Molnupiravir for the treatment of COVID-19 outpatients [Elektronisk resurs] An updated meta-analysis

• Background: The majority of available data on molnupiravir come from an unvaccinated COVID-19 population. Therefore, we conducted this meta-analysis to integrate evidence from recent randomized controlled trials (RCTs) as well as observational studies stratified by vaccination status to determine the clinical efficacy and safety of molnupiravir in COVID-19 outpatients. Methods: We searched PubMed, Embase, the Cochrane Library, medRxiv, and ClinicalTrials.gov from inception to November 2023. We conducted our meta-analysis using RevMan 5.4 with risk ratio (RR) as the effect measure. Results: We included 8 RCTs and 5 observational studies in our meta-analysis. Molnupiravir reduced the risk of all-cause mortality (RR 0.28; 95% CI: 0.20–0.79, I2 = 0%) but did not decrease the hospitalization rate (RR 0.67; 95% CI: 0.45–1.00, I2 = 53%) in the overall population; in the immunized population, no benefits were observed. Molnupiravir lowered the rate of no recovery (RR 0.78; 95% CI: 0.76–0.81, I2 = 0%) and increased virological clearance at day 5 (RR 2.68; 95% CI: 1.94–4.22, I2 = 85%). There was no increase in the incidence of adverse events. Conclusions: Molnupiravir does not decrease mortality and hospitalization rates in immunized patients with COVID-19. However, it does shorten the disease course and increases the recovery rate. The use of molnupiravir will need to be considered on a case-by-case basis in the context of the prevailing social circumstances, the resource setting, drug costs, and the healthcare burden. 

Ämnesord

Medical and Health Sciences  (hsv)

Health Sciences  (hsv)

Public Health, Global Health, Social Medicine and Epidemiology  (hsv)

Medicin och hälsovetenskap  (hsv)

Hälsovetenskaper  (hsv)

Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi  (hsv)

Genre

government publication  (marcgt)

Indexterm och SAB-rubrik

COVID-19

EIDD-2801

MK-4482

Molnupiravir

SARS-CoV-2