Abstract：
OBJECTIVE: Molnupiravir is a newer oral antiviral drug that has recently received emergency use authorization (EUA) in USA, UK and India. We aim to conduct an update on our previous systematic review to provide practical clinical guideline for using molnupiravir in patients with COVID-19.
METHODS: We systematically searched the electronic database of PubMed, MedRxiv and Google Scholar until January 5, 2022, using key MeSH keywords.
RESULTS: Final result of phase 3 study in 1433 non-hospitalized COVID-19 patients showed a significant reduction in composite risk of hospital admission or death (absolute risk difference, -3.0% [95% confidence interval {CI}, -5.9 to -0.1%]; 1-sided P = 0.02) although with a non-significant 31% relative risk reduction (RRR). RRR for death alone was 89% (95% CI, 14 to 99; P-value not reported). Number needed to treat to prevent 1 death or 1 hospitalization or death composite appears to be closely competitive to other agents having EUA in people with COVID-19. However, cost-wise molnupiravir is comparatively cheaper compared to all other agents.
CONCLUSIONS: Molnupiravir could be a useful agent in non-pregnant unvaccinated adults with COVID-19 who are at increased risk of severity including hospitalization. However, it is effective only when used within 5-days of onset of symptoms. A 5-days course seems to be safe without any obvious short-term side effects.
METHODS: We systematically searched the electronic database of PubMed, MedRxiv and Google Scholar until January 5, 2022, using key MeSH keywords.
RESULTS: Final result of phase 3 study in 1433 non-hospitalized COVID-19 patients showed a significant reduction in composite risk of hospital admission or death (absolute risk difference, -3.0% [95% confidence interval {CI}, -5.9 to -0.1%]; 1-sided P = 0.02) although with a non-significant 31% relative risk reduction (RRR). RRR for death alone was 89% (95% CI, 14 to 99; P-value not reported). Number needed to treat to prevent 1 death or 1 hospitalization or death composite appears to be closely competitive to other agents having EUA in people with COVID-19. However, cost-wise molnupiravir is comparatively cheaper compared to all other agents.
CONCLUSIONS: Molnupiravir could be a useful agent in non-pregnant unvaccinated adults with COVID-19 who are at increased risk of severity including hospitalization. However, it is effective only when used within 5-days of onset of symptoms. A 5-days course seems to be safe without any obvious short-term side effects.
摘要：
目的：Molnupiravir是一种较新的口服抗病毒药物，最近在美国获得了紧急使用授权（EUA），英国和印度。我们的目标是对我们以前的系统评价进行更新，为COVID-19患者使用莫努比拉韦提供实用的临床指南。
方法：我们系统地搜索了PubMed的电子数据库，MedRxiv和GoogleScholar，直到2022年1月5日，使用关键的MeSH关键字。
结果：1433例非住院COVID-19患者的3期研究的最终结果显示，入院或死亡的复合风险显着降低（绝对风险差异，-3.0%[95%置信区间{CI}，-5.9至-0.1%]；单侧P=0.02），尽管相对风险降低了31%（RRR）。单独死亡的RRR为89%（95%CI，14至99；P值未报告）。在COVID-19患者中，为预防1例死亡或1例住院或复合死亡而需要治疗的人数似乎与其他具有EUA的药物紧密竞争。然而,从成本上讲，与所有其他代理商相比，莫努普拉韦相对便宜。
结论：Molnupiravir可能是一种有效的药物，用于未怀孕的未接种COVID-19疫苗的成年人，他们的严重程度包括住院风险增加。然而,它只有在症状发作后5天内使用时才有效。5天的疗程似乎是安全的，没有任何明显的短期副作用。
方法：我们系统地搜索了PubMed的电子数据库，MedRxiv和GoogleScholar，直到2022年1月5日，使用关键的MeSH关键字。
结果：1433例非住院COVID-19患者的3期研究的最终结果显示，入院或死亡的复合风险显着降低（绝对风险差异，-3.0%[95%置信区间{CI}，-5.9至-0.1%]；单侧P=0.02），尽管相对风险降低了31%（RRR）。单独死亡的RRR为89%（95%CI，14至99；P值未报告）。在COVID-19患者中，为预防1例死亡或1例住院或复合死亡而需要治疗的人数似乎与其他具有EUA的药物紧密竞争。然而,从成本上讲，与所有其他代理商相比，莫努普拉韦相对便宜。
结论：Molnupiravir可能是一种有效的药物，用于未怀孕的未接种COVID-19疫苗的成年人，他们的严重程度包括住院风险增加。然而,它只有在症状发作后5天内使用时才有效。5天的疗程似乎是安全的，没有任何明显的短期副作用。
