Evaluation of favipiravir in the treatment of COVID-19 based on the real-world

ABSTRACT

Background

The role of favipiravir (FVP) as a COVID-19 treatment is recognized but not fully elucidated. We aimed to evaluate whether FVP has definite clinical efficacy and safety in the treatment of COVID-19.

Methods

International and Chinese databases were searched for randomized controlled clinical trials evaluating FVP for the treatment of COVID-19. A meta-analysis was performed and published literature was synthesized to evaluate the corresponding therapeutic effects.

Results

We included 13 studies (1430 patients in total). Meta-analysis showed that patients with mild-to-moderate disease treated with FVP had a significantly higher viral clearance rate than those in the control group 10 and 14 days after initiation of treatment [RR: 1.13 (95% CI: 1.00, 1.28), P = 0.04; I² = 39% for day 10 and RR: 1.16 (95% CI: 1.04, 1.30), P = 0.008; I² = 38% for day 14] and a significantly shorter hospital stay [MD: −1.52 (95% CI: −2.82, −0.23), P = 0.02; I² = 0%].

Conclusions

FVP significantly promotes viral clearance and reduces the hospitalization duration in mild-to-moderate COVID-19 patients, which can reduce the risk of severe disease outcomes in patients. However, more importantly, the results showed no benefit of FVP in severe patients, and caution should be taken regarding the treatment options of FVP in severe patients.

PLAIN LANGUAGE SUMMARY

The urgent need to identify effective interventions to treat novel coronavirus infections is a major challenge. The role of favipiravir (FVP) as a COVID-19 treatment is recognized but not fully elucidated. Our study showed a significant correlation between viral clearance and the promotion of clinical improvement with FVP in mild-to-moderate patients, which is significant for reducing the length of hospital stay of patients, reducing the risk of patients progressing to severe disease, thereby reducing mortality. However, the results showed no benefit of FVP in severe patients and the conclusion of this study still needs to be further verified by clinical trials with large samples.

KEYWORDS:

• Antiviral agents
• viral clearance
• covid-19
• favipiravir
• meta-analysis

Declaration of interests

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

All authors should have substantially contributed to the conception and design of the review article and interpreting the relevant literature and have been involved in writing the review article or revised it for intellectual content.

Geolocation information

China

supplementary-material

Supplemental data for this article can be accessed here

Additional information

Funding

This study was supported by National Key Clinical Specialty Construction Project (Clinical Pharmacy) and High Level Clinical Key Specialty (Clinical Pharmacy) in Guangdong Province, with the funder being the subsidy fund for medical service and security capacity improvement of the Central Department of Finance, code Z155080000004.