Merck’s COVID-19 pill causes viral mutations that can lead to new variants, according to a peer-reviewed paper published Monday in Nature.

“Molnupiravir, an antiviral medication that has been widely used against SARS-CoV-2, acts by inducing mutations in the virus genome during replication,” wrote the study’s authors.

This capability could make it more difficult to predict how the virus will change and spread, according to the authors, who warned that patients who do not clear the virus after a few days could spread its mutated form to others.

Dr. Harvey Risch, professor emeritus of epidemiology and senior research scientist at the Yale School of Public Health, told The Defender the study was “very high-quality research” and that the results are “another ‘duh’ moment.”

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