Molnupiravir: meta-analysis of COVID-19 studies

Meta-analysis of molnupiravir COVID-19 studies. Potential risks include the creation of dangerous variants, and mutagenicity, carcinogenicity, teratogenicity, and embryotoxicity1-15. Multiple analyses have identified variants potentially created by molnupiravir16-20. There is substantial publication bias. Multiple trials have not reported results and did not respond to requests21. Studies show significantly increased risk of acute kidney injury22, cardiovascular toxocity23, and neurological symptoms22. Treatment may increase viral rebound24,25.
0 0.5 1 1.5+ All studies 5% 52 180K Improvement, Studies, Patients Relative Risk Mortality 9% 28 150K Ventilation 11% 9 24K ICU admission 3% 9 28K Hospitalization 0% 24 110K Progression 32% 6 30K Recovery 6% 12 29K Cases 24% 1 1K Viral clearance 20% 15 10K RCTs 16% 18 30K RCT mortality -1% 5 25K Manufacturer 54% 7 6K Other -6% 11 25K Prophylaxis 24% 1 1K Early 4% 42 120K Late 11% 9 50K Molnupiravir for COVID-19 c19early.org February 2026 after exclusions Favorsmolnupiravir Favorscontrol
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 licensee Khoo (RCT) -33% 1.33 [0.55-3.26] no recov. 8/12 3/6 Optimus (RCT) 75% 0.25 [0.03-2.22] hosp. 1/603 4/599 licensee MOVe-OUT Jayk Ber.. (DB 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 Gleeson -129% 2.29 [0.15-34.8] death 1/21 1/48 Wong (PSM) 52% 0.48 [0.40-0.59] death 1,856 (n) 1,856 (n) Yip (PSW) -12% 1.12 [0.68-1.82] death/ICU Zou (RCT) 29% 0.71 [0.28-1.85] recov. time 77 (n) 31 (n) Flisiak 39% 0.61 [0.38-0.97] death 20/203 63/387 AGILE CST-2 Khoo (DB RCT) 67% 0.33 [0.01-8.08] oxygen 0/90 1/90 Kneidinger -15% 1.15 [0.56-2.37] severe case 8/46 26/172 Najjar-Deb.. (PSM) 19% 0.81 [0.46-1.43] death 22/2,661 27/2,661 Arbel 65+ 74% 0.26 [0.10-0.73] death 4/845 137/12,724 Arbel 40-64 -1182% 12.82 [3.41-48.2] death 4/224 7/6,075 Suzuki (PSM) -100% 2.00 [0.34-11.9] death 2/230 3/690 Brown -101% 2.01 [0.43-9.38] hosp. 8/442 2/222 PANORAMIC Butler (RCT) -27% 1.27 [0.65-2.48] death 20/11,778 15/11,230 Wong (PSM) 24% 0.76 [0.61-0.95] death Liu -162% 2.62 [0.11-60.6] ICU 1/26 0/16 Sinha (RCT) 65% 0.35 [0.16-0.73] hosp. 9/608 26/610 licensee Zheng -100% 2.00 [1.23-3.23] death/hosp. 61/2,689 34/3,331 OT​1 Bajema (PSM) 18% 0.82 [0.52-1.29] death 24/897 29.0/897 Inaba 58% 0.42 [0.02-10.1] death 0/84 1/210 Zheng (PSW) -285% 3.85 [1.54-10.0] death/hosp. 11/802 33/4,836 OT​1 Evans 51% 0.49 [0.29-0.83] death/hosp. 359 (n) 4,973 (n) Goodwin -110% 2.10 [0.19-22.9] death 1/80 2/336 Tazare -9% 1.09 [0.93-1.27] death/hosp. Butt -9% 1.09 [0.73-1.63] death/hosp. 48/1,459 44/1,459 Fung 4% 0.96 [0.93-0.99] PASC population-based cohort LONG COVID DAWN Tare (RCT) -83% 1.83 [0.69-4.82] no recov. 4/7 5/16 Cheng 15% 0.85 [0.77-0.95] death 4,146 (n) 5,792 (n) Standing (RCT) -103% 2.03 [0.52-7.94] viral+ 6/117 3/119 Razia -272% 3.72 [0.35-39.4] death 2/29 1/54 Yen 18% 0.82 [0.50-1.33] death 250 (n) 1,946 (n) SAVALO Gentile (PSM) 4% 0.96 [0.70-1.31] death case control Jorda (PSM) -27% 1.27 [0.65-2.49] death 14/10,752 21/21,504 Wei 3% 0.97 [0.82-1.17] death Zou -32% 1.32 [0.89-1.97] viral+ 26/125 84/535 AGILE CST-8 Khoo (RCT) -1% 1.01 [0.73-1.42] viral load 16 (n) 8 (n) CT​2 Hong Choi (PSW) -61% 1.61 [1.30-2.00] death Tau​2 = 0.06, I​2 = 77.5%, p = 0.56 Early treatment 4% 0.96 [0.85-1.09] 320/43,364 618.0/85,174 4% lower risk 033864 (RCT) 0% 1.00 [0.50-2.00] improv. n/a n/a FUTILITY, PENDING​3 Improvement, RR [CI] Treatment Control 035424 (RCT) 0% 1.00 [0.50-2.00] improv. n/a n/a FUTILITY, PENDING​3 MOVe-IN Arribas (DB RCT) -282% 3.82 [0.50-29.1] death 11/216 1/75 Wan 11% 0.89 [0.81-0.98] death 704/6,153 2,541/17,283 Wan 13% 0.87 [0.81-0.93] death 2,700 (n) 13,795 (n) Özdemir -50% 1.50 [0.27-8.49] death 3/39 2/39 RECOVERY Horby (RCT) -11% 1.11 [0.79-1.58] death 57/445 55/478 Lv -53% 1.53 [0.83-2.83] death 12/67 30/257 Lai 10% 0.90 [0.83-0.97] death 4,975 (n) 8,667 (n) Tau​2 = 0.00, I​2 = 0.0%, p < 0.0001 Late treatment 11% 0.89 [0.85-0.93] 787/14,595 2,629/40,594 11% lower risk MOVe-AHEAD Alpizar (DB RCT) 24% 0.76 [0.57-1.01] symp. case 78/763 103/764 Improvement, RR [CI] Treatment Control Tau​2 = 0.00, I​2 = 0.0%, p = 0.049 Prophylaxis 24% 0.76 [0.57-1.01] 78/763 103/764 24% lower risk All studies 5% 0.95 [0.88-1.03] 1,185/58,722 3,350.0/126,532 5% lower risk 52 molnupiravir COVID-19 studies c19early.org February 2026 Tau​2 = 0.03, I​2 = 74.5%, p = 0.22 Effect extraction pre-specified 1 OT: comparison with other treatment3 FUTILITY: terminated for futility, results pending 2 CT: study uses combined treatment 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 licensee Khoo (RCT) -33% 1.33 [0.55-3.26] no recov. 8/12 3/6 Optimus (RCT) 75% 0.25 [0.03-2.22] hosp. 1/603 4/599 licensee MOVe-OUT Jayk Ber.. (DB 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 Gleeson -129% 2.29 [0.15-34.8] death 1/21 1/48 Wong (PSM) 52% 0.48 [0.40-0.59] death 1,856 (n) 1,856 (n) Yip (PSW) -12% 1.12 [0.68-1.82] death/ICU Zou (RCT) 29% 0.71 [0.28-1.85] recov. time 77 (n) 31 (n) Flisiak 39% 0.61 [0.38-0.97] death 20/203 63/387 AGILE CST-2 Khoo (DB RCT) 67% 0.33 [0.01-8.08] oxygen 0/90 1/90 Kneidinger -15% 1.15 [0.56-2.37] severe case 8/46 26/172 Najjar-Deb.. (PSM) 19% 0.81 [0.46-1.43] death 22/2,661 27/2,661 Arbel 65+ 74% 0.26 [0.10-0.73] death 4/845 137/12,724 Arbel 40-64 -1182% 12.82 [3.41-48.2] death 4/224 7/6,075 Suzuki (PSM) -100% 2.00 [0.34-11.9] death 2/230 3/690 PANORAMIC Butler (RCT) -27% 1.27 [0.65-2.48] death 20/11,778 15/11,230 Wong (PSM) 24% 0.76 [0.61-0.95] death Liu -162% 2.62 [0.11-60.6] ICU 1/26 0/16 Sinha (RCT) 65% 0.35 [0.16-0.73] hosp. 9/608 26/610 licensee Zheng -100% 2.00 [1.23-3.23] death/hosp. 61/2,689 34/3,331 OT​1 Bajema (PSM) 18% 0.82 [0.52-1.29] death 24/897 29.0/897 Inaba 58% 0.42 [0.02-10.1] death 0/84 1/210 Evans 51% 0.49 [0.29-0.83] death/hosp. 359 (n) 4,973 (n) Goodwin -110% 2.10 [0.19-22.9] death 1/80 2/336 Tazare -9% 1.09 [0.93-1.27] death/hosp. Butt -9% 1.09 [0.73-1.63] death/hosp. 48/1,459 44/1,459 Fung 4% 0.96 [0.93-0.99] PASC population-based cohort LONG COVID DAWN Tare (RCT) -83% 1.83 [0.69-4.82] no recov. 4/7 5/16 Cheng 15% 0.85 [0.77-0.95] death 4,146 (n) 5,792 (n) Standing (RCT) -103% 2.03 [0.52-7.94] viral+ 6/117 3/119 Razia -272% 3.72 [0.35-39.4] death 2/29 1/54 Yen 18% 0.82 [0.50-1.33] death 250 (n) 1,946 (n) SAVALO Gentile (PSM) 4% 0.96 [0.70-1.31] death case control Jorda (PSM) -27% 1.27 [0.65-2.49] death 14/10,752 21/21,504 Wei 3% 0.97 [0.82-1.17] death AGILE CST-8 Khoo (RCT) -1% 1.01 [0.73-1.42] viral load 16 (n) 8 (n) CT​2 Tau​2 = 0.05, I​2 = 73.4%, p = 0.053 Early treatment 11% 0.89 [0.79-1.00] 275/41,995 499.0/79,581 11% lower risk 033864 (RCT) 0% 1.00 [0.50-2.00] improv. n/a n/a FUTILITY, PENDING​3 Improvement, RR [CI] Treatment Control 035424 (RCT) 0% 1.00 [0.50-2.00] improv. n/a n/a FUTILITY, PENDING​3 MOVe-IN Arribas (DB RCT) -282% 3.82 [0.50-29.1] death 11/216 1/75 Wan 11% 0.89 [0.81-0.98] death 704/6,153 2,541/17,283 Wan 13% 0.87 [0.81-0.93] death 2,700 (n) 13,795 (n) Özdemir -50% 1.50 [0.27-8.49] death 3/39 2/39 RECOVERY Horby (RCT) -11% 1.11 [0.79-1.58] death 57/445 55/478 Lv -53% 1.53 [0.83-2.83] death 12/67 30/257 Lai 10% 0.90 [0.83-0.97] death 4,975 (n) 8,667 (n) Tau​2 = 0.00, I​2 = 0.0%, p < 0.0001 Late treatment 11% 0.89 [0.85-0.93] 787/14,595 2,629/40,594 11% lower risk MOVe-AHEAD Alpizar (DB RCT) 24% 0.76 [0.57-1.01] symp. case 78/763 103/764 Improvement, RR [CI] Treatment Control Tau​2 = 0.00, I​2 = 0.0%, p = 0.049 Prophylaxis 24% 0.76 [0.57-1.01] 78/763 103/764 24% lower risk All studies 10% 0.90 [0.83-0.97] 1,140/57,353 3,231.0/120,939 10% lower risk 48 molnupiravir COVID-19 studies after exclusions c19early.org February 2026 Tau​2 = 0.02, I​2 = 69.7%, p = 0.0066 Effect extraction pre-specified 1 OT: comparison with other treatment3 FUTILITY: terminated for futility, results pending 2 CT: study uses combined treatment 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 MOVe-OUT Jayk Ber.. (DB RCT) 89% 0.11 [0.01-0.86] 1/709 9/699 Gleeson -129% 2.29 [0.15-34.8] 1/21 1/48 Wong (PSM) 52% 0.48 [0.40-0.59] 1,856 (n) 1,856 (n) Flisiak 39% 0.61 [0.38-0.97] 20/203 63/387 Najjar-Deb.. (PSM) 19% 0.81 [0.46-1.43] 22/2,661 27/2,661 Arbel 65+ 74% 0.26 [0.10-0.73] 4/845 137/12,724 Arbel 40-64 -1182% 12.82 [3.41-48.2] 4/224 7/6,075 Suzuki (PSM) -100% 2.00 [0.34-11.9] 2/230 3/690 PANORAMIC Butler (RCT) -27% 1.27 [0.65-2.48] 20/11,778 15/11,230 Wong (PSM) 24% 0.76 [0.61-0.95] Bajema (PSM) 18% 0.82 [0.52-1.29] 24/897 29.0/897 Inaba 58% 0.42 [0.02-10.1] 0/84 1/210 Goodwin -110% 2.10 [0.19-22.9] 1/80 2/336 Cheng 15% 0.85 [0.77-0.95] 4,146 (n) 5,792 (n) Razia -272% 3.72 [0.35-39.4] 2/29 1/54 Yen 18% 0.82 [0.50-1.33] 250 (n) 1,946 (n) SAVALO Gentile (PSM) 4% 0.96 [0.70-1.31] case control Jorda (PSM) -27% 1.27 [0.65-2.49] 14/10,752 21/21,504 Wei 3% 0.97 [0.82-1.17] Hong Choi (PSW) -61% 1.61 [1.30-2.00] Tau​2 = 0.13, I​2 = 81.4%, p = 0.38 Early treatment 10% 0.90 [0.72-1.13] 115/34,905 317.0/67,171 10% lower risk MOVe-IN Arribas (DB RCT) -282% 3.82 [0.50-29.1] 11/216 1/75 Improvement, RR [CI] Treatment Control Wan 11% 0.89 [0.81-0.98] 704/6,153 2,541/17,283 Wan 13% 0.87 [0.81-0.93] 2,700 (n) 13,795 (n) Özdemir -50% 1.50 [0.27-8.49] 3/39 2/39 RECOVERY Horby (RCT) -11% 1.11 [0.79-1.58] 57/445 55/478 Lv -53% 1.53 [0.83-2.83] 12/67 30/257 Lai 10% 0.90 [0.83-0.97] 4,975 (n) 8,667 (n) Tau​2 = 0.00, I​2 = 18.8%, p < 0.0001 Late treatment 11% 0.89 [0.85-0.95] 787/14,595 2,629/40,594 11% lower risk All studies 9% 0.91 [0.81-1.02] 902/49,500 2,946.0/107,765 9% lower risk 28 molnupiravir COVID-19 mortality results c19early.org February 2026 Tau​2 = 0.04, I​2 = 76.7%, p = 0.12 Favors molnupiravir Favors control 0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Wong (PSM) 58% 0.42 [0.17-1.01] 1,856 (n) 1,856 (n) Improvement, RR [CI] Treatment Control Flisiak 5% 0.95 [0.39-2.32] 7/203 14/387 Suzuki (PSM) 57% 0.43 [0.02-10.5] 0/230 1/690 Wong (PSM) 60% 0.40 [0.19-0.84] Bajema (PSM) 17% 0.83 [0.17-4.12] 3/897 3.6/897 Razia -86% 1.86 [0.12-28.7] 1/29 1/54 Hong Choi (PSW) -12% 1.12 [0.68-1.85] Tau​2 = 0.07, I​2 = 21.6%, p = 0.13 Early treatment 28% 0.72 [0.48-1.10] 11/3,215 19.6/3,884 28% lower risk Wan -7% 1.07 [0.89-1.30] 2,700 (n) 13,795 (n) Improvement, RR [CI] Treatment Control RECOVERY Horby (RCT) -43% 1.43 [0.50-4.08] 8/445 6/476 Tau​2 = 0.00, I​2 = 0.0%, p = 0.43 Late treatment -8% 1.08 [0.90-1.30] 8/3,145 6/14,271 8% higher risk All studies 11% 0.89 [0.66-1.19] 19/6,360 25.6/18,155 11% lower risk 9 molnupiravir COVID-19 mechanical ventilation results c19early.org February 2026 Tau​2 = 0.05, I​2 = 27.9%, p = 0.43 Favors molnupiravir Favors control 0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Gleeson -129% 2.29 [0.15-34.8] 1/21 1/48 Improvement, RR [CI] Treatment Control Wong (PSM) 26% 0.74 [0.45-1.21] Liu -162% 2.62 [0.11-60.6] 1/26 0/16 Bajema (PSM) 1% 0.99 [0.41-2.37] 10/897 10.1/897 Cheng 12% 0.88 [0.59-1.30] 4,146 (n) 5,792 (n) Razia -86% 1.86 [0.28-12.5] 2/29 2/54 Hong Choi (PSW) -28% 1.28 [0.68-2.38] Tau​2 = 0.00, I​2 = 0.0%, p = 0.6 Early treatment 7% 0.93 [0.72-1.21] 14/5,119 13.1/6,807 7% lower risk Wan -2% 1.02 [0.76-1.36] 2,700 (n) 13,795 (n) Improvement, RR [CI] Treatment Control Özdemir 0% 1.00 [0.15-6.75] 2/39 2/39 Tau​2 = 0.00, I​2 = 0.0%, p = 0.9 Late treatment -2% 1.02 [0.76-1.36] 2/2,739 2/13,834 2% higher risk All studies 3% 0.97 [0.80-1.18] 16/7,858 15.1/20,641 3% lower risk 9 molnupiravir COVID-19 ICU results c19early.org February 2026 Tau​2 = 0.00, I​2 = 0.0%, p = 0.77 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 licensee Optimus (RCT) 75% 0.25 [0.03-2.22] hosp. 1/603 4/599 licensee Tippabhotla (RCT) 46% 0.54 [0.22-1.34] hosp. 7/610 13/610 Gleeson 31% 0.69 [0.21-2.24] hosp. 3/21 10/48 Wong (PSM) 6% 0.94 [0.89-1.00] hosp. time 1,856 (n) 1,856 (n) Yip (PSW) -17% 1.17 [0.99-1.39] hosp. Flisiak -1% 1.01 [0.71-1.43] hosp. time 203 (n) 387 (n) AGILE CST-2 Khoo (DB RCT) 89% 0.11 [0.01-2.03] hosp. 0/90 4/90 Arbel 65+ 45% 0.55 [0.34-0.88] hosp. 18/845 513/12,724 Arbel 40-64 -80% 1.80 [0.86-3.77] hosp. 8/224 97/6,075 Brown -101% 2.01 [0.43-9.38] hosp. 8/442 2/222 PANORAMIC Butler (RCT) -7% 1.07 [0.81-1.41] hosp. 103/12,529 96/12,525 Wong (PSM) 2% 0.98 [0.89-1.06] hosp. Liu 18% 0.82 [0.63-1.06] hosp. time 26 (n) 16 (n) Sinha (RCT) 65% 0.35 [0.16-0.73] hosp. 9/608 26/610 licensee Bajema (PSM) -30% 1.30 [1.01-1.68] hosp. 162/897 124.3/897 Inaba -127% 2.27 [0.60-7.25] hosp. 5/84 8/210 Goodwin 58% 0.42 [0.05-3.23] hosp. 1/80 10/336 Razia 28% 0.72 [0.28-1.81] hosp. 5/29 13/54 SAVALO Gentile (PSM) 26% 0.74 [0.13-4.18] hosp. case control Jorda (PSM) -1% 1.01 [0.83-1.23] hosp. 150/10,752 297/21,504 Wei -8% 1.08 [1.03-1.13] hosp. Tau​2 = 0.01, I​2 = 66.2%, p = 0.83 Early treatment 1% 0.99 [0.91-1.08] 490/30,410 1,241.3/59,195 1% lower risk Wan 1% 0.99 [0.93-1.05] hosp. 2,298/6,153 2,541/17,283 Improvement, RR [CI] Treatment Control Tau​2 = 0.00, I​2 = 0.0%, p = 0.7 Late treatment 1% 0.99 [0.93-1.05] 2,298/6,153 2,541/17,283 1% lower risk All studies 0% 1.00 [0.93-1.07] 2,788/36,563 3,782.3/76,478 0% lower risk 24 molnupiravir COVID-19 hospitalization results c19early.org February 2026 Tau​2 = 0.01, I​2 = 65.3%, p = 0.94 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 licensee Optimus (RCT) 75% 0.25 [0.03-2.22] hosp. 1/603 4/599 licensee MOVe-OUT Jayk Ber.. (DB 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 Gleeson -129% 2.29 [0.15-34.8] death 1/21 1/48 Wong (PSM) 52% 0.48 [0.40-0.59] death 1,856 (n) 1,856 (n) Yip (PSW) -12% 1.12 [0.68-1.82] death/ICU Flisiak 39% 0.61 [0.38-0.97] death 20/203 63/387 AGILE CST-2 Khoo (DB RCT) 67% 0.33 [0.01-8.08] oxygen 0/90 1/90 Kneidinger -15% 1.15 [0.56-2.37] severe case 8/46 26/172 Najjar-Deb.. (PSM) 19% 0.81 [0.46-1.43] death 22/2,661 27/2,661 Arbel 65+ 74% 0.26 [0.10-0.73] death 4/845 137/12,724 Arbel 40-64 -1182% 12.82 [3.41-48.2] death 4/224 7/6,075 Suzuki (PSM) -100% 2.00 [0.34-11.9] death 2/230 3/690 Brown -101% 2.01 [0.43-9.38] hosp. 8/442 2/222 PANORAMIC Butler (RCT) -27% 1.27 [0.65-2.48] death 20/11,778 15/11,230 Wong (PSM) 24% 0.76 [0.61-0.95] death Liu -162% 2.62 [0.11-60.6] ICU 1/26 0/16 Sinha (RCT) 65% 0.35 [0.16-0.73] hosp. 9/608 26/610 licensee Zheng -100% 2.00 [1.23-3.23] death/hosp. 61/2,689 34/3,331 OT​1 Bajema (PSM) 18% 0.82 [0.52-1.29] death 24/897 29.0/897 Inaba 58% 0.42 [0.02-10.1] death 0/84 1/210 Zheng (PSW) -285% 3.85 [1.54-10.0] death/hosp. 11/802 33/4,836 OT​1 Evans 51% 0.49 [0.29-0.83] death/hosp. 359 (n) 4,973 (n) Goodwin -110% 2.10 [0.19-22.9] death 1/80 2/336 Tazare -9% 1.09 [0.93-1.27] death/hosp. Butt -9% 1.09 [0.73-1.63] death/hosp. 48/1,459 44/1,459 Fung 4% 0.96 [0.93-0.99] PASC population-based cohort LONG COVID Cheng 15% 0.85 [0.77-0.95] death 4,146 (n) 5,792 (n) Razia -272% 3.72 [0.35-39.4] death 2/29 1/54 Yen 18% 0.82 [0.50-1.33] death 250 (n) 1,946 (n) SAVALO Gentile (PSM) 4% 0.96 [0.70-1.31] death case control Jorda (PSM) -27% 1.27 [0.65-2.49] death 14/10,752 21/21,504 Wei 3% 0.97 [0.82-1.17] death Hong Choi (PSW) -61% 1.61 [1.30-2.00] death Tau​2 = 0.07, I​2 = 80.1%, p = 0.31 Early treatment 7% 0.93 [0.82-1.07] 276/43,010 523.0/84,459 7% lower risk MOVe-IN Arribas (DB RCT) -282% 3.82 [0.50-29.1] death 11/216 1/75 Improvement, RR [CI] Treatment Control Wan 11% 0.89 [0.81-0.98] death 704/6,153 2,541/17,283 Wan 13% 0.87 [0.81-0.93] death 2,700 (n) 13,795 (n) Özdemir -50% 1.50 [0.27-8.49] death 3/39 2/39 RECOVERY Horby (RCT) -11% 1.11 [0.79-1.58] death 57/445 55/478 Lv -53% 1.53 [0.83-2.83] death 12/67 30/257 Lai 10% 0.90 [0.83-0.97] death 4,975 (n) 8,667 (n) Tau​2 = 0.00, I​2 = 18.8%, p < 0.0001 Late treatment 11% 0.89 [0.85-0.95] 787/14,595 2,629/40,594 11% lower risk All studies 6% 0.94 [0.86-1.03] 1,063/57,605 3,152.0/125,053 6% lower risk 43 molnupiravir COVID-19 serious outcomes c19early.org February 2026 Tau​2 = 0.03, I​2 = 77.9%, p = 0.16 Effect extraction pre-specified(most serious outcome) 1 OT: comparison with other treatment 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) licensee Improvement, RR [CI] Treatment Control Khoo (RCT) -33% 1.33 [0.55-3.26] no recov. 8/12 3/6 Optimus (RCT) -15% 1.15 [1.02-1.31] no recov. 286/603 246/599 licensee MOVe-OUT Jayk Ber.. (DB RCT) 15% 0.85 [0.75-0.98] recovery 709 (n) 699 (n) Zou (RCT) 29% 0.71 [0.28-1.85] recov. time 77 (n) 31 (n) AGILE CST-2 Khoo (DB RCT) -12% 1.12 [0.71-1.79] no recov. 27/90 24/90 PANORAMIC Butler (RCT) 22% 0.78 [0.75-0.81] no recov. 3,856/12,403 4,838/12,140 DAWN Tare (RCT) -83% 1.83 [0.69-4.82] no recov. 4/7 5/16 Tau​2 = 0.04, I​2 = 84.1%, p = 0.26 Early treatment 10% 0.90 [0.75-1.08] 4,181/14,272 5,116/13,951 10% lower risk 033864 (RCT) 0% 1.00 [0.50-2.00] improv. n/a n/a FUTILITY, PENDING​1 Improvement, RR [CI] Treatment Control 035424 (RCT) 0% 1.00 [0.50-2.00] improv. n/a n/a FUTILITY, PENDING​1 MOVe-IN Arribas (DB RCT) 1% 0.99 [0.68-1.45] no recov. 72 (n) 75 (n) RECOVERY Horby (RCT) -9% 1.09 [0.88-1.35] no disch. 126/445 124/478 Tau​2 = 0.00, I​2 = 0.0%, p = 0.53 Late treatment -6% 1.06 [0.89-1.26] 126/517 124/553 6% higher risk All studies 6% 0.94 [0.81-1.09] 4,307/14,789 5,240/14,504 6% lower risk 12 molnupiravir COVID-19 recovery results c19early.org February 2026 Tau​2 = 0.03, I​2 = 79.6%, p = 0.39 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+ MOVe-AHEAD Alpizar (DB RCT) 24% 0.76 [0.57-1.01] symp. case 78/763 103/764 Improvement, RR [CI] Treatment Control Tau​2 = 0.00, I​2 = 0.0%, p = 0.049 Prophylaxis 24% 0.76 [0.57-1.01] 78/763 103/764 24% lower risk All studies 24% 0.76 [0.57-1.01] 78/763 103/764 24% lower risk 1 molnupiravir COVID-19 case result c19early.org February 2026 Tau​2 = 0.00, I​2 = 0.0%, p = 0.049 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) 41% 0.59 [0.51-0.69] viral+ 174/603 291/599 licensee MOVe-OUT Jayk Ber.. (DB RCT) 4% 0.96 [0.90-1.02] viral load 518 (n) 510 (n) Tippabhotla (RCT) 59% 0.41 [0.29-0.57] viral+ 42/610 103/610 Wong (PSM) 28% 0.72 [0.61-0.87] viral+ 1,856 (n) 1,856 (n) Zou (RCT) 10% 0.90 [0.83-0.97] viral time 76 (n) 31 (n) AGILE CST-2 Khoo (DB RCT) 23% 0.77 [0.58-1.09] viral+ 90 (n) 90 (n) PANORAMIC Butler (RCT) -95% 1.95 [1.15-3.31] viral load 21 (n) 11 (n) Liu 21% 0.79 [0.59-1.05] viral time 26 (n) 16 (n) Sinha (RCT) 48% 0.52 [0.42-0.63] viral load 608 (n) 610 (n) licensee Standing (RCT) -103% 2.03 [0.52-7.94] viral+ 6/117 3/119 Zou -32% 1.32 [0.89-1.97] viral+ 26/125 84/535 AGILE CST-8 Khoo (RCT) -1% 1.01 [0.73-1.42] viral load 16 (n) 8 (n) CT​1 Tau​2 = 0.06, I​2 = 88.2%, p = 0.0046 Early treatment 21% 0.79 [0.67-0.93] 258/4,784 490/5,049 21% lower risk MOVe-IN Arribas (DB RCT) 12% 0.88 [0.62-1.25] viral+ 26/52 34/60 Improvement, RR [CI] Treatment Control RECOVERY Horby (RCT) 12% 0.88 [0.85-0.91] viral load 445 (n) 478 (n) Tau​2 = 0.00, I​2 = 0.0%, p < 0.0001 Late treatment 12% 0.88 [0.85-0.91] 26/497 34/538 12% lower risk All studies 20% 0.80 [0.71-0.89] 284/5,281 524/5,587 20% lower risk 15 molnupiravir COVID-19 viral clearance results c19early.org February 2026 Tau​2 = 0.03, I​2 = 86.4%, p = 0.00011 1 CT: study uses combined treatment 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 licensee Khoo (RCT) -33% 1.33 [0.55-3.26] no recov. 8/12 3/6 Optimus (RCT) 75% 0.25 [0.03-2.22] hosp. 1/603 4/599 licensee MOVe-OUT Jayk Ber.. (DB 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 Zou (RCT) 29% 0.71 [0.28-1.85] recov. time 77 (n) 31 (n) AGILE CST-2 Khoo (DB RCT) 67% 0.33 [0.01-8.08] oxygen 0/90 1/90 PANORAMIC Butler (RCT) -27% 1.27 [0.65-2.48] death 20/11,778 15/11,230 Sinha (RCT) 65% 0.35 [0.16-0.73] hosp. 9/608 26/610 licensee DAWN Tare (RCT) -83% 1.83 [0.69-4.82] no recov. 4/7 5/16 Standing (RCT) -103% 2.03 [0.52-7.94] viral+ 6/117 3/119 AGILE CST-8 Khoo (RCT) -1% 1.01 [0.73-1.42] viral load 16 (n) 8 (n) CT​1 Tau​2 = 0.23, I​2 = 53.4%, p = 0.12 Early treatment 27% 0.73 [0.49-1.09] 63/15,138 103/14,450 27% lower risk 033864 (RCT) 0% 1.00 [0.50-2.00] improv. n/a n/a FUTILITY, PENDING​2 Improvement, RR [CI] Treatment Control 035424 (RCT) 0% 1.00 [0.50-2.00] improv. n/a n/a FUTILITY, PENDING​2 MOVe-IN Arribas (DB RCT) -282% 3.82 [0.50-29.1] death 11/216 1/75 RECOVERY Horby (RCT) -11% 1.11 [0.79-1.58] death 57/445 55/478 Tau​2 = 0.00, I​2 = 0.0%, p = 0.51 Late treatment -10% 1.10 [0.83-1.46] 68/661 56/553 10% higher risk MOVe-AHEAD Alpizar (DB RCT) 24% 0.76 [0.57-1.01] symp. case 78/763 103/764 Improvement, RR [CI] Treatment Control Tau​2 = 0.00, I​2 = 0.0%, p = 0.049 Prophylaxis 24% 0.76 [0.57-1.01] 78/763 103/764 24% lower risk All studies 16% 0.84 [0.66-1.08] 209/16,562 262/15,767 16% lower risk 18 molnupiravir COVID-19 Randomized Controlled Trials c19early.org February 2026 Tau​2 = 0.10, I​2 = 45.4%, p = 0.18 Effect extraction pre-specified 1 CT: study uses combined treatment2 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 MOVe-OUT Jayk Ber.. (DB RCT) 89% 0.11 [0.01-0.86] 1/709 9/699 PANORAMIC Butler (RCT) -27% 1.27 [0.65-2.48] 20/11,778 15/11,230 Tau​2 = 1.60, I​2 = 64.8%, p = 0.36 Early treatment 58% 0.42 [0.07-2.56] 21/12,627 25/11,991 58% lower risk MOVe-IN Arribas (DB RCT) -282% 3.82 [0.50-29.1] 11/216 1/75 Improvement, RR [CI] Treatment Control RECOVERY Horby (RCT) -11% 1.11 [0.79-1.58] 57/445 55/478 Tau​2 = 0.21, I​2 = 27.3%, p = 0.51 Late treatment -35% 1.35 [0.56-3.26] 68/661 56/553 35% higher risk All studies -1% 1.01 [0.54-1.91] 89/13,288 81/12,544 1% higher risk 5 molnupiravir COVID-19 RCT mortality results c19early.org February 2026 Tau​2 = 0.19, I​2 = 45.4%, p = 0.98 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 licensee Optimus (RCT) 75% 0.25 [0.03-2.22] hosp. 1/603 4/599 licensee MOVe-OUT Jayk Ber.. (DB RCT) 89% 0.11 [0.01-0.86] death 1/709 9/699 MOVe-IN Arribas (DB RCT) -282% 3.82 [0.50-29.1] death 11/216 1/75 Sinha (RCT) 65% 0.35 [0.16-0.73] hosp. 9/608 26/610 licensee MOVe-AHEAD Alpizar (DB RCT) 24% 0.76 [0.57-1.01] symp. case 78/763 103/764 Manufacturer 54% 0.46 [0.24-0.86] 107/3,410 167/3,179 54% lower risk Khoo (RCT) -33% 1.33 [0.55-3.26] no recov. 8/12 3/6 Improvement, RR [CI] Treatment Control 033864 (RCT) 0% 1.00 [0.50-2.00] improv. n/a n/a FUTILITY, PENDING​2 035424 (RCT) 0% 1.00 [0.50-2.00] improv. n/a n/a FUTILITY, PENDING​2 Tippabhotla (RCT) 46% 0.54 [0.22-1.34] hosp. 7/610 13/610 Zou (RCT) 29% 0.71 [0.28-1.85] recov. time 77 (n) 31 (n) AGILE CST-2 Khoo (DB RCT) 67% 0.33 [0.01-8.08] oxygen 0/90 1/90 PANORAMIC Butler (RCT) -27% 1.27 [0.65-2.48] death 20/11,778 15/11,230 DAWN Tare (RCT) -83% 1.83 [0.69-4.82] no recov. 4/7 5/16 Standing (RCT) -103% 2.03 [0.52-7.94] viral+ 6/117 3/119 RECOVERY Horby (RCT) -11% 1.11 [0.79-1.58] death 57/445 55/478 AGILE CST-8 Khoo (RCT) -1% 1.01 [0.73-1.42] viral load 16 (n) 8 (n) CT​1 Non-manufacturer -6% 1.06 [0.88-1.28] 102/13,152 95/12,588 6% higher risk Molnupiravir COVID-19 manufacturer vs. other RCTs c19early.org February 2026 Effect extraction pre-specified 1 CT: study uses combined treatment2 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+ Hetero (RCT) 70% 0.30 [0.13-0.70] hosp. 7/371 23/370 licensee Improvement, RR [CI] Treatment Control Khoo (RCT) -33% 1.33 [0.55-3.26] no recov. 8/12 3/6 MOVe-OUT Jayk Ber.. (DB 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 Wong (PSM) 52% 0.48 [0.40-0.59] death 1,856 (n) 1,856 (n) Yip (PSW) -12% 1.12 [0.68-1.82] death/ICU Zou (RCT) 29% 0.71 [0.28-1.85] recov. time 77 (n) 31 (n) Flisiak 39% 0.61 [0.38-0.97] death 20/203 63/387 AGILE CST-2 Khoo (DB RCT) 67% 0.33 [0.01-8.08] oxygen 0/90 1/90 Kneidinger -15% 1.15 [0.56-2.37] severe case 8/46 26/172 Najjar-Deb.. (PSM) 19% 0.81 [0.46-1.43] death 22/2,661 27/2,661 Suzuki (PSM) -100% 2.00 [0.34-11.9] death 2/230 3/690 Brown -101% 2.01 [0.43-9.38] hosp. 8/442 2/222 PANORAMIC Butler (RCT) -27% 1.27 [0.65-2.48] death 20/11,778 15/11,230 Wong (PSM) 24% 0.76 [0.61-0.95] death Liu -162% 2.62 [0.11-60.6] ICU 1/26 0/16 Sinha (RCT) 65% 0.35 [0.16-0.73] hosp. 9/608 26/610 licensee Zheng -100% 2.00 [1.23-3.23] death/hosp. 61/2,689 34/3,331 OT​1 Evans 51% 0.49 [0.29-0.83] death/hosp. 359 (n) 4,973 (n) Goodwin -110% 2.10 [0.19-22.9] death 1/80 2/336 Butt -9% 1.09 [0.73-1.63] death/hosp. 48/1,459 44/1,459 Fung 4% 0.96 [0.93-0.99] PASC population-based cohort LONG COVID DAWN Tare (RCT) -83% 1.83 [0.69-4.82] no recov. 4/7 5/16 Cheng 15% 0.85 [0.77-0.95] death 4,146 (n) 5,792 (n) Standing (RCT) -103% 2.03 [0.52-7.94] viral+ 6/117 3/119 Razia -272% 3.72 [0.35-39.4] death 2/29 1/54 Yen 18% 0.82 [0.50-1.33] death 250 (n) 1,946 (n) SAVALO Gentile (PSM) 4% 0.96 [0.70-1.31] death case control Jorda (PSM) -27% 1.27 [0.65-2.49] death 14/10,752 21/21,504 Wei 3% 0.97 [0.82-1.17] death Zou -32% 1.32 [0.89-1.97] viral+ 26/125 84/535 Hong Choi (PSW) -61% 1.61 [1.30-2.00] death Tau​2 = 0.06, I​2 = 77.2%, p = 0.23 Early treatment 8% 0.92 [0.81-1.05] 275/39,732 405/59,715 8% lower risk MOVe-IN Arribas (DB RCT) -282% 3.82 [0.50-29.1] death 11/216 1/75 Improvement, RR [CI] Treatment Control Wan 11% 0.89 [0.81-0.98] death 704/6,153 2,541/17,283 Wan 13% 0.87 [0.81-0.93] death 2,700 (n) 13,795 (n) Özdemir -50% 1.50 [0.27-8.49] death 3/39 2/39 RECOVERY Horby (RCT) -11% 1.11 [0.79-1.58] death 57/445 55/478 Lv -53% 1.53 [0.83-2.83] death 12/67 30/257 Lai 10% 0.90 [0.83-0.97] death 4,975 (n) 8,667 (n) Tau​2 = 0.00, I​2 = 18.8%, p < 0.0001 Late treatment 11% 0.89 [0.85-0.95] 787/14,595 2,629/40,594 11% lower risk MOVe-AHEAD Alpizar (DB RCT) 24% 0.76 [0.57-1.01] symp. case 78/763 103/764 Improvement, RR [CI] Treatment Control Tau​2 = 0.00, I​2 = 0.0%, p = 0.049 Prophylaxis 24% 0.76 [0.57-1.01] 78/763 103/764 24% lower risk All studies 8% 0.92 [0.85-1.00] 1,140/55,090 3,137/101,073 8% lower risk 40 molnupiravir COVID-19 peer reviewed studies c19early.org February 2026 Tau​2 = 0.02, I​2 = 74.4%, p = 0.05 Effect extraction pre-specified(most serious outcome) 1 OT: comparison with other treatment Favors molnupiravir Favors control 0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Fung 4% 0.96 [0.93-0.99] PASC population-based cohort Improvement, RR [CI] Treatment Control Tau​2 = 0.00, I​2 = 0.0%, p = 0.001 Early treatment 4% 0.96 [0.93-0.99] 4% lower risk All studies 4% 0.96 [0.93-0.99] 4% lower risk 1 molnupiravir COVID-19 long COVID result c19early.org February 2026 Tau​2 = 0.00, I​2 = 0.0%, p = 0.001 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 [0.01-0.75] viral+ 0/53 6/54 Fischer (RCT) 91% 0.09 [0.01-0.83] 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 licensee Hetero (RCT) 33% 0.67 [0.54-0.82] recov. time 371 (n) 370 (n) licensee 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 Optimus (RCT) 75% 0.25 [0.03-2.22] hosp. 1/603 4/599 licensee Optimus (RCT) -15% 1.15 [1.02-1.31] no recov. 286/603 246/599 licensee Optimus (RCT) -15% 1.15 [1.02-1.30] no recov. 303/603 262/599 licensee Optimus (RCT) 9% 0.91 [0.82-1.02] no recov. 308/603 335/599 licensee Optimus (RCT) 4% 0.96 [0.90-1.03] no recov. 431/603 446/599 licensee Optimus (RCT) -28% 1.28 [0.48-3.41] no recov. 9/603 7/599 licensee Optimus (RCT) -32% 1.32 [0.56-3.12] no recov. 12/603 9/599 licensee Optimus (RCT) 88% 0.12 [0.07-0.21] no recov. 13/603 106/599 licensee Optimus (RCT) 46% 0.54 [0.45-0.65] no recov. 127/603 234/599 licensee Optimus (RCT) 41% 0.59 [0.51-0.69] viral+ 174/603 291/599 licensee Optimus (RCT) 1% 0.99 [0.35-2.81] viral+ 7/603 7/599 licensee Optimus (RCT) 86% 0.14 [0.08-0.25] viral+ 13/603 92/599 licensee MOVe-OUT Jayk Ber.. (DB RCT) 89% 0.11 [0.01-0.86] death 1/709 9/699 MOVe-OUT Jayk Ber.. (DB RCT) 30% 0.70 [0.48-1.00] death/hosp. 48/709 68/699 MOVe-OUT Jayk Ber.. (DB RCT) 94% 0.06 [0.00-0.97] death/hosp. 0/37 9/47 MOVe-OUT Jayk Ber.. (DB RCT) 50% 0.50 [0.20-1.26] death/hosp. 6/75 13/82 MOVe-OUT Jayk Ber.. (DB RCT) 24% 0.76 [0.42-1.38] death/hosp. 18/237 22/221 MOVe-OUT Jayk Ber.. (DB RCT) 42% 0.58 [0.20-1.68] death/hosp. 5/47 7/38 MOVe-OUT Jayk Ber.. (DB RCT) 15% 0.85 [0.75-0.98] recovery 709 (n) 699 (n) MOVe-OUT Jayk Ber.. (DB RCT) 19% 0.81 [0.71-0.92] recovery 709 (n) 699 (n) MOVe-OUT Jayk Ber.. (DB RCT) 15% 0.85 [0.75-0.97] recovery 709 (n) 699 (n) MOVe-OUT Jayk Ber.. (DB RCT) 14% 0.86 [0.76-0.97] recovery 709 (n) 699 (n) MOVe-OUT Jayk Ber.. (DB RCT) 4% 0.96 [0.90-1.02] viral load 518 (n) 510 (n) MOVe-OUT Jayk Ber.. (DB RCT) -2% 1.02 [0.97-1.08] viral load 516 (n) 513 (n) MOVe-OUT Jayk Ber.. (DB RCT) 1% 0.99 [0.93-1.05] viral load 515 (n) 506 (n) MOVe-OUT Jayk Ber.. (DB RCT) 13% 0.87 [0.79-0.95] viral load 558 (n) 547 (n) MOVe-OUT Jayk Ber.. (DB RCT) 17% 0.83 [0.71-0.97] viral load 570 (n) 570 (n) 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 Gleeson -129% 2.29 [0.15-34.8] death 1/21 1/48 Gleeson -14% 1.14 [0.11-11.9] death 1/21 2/48 Gleeson -129% 2.29 [0.15-34.8] ICU 1/21 1/48 Gleeson 31% 0.69 [0.21-2.24] hosp. 3/21 10/48 Wong (PSM) 52% 0.48 [0.40-0.59] death 1,856 (n) 1,856 (n) Wong (PSM) 58% 0.42 [0.17-1.01] ventilation 1,856 (n) 1,856 (n) Wong (PSM) 40% 0.60 [0.52-0.69] progression 1,856 (n) 1,856 (n) Wong (PSM) 6% 0.94 [0.89-1.00] hosp. time 1,856 (n) 1,856 (n) Wong (PSM) 28% 0.72 [0.61-0.87] viral+ 1,856 (n) 1,856 (n) Yip (PSW) -12% 1.12 [0.68-1.82] death/ICU Yip (PSW) -17% 1.17 [0.99-1.39] hosp. Zou (RCT) 29% 0.71 [0.28-1.85] recov. time 77 (n) 31 (n) Zou (RCT) 10% 0.90 [0.83-0.97] viral time 76 (n) 31 (n) Zou (RCT) 51% 0.49 [0.28-0.84] viral+ 18/76 15/31 Zou (RCT) 37% 0.63 [0.51-0.78] viral+ 45/76 29/31 Zou (RCT) 18% 0.82 [0.73-0.92] viral+ 62/76 31/31 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) AGILE CST-2 Khoo (DB RCT) 67% 0.33 [0.01-8.08] oxygen 0/90 1/90 AGILE CST-2 Khoo (DB RCT) 89% 0.11 [0.01-2.03] hosp. 0/90 4/90 AGILE CST-2 Khoo (DB RCT) -12% 1.12 [0.71-1.79] no recov. 27/90 24/90 AGILE CST-2 Khoo (DB RCT) 23% 0.77 [0.58-1.09] viral+ 90 (n) 90 (n) Kneidinger -15% 1.15 [0.56-2.37] severe case 8/46 26/172 Najjar-Deb.. (PSM) 19% 0.81 [0.46-1.43] death 22/2,661 27/2,661 Najjar-Deb.. (PSM) 17% 0.83 [0.57-1.21] progression 50/2,661 60/2,661 Najjar-Deb.. (PSM) 25% 0.75 [0.51-1.12] severe case 43/2,661 57/2,661 Arbel 65+ 74% 0.26 [0.10-0.73] death 4/845 137/12,724 Arbel 65+ -1182% 12.82 [3.41-48.2] death 4/224 7/6,075 Arbel 65+ 45% 0.55 [0.34-0.88] hosp. 18/845 513/12,724 Arbel 65+ -80% 1.80 [0.86-3.77] hosp. 8/224 97/6,075 Arbel 40-64 -1182% 12.82 [3.41-48.2] death 4/224 7/6,075 Arbel 40-64 -80% 1.80 [0.86-3.77] hosp. 8/224 97/6,075 Suzuki (PSM) -100% 2.00 [0.34-11.9] death 2/230 3/690 Suzuki (PSM) 57% 0.43 [0.02-10.5] ventilation 0/230 1/690 Suzuki (PSM) 53% 0.47 [0.22-0.98] progression 9/230 58/690 Brown -101% 2.01 [0.43-9.38] hosp. 8/442 2/222 PANORAMIC Butler (RCT) -27% 1.27 [0.65-2.48] death 20/11,778 15/11,230 PANORAMIC Butler (RCT) 40% 0.60 [0.14-2.51] death 3/12,529 5/12,525 PANORAMIC Butler (RCT) -6% 1.06 [0.81-1.41] death/hosp. 105/12,529 98/12,525 PANORAMIC Butler (RCT) -7% 1.07 [0.81-1.41] hosp. 103/12,529 96/12,525 PANORAMIC Butler (RCT) 2% 0.98 [0.94-1.01] transmission 3,887/10,803 3,873/10,548 PANORAMIC Butler (RCT) 22% 0.78 [0.75-0.81] no recov. 3,856/12,403 4,838/12,140 PANORAMIC Butler (RCT) 19% 0.81 [0.78-0.83] recov. time 12,403 (n) 12,140 (n) PANORAMIC Butler (RCT) 30% 0.70 [0.67-0.73] no recov. 2,675/12,403 3,766/12,140 PANORAMIC Butler (RCT) 26% 0.74 [0.71-0.76] recov. time 12,403 (n) 12,140 (n) PANORAMIC Butler (RCT) -95% 1.95 [1.15-3.31] viral load 21 (n) 11 (n) PANORAMIC Butler (RCT) 92% 0.08 [0.05-0.14] viral load 33 (n) 26 (n) Wong (PSM) 24% 0.76 [0.61-0.95] death Wong (PSM) 60% 0.40 [0.19-0.84] ventilation Wong (PSM) 26% 0.74 [0.45-1.21] ICU Wong (PSM) 2% 0.98 [0.89-1.06] hosp. Liu -162% 2.62 [0.11-60.6] ICU 1/26 0/16 Liu 8% 0.92 [0.17-4.94] progression 3/26 2/16 Liu 18% 0.82 [0.63-1.06] hosp. time 26 (n) 16 (n) Liu 21% 0.79 [0.59-1.05] viral time 26 (n) 16 (n) Liu -23% 1.23 [0.12-12.5] viral+ 2/26 1/16 Liu 28% 0.72 [0.29-1.76] viral+ 7/26 6/16 Liu 38% 0.62 [0.41-0.92] viral+ 14/26 14/16 Liu 18% 0.82 [0.64-1.05] viral+ 20/26 15/16 Liu 12% 0.88 [0.75-1.05] viral+ 23/26 16/16 Sinha (RCT) 65% 0.35 [0.16-0.73] hosp. 9/608 26/610 licensee Sinha (RCT) 53% 0.47 [0.26-0.85] no improv. 16/608 34/610 licensee Sinha (RCT) 48% 0.52 [0.42-0.63] viral load 608 (n) 610 (n) licensee Zheng -100% 2.00 [1.23-3.23] death/hosp. 61/2,689 34/3,331 OT​1 Zheng -85% 1.85 [1.14-3.03] death/hosp. 55/2,689 32/3,331 OT​1 Bajema (PSM) 18% 0.82 [0.52-1.29] death 24/897 29.0/897 Bajema (PSM) 49% 0.51 [0.20-1.27] death 7/897 13.8/897 Bajema (PSM) 17% 0.83 [0.17-4.12] ventilation 3/897 3.6/897 Bajema (PSM) 1% 0.99 [0.41-2.37] ICU 10/897 10.1/897 Bajema (PSM) -30% 1.30 [1.01-1.68] hosp. 162/897 124.3/897 Bajema (PSM) 9% 0.91 [0.59-1.41] hosp. 37/897 40.5/897 Inaba 58% 0.42 [0.02-10.1] death 0/84 1/210 Inaba -127% 2.27 [0.60-7.25] death/hosp. 5/84 8/210 Inaba -127% 2.27 [0.60-7.25] hosp. 5/84 8/210 Zheng (PSW) -285% 3.85 [1.54-10.0] death/hosp. 11/802 33/4,836 OT​1 Evans 51% 0.49 [0.29-0.83] death/hosp. 359 (n) 4,973 (n) Goodwin -110% 2.10 [0.19-22.9] death 1/80 2/336 Goodwin 58% 0.42 [0.05-3.23] hosp. 1/80 10/336 Goodwin 53% 0.47 [0.11-1.97] hosp. 2/80 18/336 Tazare -9% 1.09 [0.93-1.27] death/hosp. Butt -9% 1.09 [0.73-1.63] death/hosp. 48/1,459 44/1,459 Fung 4% 0.96 [0.93-0.99] PASC population-based cohort LONG COVID Fung 8% 0.92 [0.90-0.94] PASC population-based cohort LONG COVID DAWN Tare (RCT) -83% 1.83 [0.69-4.82] no recov. 4/7 5/16 DAWN Tare (RCT) 0% 1.00 [0.61-1.63] no recov. 6/8 12/16 Cheng 15% 0.85 [0.77-0.95] death 4,146 (n) 5,792 (n) Cheng -0% 1.00 [0.76-1.33] oxygen 4,146 (n) 5,792 (n) Cheng 12% 0.88 [0.59-1.30] ICU 4,146 (n) 5,792 (n) Standing (RCT) -103% 2.03 [0.52-7.94] viral+ 6/117 3/119 Standing (RCT) 31% 0.69 [0.44-1.07] viral+ 26/249 52/343 Razia -272% 3.72 [0.35-39.4] death 2/29 1/54 Razia -86% 1.86 [0.12-28.7] ventilation 1/29 1/54 Razia -86% 1.86 [0.28-12.5] ICU 2/29 2/54 Razia 28% 0.72 [0.28-1.81] hosp. 5/29 13/54 Yen 18% 0.82 [0.50-1.33] death 250 (n) 1,946 (n) SAVALO Gentile (PSM) 4% 0.96 [0.70-1.31] death case control SAVALO Gentile (PSM) 26% 0.74 [0.13-4.18] hosp. case control SAVALO Gentile (PSM) 65% 0.35 [0.15-0.81] progression case control Jorda (PSM) -27% 1.27 [0.65-2.49] death 14/10,752 21/21,504 Jorda (PSM) -1% 1.01 [0.83-1.23] hosp. 150/10,752 297/21,504 Wei 3% 0.97 [0.82-1.17] death Wei 2% 0.98 [0.74-1.30] death Wei 41% 0.59 [0.41-0.92] death Wei -8% 1.08 [1.03-1.13] hosp. Wei -6% 1.06 [0.98-1.13] hosp. population-based cohort Wei 10% 0.90 [0.80-1.01] hosp. population-based cohort Zou -32% 1.32 [0.89-1.97] viral+ 26/125 84/535 AGILE CST-8 Khoo (RCT) -1% 1.01 [0.73-1.42] viral load 16 (n) 8 (n) CT​2 AGILE CST-8 Khoo (RCT) -12% 1.12 [0.72-1.75] viral load 16 (n) 8 (n) CT​2 AGILE CST-8 Khoo (RCT) -31% 1.31 [0.76-2.25] viral load 16 (n) 8 (n) CT​2 AGILE CST-8 Khoo (RCT) -27% 1.27 [0.65-2.46] viral load 16 (n) 8 (n) CT​2 AGILE CST-8 Khoo (RCT) 1% 0.99 [0.73-1.33] viral load 16 (n) 8 (n) CT​2 AGILE CST-8 Khoo (RCT) 17% 0.83 [0.26-2.64] viral+ 5/16 3/8 CT​2 Hong Choi (PSW) -61% 1.61 [1.30-2.00] death Hong Choi (PSW) -12% 1.12 [0.68-1.85] ventilation Hong Choi (PSW) -28% 1.28 [0.68-2.38] ICU 033864 (RCT) 0% 1.00 [0.50-2.00] improv. n/a n/a FUTILITY, PENDING​3 035424 (RCT) 0% 1.00 [0.50-2.00] improv. n/a n/a FUTILITY, PENDING​3 MOVe-IN Arribas (DB RCT) -282% 3.82 [0.50-29.1] death 11/216 1/75 MOVe-IN Arribas (DB RCT) -217% 3.17 [0.34-29.8] death 3/71 1/75 MOVe-IN Arribas (DB RCT) -317% 4.17 [0.48-36.4] death 4/72 1/75 MOVe-IN Arribas (DB RCT) -311% 4.11 [0.47-35.9] death 4/73 1/75 MOVe-IN Arribas (DB RCT) 1% 0.99 [0.68-1.45] no recov. 72 (n) 75 (n) MOVe-IN Arribas (DB RCT) 12% 0.88 [0.61-1.28] no recov. 73 (n) 75 (n) MOVe-IN Arribas (DB RCT) -1% 1.01 [0.69-1.47] no recov. 73 (n) 75 (n) MOVe-IN Arribas (DB RCT) 12% 0.88 [0.62-1.25] viral+ 26/52 34/60 MOVe-IN Arribas (DB RCT) -2% 1.02 [0.74-1.41] viral+ 29/50 34/60 MOVe-IN Arribas (DB RCT) 21% 0.79 [0.56-1.13] viral+ 27/60 34/60 MOVe-IN Arribas (DB RCT) 8% 0.92 [0.41-2.08] viral+ 9/53 10/54 MOVe-IN Arribas (DB RCT) -48% 1.48 [0.72-3.03] viral+ 14/51 10/54 MOVe-IN Arribas (DB RCT) 21% 0.79 [0.34-1.84] viral+ 8/55 10/54 Wan 11% 0.89 [0.81-0.98] death 704/6,153 2,541/17,283 Wan 1% 0.99 [0.93-1.05] hosp. 2,298/6,153 2,541/17,283 Wan -4% 1.04 [0.98-1.10] progression 2,300/6,153 2,541/17,283 Wan 13% 0.87 [0.81-0.93] death 2,700 (n) 13,795 (n) Wan -7% 1.07 [0.89-1.30] ventilation 2,700 (n) 13,795 (n) Wan -2% 1.02 [0.76-1.36] ICU 2,700 (n) 13,795 (n) Özdemir -50% 1.50 [0.27-8.49] death 3/39 2/39 Özdemir 0% 1.00 [0.15-6.75] ICU 2/39 2/39 RECOVERY Horby (RCT) -11% 1.11 [0.79-1.58] death 57/445 55/478 RECOVERY Horby (RCT) 7% 0.93 [0.68-1.28] death 74/445 79/478 RECOVERY Horby (RCT) -43% 1.43 [0.50-4.08] ventilation 8/445 6/476 RECOVERY Horby (RCT) -9% 1.09 [0.88-1.35] no disch. 126/445 124/478 RECOVERY Horby (RCT) 12% 0.88 [0.85-0.91] viral load 445 (n) 478 (n) Lv -53% 1.53 [0.83-2.83] death 12/67 30/257 Lai 10% 0.90 [0.83-0.97] death 4,975 (n) 8,667 (n) MOVe-AHEAD Alpizar (DB RCT) 24% 0.76 [0.57-1.01] symp. case 78/763 103/764 Molnupiravir COVID-19 outcomes c19early.org February 2026 1 OT: comparison with other treatment3 FUTILITY: terminated for futility, results pending 2 CT: study uses combined treatment Favors molnupiravir Favors control
References