Efficacy and Safety of Molnupiravir Treatment for COVID-19: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

"Declarations Funding: This work was supported by the 10.13039/100012542Sichuan Science and Technology Program (Project number: 2022JDR0326, 2023JDR0246). Competing Interests: The authors declare that they have no competing interests. Ethical Approval: Not required. Sequence Information: Not applicable. Acknowledgments: This research was supported by National Key Clinical Specialties Construction Program. Competing Interests: The authors declare that they have no competing interests."

"Funding: This work was supported by the 10.13039/100012542Sichuan Science and Technology Program (Project number: 2022JDR0326, 2023JDR0246)."

"The literature was retrieved from PubMed, Embase, CENTRAL (Cochrane Central Register of Controlled Trials), ClinicalTrials.gov, ICTRP (International Clinical Trials Registry Platform) and medRxiv from inception up to 1 January 2023. The following search terms were used: “COVID-19”, “SARS-CoV-2”, “molnupiravir” and “randomized controlled trial”. All search strategies were developed and implemented independently by two investigators and then cross-checked. A sample of the search strategy based on PubMed is listed in Appendix 1. The RCTs included in this study were divided into two categories: RCTs that have been published or have not been published but have research results; and RCTs that are currently in progress. Reference lists of identified studies were also searched to avoid missing potentially relevant studies. After using EndNote X7 to screen duplicates, the two researchers read the title and abstract of these articles back-to-back for preliminary screening and further read the full text that initially met the inclusion criteria to determine whether they were finally included. When the two researchers disagreed, the third researcher made the final decision. The protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO Code No: CRD42023388502). Meta-analysis was performed based on Review Manager 5.4 software (PROSPERO Code No: CRD42023388502). Outcomes were calculated by risk ratio (RR) and 95% confidence intervals (CI). The Q statistic test and I2 test were used to test the heterogeneity between studies. When there was statistical heterogeneity, owing to the anticipated heterogeneity of the included studies, a random-effects model was used to estimate effect sizes, which provided more conservative estimates of the 95% CIs ,. If there was no statistical heterogeneity between studies, the fixed effects model was used. A sensitivity analysis of the study was performed to examine the robustness of the results."