Table 2.
Impact of molnupiravir on SARS-CoV-2 variants of concern.
| Variants | Sub Variants | Major Mutations in Spike Protein | Impact of Molnupiravir | References |
|---|---|---|---|---|
| Delta | B.1.617.2 | T19R, G142D, FR156⁃157del, R158G, L452R, T478K, D614G, P681R, D950N | Studies shows that molnupiravir and its metabolite (EIDD-1931) inhibited the VeroE6-GFP cells in the SARS-CoV assay. | [76] |
| B.1.617.2 | The in vivo study for the efficacy of molnupiravir in ferrets and dwarf hamster model indicate that it reduced the lung viral load and prevented transmission. | [78] | ||
| B.1.617.2 | The early treatment of mild to moderately infected SARS-CoV-2 unvaccinated adult patient with molnupiravir decreases hospitalization and probability of death by 7.3%. | [79] | ||
| B.1.617.2.1 OR AY.1 | K417N, A1146T, V70F, and W258L | Although molnupiravir is recommended by USFDA, specific study related to B.1.617.2.1 is required to prove its efficacy and safety. | [90] | |
| Omicron | B. A1 | P681H, A67V, H655Y, S371L, and N679K | The susceptibility of molnupiravir was found to be 0.43 ± 0.08(IC50). This proves its effectiveness against B. A1. | [91,92] |
| B. A2 | S371F, D405N | A lower mortality rate, lower risk of SARS-CoV-2 progression, and redundancy in oxygen therapy was reported in molnupiravir-treated groups compared to the matched controls. | [85] | |
| B. A2 | S371F, D405N | The overall viral RNA clearance was decrease in molnupiravir group. | [86] | |
| B. A2 | P132H, S371F, D405N | The therapeutic results indicate that molnupiravir and its metabolite (EIDD-1931) inhibit the cytopathogenicity in VeroE6-GFP cells. | [93] | |
| B. A3 | A67V, H69del, V70del, T95I, V143del, Y144del, Y145del, N211I, L212del, S371F, D405N and G446S | Although molnupiravir is recommended by USFDA, specific study related to BA.3 is required to prove its efficacy and safety. | [94] | |
| B. A4 | Del69-70, 44 L452R, F486V, and R493Q | Use of molnupiravir is recommended by Japan government along with two other drugs, but clinical trials are not performed to support the data. | [95,96] | |
| B. A5 | Del69-70, 44 L452R, F486V, and R493Q | Use of molnupiravir is recommended by Japan government along with two other drugs, but clinical trials are not performed to support the data. | [95,96] | |
| Hybrid Variant | XD | E172D | A detailed study is required to prove the efficacy of molnupiravir against XD hybrid variant. | [97] |
| XE | A detailed study is required to prove the efficacy of molnupiravir against XD hybrid variant. | [97] | ||
| XF | A detailed study is required to prove the efficacy of molnupiravir against XD hybrid variant. | [97] |