Molnupiravir – recomm – Covid Guidelines India

We recommend against use of Molnupiravir in patients with COVID-19 infection and no risk factors for severe disease (strong recommendation)

Definition of mild:

• Symptomatic (any acute COVID-19 related symptoms)
• AND respiratory rate <24/min • WITHOUT pneumonia or hypoxia

Definition of moderate illness:

• Pneumonia (clinical or radiological) OR hypoxia (SpO2 <94% in adults with no underlying lung disease) • AND respiratory rate ≤30/min • AND SpO2 ≥90% on room air

Definition of Severe illness

Pneumonia with ANY ONE of the following:

• severe respiratory distress or respiratory rate >30/min
• SpO2 <90% on room air • NO invasive or non-invasive respiratory support needed

Definition of critical:

• Requirement for high-level respiratory support: noninvasive ventilation, high-flow oxygen (≥20 litres per minute) or invasive mechanical ventilation
• OR acute respiratory distress syndrome (PaO2/FiO2 ratio of <300) • OR sepsis • OR shock

We recommend against routine use of Molnupiravir in non-hospitalized patients with COVID-19 infection with mild to moderate COVID-19 (conditional recommendation)

A conditional recommendation is one for which the desirable effects probably outweigh the undesirable effects (weak recommendation FOR an intervention) or undesirable effects probably outweigh the desirable effects (weak recommendation AGAINST an intervention) but appreciable uncertainty exists. This implies that not all will be best served by this recommendation and decisions can be made by the patient and caregiver based on patient values, resources and setting with a clear understanding of the ensuing harms and benefits.