| Outcome |
Relative effect
(95% CI) |
Absolute effect
(95% CI)1 |
Certainty of the Evidence
(GRADE) |
Viral negative conversion
D7 |
RR: 1.97
(0.76 - 5.10) |
94 more per 1000
(from 23 fewer to 396 more)
|
Very low certainty
Reasons to downgrade
Risk of bias: Serious
Risk of bias downgraded by 1 level: some concerns or high risk regarding missing data and selection of the reported results Inconsistency: Very serious
Inconsistency downgraded by 2 levels: I²=:91.5% Indirectness: Not serious
Imprecision: Very serious
due to wide confidence interval consistent with the possibility for benefit and the possibility for no effect and low number of particpants
|
| 3 trials
Koudinya Tippabhotla S, 2022; Jayk Bernal A, 2021; Fischer W, 2021
2770 participants
|
|
Molnupiravir
190 per 1,000
(73 - 492) |
Standard care/Placebo
96
per 1,000 |
|
Clinical improvement
D28 |
RR: 1.12
(1.07 - 1.18) |
95 more per 1000
(from 56 more to 143 more)
|
Low certainty
Reasons to downgrade
Risk of bias: Not serious Inconsistency: Not serious Indirectness: Serious
despite a multicentre design this is a single study from a single country, therefore results in this population might not be generalizable to other settings. Imprecision: Serious
due to low number of participants
|
| 1 trials
Koudinya Tippabhotla S, 2022
1220 participants
|
|
Molnupiravir
890 per 1,000
(851 - 938) |
Standard care/Placebo
795
per 1,000 |
|
Clinical improvement
D60 |
Outcome not yet measured or reported
|
|
WHO progression score (level 7 or above)
D28 |
RR:
( - ) |
Zero events in both groups
|
Very low certainty
Reasons to downgrade
Risk of bias: Not serious Inconsistency: Not serious Indirectness: Serious
despite a multicentre design this is a single study from a single country, therefore results in this population might not be generalizable to other settings. Imprecision: Very serious
no events in both groups and low number of participants
|
| 1 trials
Koudinya Tippabhotla S, 2022
1220 participants
|
|
Molnupiravir
0 per 1,000
( - ) |
Standard care/Placebo
0
per 1,000 |
|
WHO progression score (level 7 or above)
D60 |
Outcome not yet measured or reported
|
|
All-cause mortality
D28 |
RR: 0.19
(0.04 - 0.86) |
6 fewer per 1000
(from 7 fewer to 1 fewer)
|
Moderate certainty
Reasons to downgrade
Risk of bias: Not serious Inconsistency: Not serious Indirectness: Not serious
Imprecision: Serious
due to low number of participants
|
| 4 trials
Koudinya Tippabhotla S, 2022; Caraco Y, 2021; Jayk Bernal A, 2021; Fischer W, 2021
2920 participants
|
|
Molnupiravir
1 per 1,000
(0 - 6) |
Standard care/Placebo
8
per 1,000 |
|
All-cause mortality
D60 |
Outcome not yet measured or reported
|
|
Adverse events
|
RR: 0.94
(0.83 - 1.06) |
15 fewer per 1000
(from 42 fewer to 15 more)
|
Moderate certainty
Reasons to downgrade
Risk of bias: Not serious Inconsistency: Not serious Indirectness: Not serious Imprecision: Serious
due to low number of participants
|
| 4 trials
Koudinya Tippabhotla S, 2022; Caraco Y, 2021; Jayk Bernal A, 2021; Fischer W, 2021
2920 participants
|
|
Molnupiravir
230 per 1,000
(203 - 259) |
Standard care/Placebo
245
per 1,000 |
|
Serious adverse events
|
RR: 0.75
(0.53 - 1.05) |
12 fewer per 1000
(from 23 fewer to 2 more)
|
Low certainty
Reasons to downgrade
Risk of bias: Not serious Inconsistency: Not serious Indirectness: Not serious
Imprecision: Very serious
due to very wide confidence interval consistent with the possibility for benefit and the possibility for no effect and low number of participants
|
| 4 trials
Koudinya Tippabhotla S, 2022; Caraco Y, 2021; Jayk Bernal A, 2021; Fischer W, 2021
2920 participants
|
|
Molnupiravir
37 per 1,000
(26 - 52) |
Standard care/Placebo
49
per 1,000 |
|
Hospitalisation or death
* |
RR: 0.68
(0.50 - 0.94) |
19 fewer per 1000
(from 30 fewer to 4 fewer)
|
Moderate certainty
Reasons to downgrade
Risk of bias: Not serious Inconsistency: Not serious Indirectness: Not serious
Imprecision: Serious
due to low number of participants
|
| 3 trials
Caraco Y, 2021; Jayk Bernal A, 2021; Koudinya Tippabhotla S, 2022
2803 participants
|
|
Molnupiravir
41 per 1,000
(30 - 57) |
Standard care/Placebo
61
per 1,000 |
|
1The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI)
CI: Confidence interval; RR: Risk ratio
GRADE Working Group grades of evidence
High certainty: We are very confident that the true effect lies close to that of the estimate of the effect
Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect
Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect
