious outcomes
c19mp.com Jul 2022
Tau2 = 0.23, I2 = 76.4%, p = 0.049
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
c19mp.com Jul 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
Tau2 = 0.00, I2 = 0.0%, p < 0.0001
Early treatment
58%
0.42 [0.34-0.53]
90/903
205/844
58% 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
41%
0.59 [0.41-0.86]
116/3,070
239/9,300
41% improvement
5 molnupiravir COVID-19 viral clearance results
c19mp.com Jul 2022
Tau2 = 0.14, I2 = 86.0%, p = 0.0057
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
Tau2 = 0.14, I2 = 43.2%, p = 0.0027
Early treatment
53%
0.47 [0.29-0.77]
61/2,017
142/1,927
53% 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
36%
0.64 [0.40-1.03]
72/2,233
143/2,002
36% improvement
9 molnupiravir COVID-19 Randomized Controlled Trials
c19mp.com Jul 2022
Tau2 = 0.26, I2 = 60.7%, p = 0.066
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
c19mp.com Jul 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
c19mp.com Jul 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.
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
c19mp.com Jul 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