Myocarditis, however, has shown to be more common in the male population than in the female. Multiple studies report a 1:1.3-1.7 female-male ratio of prevalence of myocarditis. In young adults, up to 20% of all cases of sudden death are due to myocarditis. Young males specifically have a higher incidence rate than any other population due to their testosterone levels creating a greater inflammatory response that increases the chance of cardiac pathologies. While males tend to have a higher risk of developing myocarditis, females tend to display more severe signs and symptoms, such as ventricular tachycardia and ventricular fibrillation, but do so at an older age. Among patients with HIV, myocarditis is the most common cardiac pathological finding at autopsy, with a prevalence of 50% or more.Myocarditis is the third most common cause of death among young adults with a cumulative incidence rate globally of 1.5 cases per 100,000 persons annually. Myocarditis accounts for approximately 20% of sudden cardiac death in a variety of populations, including adults under the age of 40, young athletes, United States Air Force recruits, and elite Swedish orienteers. With individuals who develop myocarditis, the first year is difficult as a collection of cases have shown there is a 20% mortality rate. Myocarditis in COVID-19
One notable instance of viral myocarditis is the involvement of the SARS-CoV-2 virus; myocarditis from SARS-CoV-2 is associated with a spectrum of severities from asymptomatic to fulminant, and is a complication in approximately 2-7% of COVID-19 cases.
This causes more mutations in all downstream copies than the virus can survive, an effect called viral error catastrophe or lethal mutagenesis. Chemistry
The first synthesis of molnupiravir was disclosed in a patent filed by Emory University in 2018.In the first step, acetone is used as a protecting group to render two of the three hydroxy groups of uridine unreactive to treatment with the acid anhydride of isobutyric acid, which converts the third hydroxy group to its ester. Treatment with 1,2,4-triazole and phosphoryl chloride produces a reactive intermediate in which the triazole portion can be replaced with hydroxylamine. Finally, removal of the protecting group using formic acid converts the material to molnupiravir. : 93–95 
Alternative patented routes to molnupiravir have been reviewed. History
Molnupiravir was developed at Emory University by its drug innovation company, Drug Innovation Ventures at Emory (DRIVE). In 2014, DRIVE began a screening project funded by the Defense Threat Reduction Agency to find an antiviral drug targeting Venezuelan equine encephalitis virus (VEEV), which led to the discovery of EIDD-1931. When turned into the prodrug EIDD-2801 (molnupiravir), the compound also showed activity against other RNA viruses including influenza, Ebola, chikungunya, and various coronaviruses.The international nonproprietary name of the drug was inspired by that of Thors hammer, Mjölnir.