The novel coronavirus outbreak began in late December 2019 and rapidly spread worldwide, critically impacting public health systems. A number of already approved and marketed drugs are being tested for repurposing, including Favipiravir. We aim to investigate the efficacy and safety of Favipiravir in treatment of COVID-19 patients through a systematic review and meta-analysis. This systematic review and meta-analysis were reported in accordance with the PRISMA statement. We registered the protocol in the PROSPERO (CRD42020180032). All clinical trials which addressed the safety and efficacy of Favipiravir in comparison to other control groups for treatment of patients with confirmed infection with SARS-CoV2 were included. We searched electronic databases including LitCovid/PubMed, Scopus, Web of Sciences, Cochrane, and Scientific Information Database up to 31 December 2020. We assessed the risk of bias of the included studies using Cochrane Collaboration criteria. All analyses were performed using the Comprehensive Meta-Analysis software version 2, and the risk ratio index was calculated. Egger and Begg test was used for assessing publication bias. Nine studies were included in our meta-analysis. The results of the meta-analysis revealed a significant clinical improvement in the Favipiravir group versus the control group during seven days after hospitalization (RR = 1.24, 95% CI: 1.09–1.41; P = 0.001). Viral clearance was more in 14 days after hospitalization in Favipiravir group than control group, but this finding marginally not significant (RR = 1.11, 95% CI: 0.98–1.25; P = 0.094). Requiring supplemental oxygen therapy in the Favipiravir group was 7% less than the control group, (RR = 0.93, 95% CI: 0.67–1.28; P = 0.664). Transferred to ICU and adverse events were not statistically different between two groups. The mortality rate in the Favipiravir group was approximately 30% less than the control group, but this finding not statistically significant. Favipiravir possibly exerted no significant beneficial effect in the term of mortality in the general group of patients with mild to moderate COVID-19. We should consider that perhaps the use of antiviral once the patient has symptoms is too late and this would explain their low efficacy in the clinical setting.

This study aimed to examine the efficacy and safety of nirmatrelvir/ritonavir (Paxlovid) for coronavirus disease 2019 (COVID‐19). PubMed, Cochrane Library, Web of Science, medRxiv, and Google Scholar were searched to identify the relevant evidence up to November 10, 2022. The reference lists of key studies were also scanned to find additional records. The quality of the studies was evaluated using the Cochrane tools for assessing the risk of bias. The Comprehensive Meta‐Analysis software version 3.0 was employed for data analysis. Twenty‐three studies involving 314 353 patients were included in the analysis. The findings of the meta‐analysis showed a significant difference between the Paxlovid and no‐Paxlovid groups in terms of mortality rate (odds ratio [OR] = 0.25; 95% confidence interval [CI]: 0.14–0.45), hospitalization rate (OR = 0.40; 95% CI: 0.24–0.69), polymerase chain reaction negative conversion time (mean difference [MD] = −2.46; 95% CI: −4.31 to −0.61), and hospitalization or death rate (OR = 0.17; 95% CI: 0.06–0.46). However, no significant difference was observed between the two groups in terms of COVID‐19 rebound (OR = 0.84; 95% CI: 0.67–1.04), emergency department visit (OR = 0.75; 95% CI: 0.45–1.24), intensive care unit admission (OR = 0.37; 95% CI: 0.13–1.01), and adverse events (OR = 2.20; 95% CI: 0.42–11.47). The results of the present study support the efficacy and safety of Paxlovid in the treatment of patients with COVID‐19. Further research is needed to investigate the COVID‐19 rebound after Paxlovid treatment.

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The therapeutic potential of sotrovimab in the treatment of coronavirus disease 2019 (COVID‐19) is a controversial issue. The aim of this study was to evaluate the efficacy and safety of sotrovimab in COVID‐19 patients. To this end, PubMed, Cochrane Library, Embase, Web of Science, medRxiv, and Google Scholar were searched up to 15 August 2022. The reference lists of key studies were also scanned to find additional records. Meta‐analysis was performed using Comprehensive Meta‐Analysis. Seventeen studies involving 27,429 patients were included. A significant difference was observed in mortality rate (odds ratio [OR] = 0.40; 95% CI: 0.25–0.63, p = 0.00), hospitalisation rate (OR = 0.53; 95% CI: 0.43–0.65. p = 0.00), hospital or death rate (OR = 0.43; 95% CI: 0.25–0.73, p = 0.00), the need for mechanical ventilation (OR = 0.57; 95% CI: 0.33–0.96, p = 0.03), and ICU admission (OR = 0.33; 95% CI: 0.17–0.67, p = 0.00) of the sotrovimab‐receiving group compared to those having no sotrovimab. However, no significant difference was observed between the two groups in terms of disease progression (OR = 0.45; 95% CI: 0.16–1.24, p = 0.12) and emergency department visit (OR = 1.01; 95% CI: 0.83–1.24, p = 0.87). The two groups had no significant difference in terms of incidence of adverse events (OR = 0.98; 95% CI: 0.78–1.23, p = 0.88). The findings of the present meta‐analysis support that sotrovimab could be an effective and safe treatment option to reduce mortality and hospitalisation rate in both Delta and Omicron Variants of COVID‐19.

Objective To provide the latest evidence for the efficacy and safety of arbidol (umifenovir) in COVID‐19 treatment. Methods A literature systematic search was carried out in PubMed, Cochrane Library, Embase, and medRxiv up to May 2021. The Cochrane risk of bias tool and Newcastle–Ottawa scale were used to assess the quality of included studies. Meta‐analysis was performed using RevMan 5.3. Results Sixteen studies were met the inclusion criteria. No significant difference was observed between arbidol and non‐antiviral treatment groups neither for primary outcomes, including the negative rate of PCR (NR‐PCR) on Day 7 (risk ratio [RR]: 0.94; 95% confidence interval (CI): 0.78–1.14) and Day 14 (RR: 1.10; 95% CI: 0.96–1.25), and PCR negative conversion time (PCR‐NCT; mean difference [MD]: 0.74; 95% CI: −0.87 to 2.34), nor secondary outcomes ( p > .05). However, arbidol was associated with higher adverse events (RR: 2.24; 95% CI: 1.06–4.73). Compared with lopinavir/ritonavir, arbidol showed better efficacy for primary outcomes ( p < .05). Adding arbidol to lopinavir/ritonavir also led to better efficacy in terms of NR‐PCR on Day 7 and PCR‐NCT ( p < .05). There was no significant difference between arbidol and chloroquine in primary outcomes ( p > .05). No remarkable therapeutic effect was observed between arbidol and other agents ( p > .05). Conclusion The present meta‐analysis showed no significant benefit of using arbidol compared with non‐antiviral treatment or other therapeutic agents against COVID‐19 disease. High‐quality studies are needed to establish the efficacy and safety of arbidol for COVID‐19.

The novel coronavirus outbreak began in late December 2019 and rapidly spread worldwide, critically impacting public health systems. Several already approved and marketed drugs are being tested for repurposing, including Favipiravir. We aim to investigate the efficacy and safety of Favipiravir in the treatment of COVID-19 patients through a systematic review and meta-analysis. This systematic review and meta-analysis were reported following the PRISMA statement. We registered the protocol in the PROSPERO (CRD42020180032). All clinical trials which addressed the safety and efficacy of Favipiravir in comparison to other control groups for treatment of patients with confirmed infection with SARS-CoV2 were included. We searched electronic databases including LitCovid hub/PubMed, Scopus, ISI web of Sciences, Cochrane, and Scientific Information Database up to 31 December 2020. We assessed the risk of bias of the included studies using Cochrane Collaboration criteria. All analyses were performed using the Comprehensive Meta-Analysis software version 2, and the risk ratio index was calculated. Egger and Begg's test was used for assessing publication bias. Nine studies were included in our meta-analysis. The results of the meta-analysis revealed a significant clinical improvement in the Favipiravir group versus the control group during seven days after hospitalization (RR=1.24, 95% CI: 1.09-1.41; P=0.001). Viral clearance was more in 14 days after hospitalization in the Favipiravir group than in the control group, but this finding marginally not significant (RR=1.11, 95% CI: 0.98-1.25; P=0.094). Requiring supplemental oxygen therapy in the Favipiravir group was 7% less than the control group, (RR=0.93, 95% CI: 0.67-1.28; P=0.664). Transferred to ICU and adverse events were not statistically different between the two groups. The mortality rate in the Favipiravir group was approximately 30% less than the control group, but this finding not statistically significant. Favipiravir possibly exerted no significant beneficial effect in the term of mortality in the general group of patients with mild to moderate COVID-19. We should consider that perhaps the use of antiviral once the patient has symptoms is too late and this would explain their low efficacy in the clinical setting.

Purpose: To provide the latest evidence on the efficacy and safety of lopinavir/ritonavir compared to other treatment options for COVID-19. Methods: We searched PubMed, Cochran Library, Embase, Scopus, and Web of Science for the relevant records up to April 2021. Moreover, we scanned MedRxiv, Google Scholar, and clinical registry databases to identify additional records. We have used the Newcastle-Ottawa Scale and Cochrane risk of bias tools to assess the quality of studies. This Meta-analysis was conducted using RevMan software (version 5.3). Results: Fourteen studies were included. No significant difference was observed between lopinavir/ritonavir and non-antiviral treatment groups in terms of negative rate of PCR (polymerase chain reaction) on day 7 (risk ratio [RR]: 0.83; 95% CI: 0.63 to 1.09; P=0.17), and day 14 (RR: 0.93; 95% CI: 0.81 to 1.05; P=0.25), PCR negative conversion time (mean difference [MD]: 1.09; 95% CI: -0.10 to 2.29; P=0.07), secondary outcomes, and adverse events (P>0.05). There was no significant difference between lopinavir/ritonavir and chloroquine as well as lopinavir/ritonavir and hydroxychloroquine regarding the efficacy outcomes (P>0.05). However, lopinavir/ritonavir showed better efficacy than arbidol for the same outcomes (P<0.05). Lopinavir/ritonavir plus arbidol was effective compared to arbidol alone in terms of the negative rate of PCR on day 7 (P=0.02). However, this difference was not significant regarding other efficacy outcomes (P>0.05). Conclusion: Lopinavir/ritonavir has no more treatment effects than other therapeutic agents used herein in COVID-19 patients.

The efficacy and safety of Hydroxychloroquine (HCQ) in treating coronavirus disease (COVID-19) is disputed. This systematic review and meta-analysis aimed to examine the efficacy and safety of HCQ in addition to standard of care (SOC) in COVID-19. PubMed, the Cochrane Library, Embase, Web of sciences, and medRxiv were searched up to March 15, 2021. Clinical studies registry databases were also searched for identifying potential clinical trials. The references list of the key studies was reviewed to identify additional relevant resources. The quality of the included studies was evaluated using the Cochrane Collaboration tool and Jadad checklist. Meta-analysis was performed using RevMan software (version 5.3). Eleven randomized controlled trials with a total number of 8161 patients were identified as eligible for meta-analysis. No significant differences were observed between the two treatment groups in terms of negative rate of polymerase chain reaction (PCR) (Risk ratio [RR]: 0.99, 95% confidence interval (CI) 0.90, 1.08; P = 0.76), PCR negative conversion time (Mean difference [MD]: − 1.06, 95% CI − 3.10, 0.97; P = 0.30), all-cause mortality (RR: 1.09, 95% CI 1.00, 1.20; P = 0.06), body temperature recovery time (MD: − 0.64, 95% CI − 1.37, 0.10; P = 0.09), length of hospital stay (MD: − 0.17, 95% CI − 0.80, 0.46; P = 0.59), use of mechanical ventilation (RR: 1.12, 95% CI 0.95, 1.32; P = 0.19), and disease progression (RR = 0.82, 95% CI 0.37, 1.85; P = 0.64). However, there was a significant difference between two groups regarding adverse events (RR: 1.81, 95% CI 1.36, 2.42; P < 0.05). The findings suggest that the addition of HCQ to SOC has no benefit in the treatment of hospitalized patients with COVID-19. Additionally, it is associated with more adverse events.