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Antiviral Therapeutic Approaches for SARS-CoV-2 Infection: A Systematic Review
Victoria Gil Martínez1, Ana Avedillo Salas1, Sonia Santander Ballestín1
1Department of Pharmacology, Physiology and Legal and Forensic Medicine, Faculty of Medicine, University of Zaragoza, 50009 Zaragoza, Spain.
Remdesivir and favipiravir accelerate clinical improvement in COVID-19 patients and are well tolerated. However, lopinavir/ritonavir, ribavirin, and umifenovir are not recommended for hospitalized patients due to lack of efficacy or safety concerns.
Area of Science:
- Infectious Diseases
- Pharmacology
- Virology
Background:
- Limited etiological treatments for SARS-CoV-2 necessitate repurposing existing drugs.
- Antivirals effective against SARS and MERS have been explored for COVID-19 treatment.
- Need for evidence-based guidance on antiviral efficacy and safety in COVID-19.
Purpose of the Study:
- To systematically review the efficacy and safety of five antivirals in COVID-19 patients.
- To evaluate drugs with in vitro or prior SARS/MERS efficacy for COVID-19 application.
Main Methods:
- Systematic review conducted according to PRISMA statement guidelines.
- Comprehensive database search (PubMed, WoS, MEDLINE, Cochrane) until April 2021.
- Independent extraction of intervention/comparison group data, demographics, and results.
Main Results:
- Remdesivir accelerates clinical improvement but does not reduce mortality; well tolerated.
- Favipiravir shows promise for symptom resolution but lacks impact on viral clearance; safe.
- Lopinavir/ritonavir associated with gastrointestinal adverse events and unproven efficacy.
- Ribavirin and umifenovir showed no significant differences compared to control groups.
Conclusions:
- Remdesivir and favipiravir are well-tolerated and effective in improving clinical outcomes.
- Evidence does not support the use of lopinavir/ritonavir, ribavirin, or umifenovir in hospitalized COVID-19 patients.
- Further research may be needed to clarify the role of specific antivirals in COVID-19 management.
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