Fig. 6: Viral mutations in molnupiravir and Usual Care groups.

a The number of mutations (mean= 553 and standard deviation=391), in samples taken at treatment-end (Day 5) is significantly higher (Mann–Whitney test) in molnupiravir-treated participants with detectable virus at Day 14 (orange, n = 100 participants) compared with those who cleared virus between Days 5–14 (red, n = 87 participants). Box-plot midline is the median, the upper and lower limits the 75th and 25th percentile, the whiskers 1.5 times the interquartile range. Data beyond that are represented as points. There is no difference between the numbers of mutations in the comparable Usual Care groups (mean = 45 and standard deviation=31.2, n orange = 94 participants, n red = 158 participants). b Viral load trajectories (mean and standard deviation) for molnupiravir-treated and Usual Care participants with any know spike neutralisation-escape missense mutation occurring at any time point post baseline at consensus level (allele frequency (AF) > 50%) in red, below consensus level (1–50%) in purple or with no mutations (grey). Participants (441) were required to have viral load data for baseline, Day 5 and Day 14 and sequence data for all positive viral loads. The table shows the total number of participants with consensus, below consensus and zero known neutralisation escape mutations for molnupiravir and Usual Care groups, c Consensus level (>50%) amino acid substitutions occurring in Day 14 sequences from molnupiravir (purple) and Usual Care (grey) participants. Mutations occurring in more than one participant’s sample are shown above the rest. Schematic of the SARS-CoV-2 genome is shown along the bottom. ****P < 0.0001. Source data are provided as a Source Data file.