This initially reversible process overwhelms the hepatocytes ability to maintain lipid homeostasis leading to a toxic effect  as fat molecules accumulate and are broken down in the setting of an oxidative stress response. Over time, this abnormal lipid deposition triggers the immune system via toll-like receptor 4 (TLR4) resulting in the production of inflammatory cytokines such as TNF that cause liver cell injury and death. These events mark the transition to steatohepatitis and in the setting of chronic injury, fibrosis eventually develops setting up events that lead to cirrhosis and hepatocellular carcinoma. Microscopically, changes that can be seen include steatosis with large and swollen hepatocytes (ballooning), evidence of cellular injury and cell death (apoptosis, necrosis), evidence of inflammation in particular in zone 3 of the liver, variable degrees of fibrosis and Mallory bodies. Diagnosis
Diagnosis of hepatitis is made on the basis of some or all of the following: a persons signs and symptoms, medical history including sexual and substance use history, blood tests, imaging, and liver biopsy. In general, for viral hepatitis and other acute causes of hepatitis, the persons blood tests and clinical picture are sufficient for diagnosis. For other causes of hepatitis, especially chronic causes, blood tests may not be useful. In this case, liver biopsy is the gold standard for establishing the diagnosis: histopathologic analysis is able to reveal the precise extent and pattern of inflammation and fibrosis.
The final analysis reported a 30% reduction in hospitalizations and deaths.As of January 2022, the Panoramic trial is testing molnupiravirs effectiveness. References
Further reading
Thorlund K, Sheldrick K, Meyerowitz-Katz G, Singh S, Hill A (March 2022). "Making Statistical Sense of the Molnupiravir MOVe-OUT Clinical Trial". Am J Trop Med Hyg. 106 (5): 1301–1304. doi:10.4269/ajtmh.21-1339. PMC 9128711. PMID 35276667. S2CID 247406958. External links

"Molnupiravir". Drug Information Portal. U.S. National Library of Medicine.