Effectiveness of Molnupiravir for the Treatment of COVID-19: A Systematic Literature Review of Real-World Observational Studies

Molnupiravir (MOV), an oral antiviral, is prescribed to treat adult patients with mild-to-moderate COVID-19 at risk of progressing to severe disease. This systematic literature review assessed the real-world effectiveness of MOV for reducing the progression to severe COVID-19 outcomes in clinical settings, including high-risk or special populations (type 2 diabetes, chronic respiratory diseases, immunocompromised conditions, older adults, and nursing home residents). Studies comparing MOV-treated with untreated groups of non-hospitalized adults at risk of progression to severe COVID-19 outcomes (hospitalization, death, and the composite of hospitalization/death) were identified from EMBASE and PubMed (January 1, 2021‒May 24, 2024). Twenty-one general and special population studies were included. General population studies (n=16) showed that MOV reduced the risk of death, hospitalization, and hospitalization/death. Special population studies (n=10; five additional and five general population articles with subgroups of interest) also showed that MOV reduced the risk of the same outcomes, with a more pronounced effect in older adults (≥60 years). The wide range of risk reduction observed might be attributed to variability in COVID-19 hospitalization guidelines and vaccination coverage. Findings support the effectiveness of MOV in reducing the risk of hospitalization, death, and hospitalization/death compared with untreated groups, including high-risk adults with underlying comorbidities. Supplementary Material File (merck_molnupiravir slr manuscript_final.docx) - Download - 1.18 MB Information & Authors Information Version history Peer review timeline Published Current Medical Research and Opinion Version of Record5 Sep 2025Published Copyright This work is licensed under a Non Exclusive No Reuse License.

Authors Metrics & Citations Metrics Article Usage 218views 106downloads Citations Download citation Samantha G. Bromfield, Ramu Periyasamy, Veeri Rajendra Babu, et al. Effectiveness of Molnupiravir for the Treatment of COVID-19: A Systematic Literature Review of Real-World Observational Studies. Authorea. 17 April 2025. DOI: https://doi.org/10.22541/au.174489684.47331710/v1 DOI: https://doi.org/10.22541/au.174489684.47331710/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. For more information or tips please see 'Downloading to a citation manager' in the Help menu.