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Review
. 2023 Feb 15;12(2):393.
doi: 10.3390/antibiotics12020393.

Real-World Clinical Outcomes of Molnupiravir for the Treatment of Mild to Moderate COVID-19 in Adult Patients during the Dominance of the Omicron Variant: A Meta-Analysis

Chienhsiu Huang  1 , Tsung-Lung Lu  2 , Lichen Lin  2
Affiliations
Review

Real-World Clinical Outcomes of Molnupiravir for the Treatment of Mild to Moderate COVID-19 in Adult Patients during the Dominance of the Omicron Variant: A Meta-Analysis

Chienhsiu Huang et al. Antibiotics (Basel). .

Abstract

Introduction: The therapeutic impact of molnupiravir in the Omicron variant phase is unknown. The goal of the current meta-analysis was to compare the real-world clinical outcomes of molnupiravir for the treatment of mild to moderate COVID-19 during the dominance of the Omicron variant in adult patients to that of a placebo.

Methods: To be included, studies had to directly compare the clinical effectiveness of molnupiravir in treating adult COVID-19 patients to that of a placebo. Studies were included based on the following outcomes: all-cause mortality, composite outcome of disease progression, hospitalization rate, and viral load.

Results: The current meta-analysis included six studies that indicated that the risk of mortality was reduced by 34%, and the risk of composite outcome of disease progression was reduced by 37% among patients who received molnupiravir. Molnupiravir was associated with faster reduction in viral loads than the placebo. There was no clinical benefit of reducing all-cause mortality in mild to moderate COVID-19 patients with high COVID-19 vaccination coverage.

Conclusion: The clinical effectiveness of molnupiravir was associated with COVID-19 vaccination coverage in COVID-19 patients. There is a lack of detailed data on its effectiveness in vaccinated patients, especially those with low COVID-19 vaccination coverage.

Keywords: COVID-19; COVID-19 vaccination coverage; all-cause mortality; composite outcome of disease progression; molnupiravir; viral load.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of the study selection process. Six studies were included in the meta-analysis, including one randomized controlled trial, five retrospective observational studies.
Figure 2
Figure 2
Risk of bias of one randomized controlled trial [26].
Figure 3
Figure 3
All-cause mortality between molnupiravir and placebo in the treatment of mild to moderate COVID-19 in adult patients [26,27,28,29,30,31].
Figure 4
Figure 4
All-cause mortality between molnupiravir and placebo in the treatment of mild to moderate COVID-19 in adult patients with high COVID-19 vaccination coverage [26,28,29].
Figure 5
Figure 5
All-cause mortality between molnupiravir and placebo in the treatment of mild to moderate COVID-19 in adult patients with low COVID-19 vaccination coverage [30,31].
Figure 6
Figure 6
Composite outcome of disease progression between molnupiravir and placebo in the treatment of mild to moderate COVID-19 in adult patients [28,29,30,31].
Figure 7
Figure 7
Hospitalization between molnupiravir and placebo in the treatment of mild to moderate COVID-19 in adult patients [26,31].
See this image and copyright information in PMC

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