Background The COVID-19 causing coronavirus is an enveloped RNA virus that utilizes an enzyme RNA dependent RNA polymerase for its replication. Favipiravir (FVP) triphosphate, a purine nucleoside analog, inhibits that enzyme. We have conducted this systematic review and meta-analysis on efficacy and safety of the drug FVP as a treatment for COVID-19. Methods Databases like Pubmed, Pubmed Central, Scopus, Embase, Google Scholar, preprint sites, and clinicaltirals.gov were searched. The studies with the standard of care (SOC) and FVP as a treatment drug were considered as the treatment group and the SOC with other antivirals and supportive care as the control group. Quantitative synthesis was done using RevMan 5.4. Clinical improvement, negative conversion of reverse transcription-polymerase chain reaction (RT-PCR), adverse effects, and oxygen requirements were studied. Results We identified a total of 1798 studies after searching the electronic databases. Nine in the qualitative studies and four studies in the quantitative synthesis met the criteria. There was a significant clinical improvement in the FVP group on the 14th day compared to the control group (RR 1.29, 1.08–1.54). Clinical deterioration rates were less likely in the FVP group though statistically not significant (OR 0.59, 95% CI 0.30–1.14) at the endpoint of study (7–15 days). The meta-analysis showed no significant differences between the two groups on viral clearance (day 14: RR 1.06, 95% CI 0.84–1.33), non-invasive ventilation or oxygen requirement (OR 0.76, 95% CI 0.42–1.39), and adverse effects (OR 0.69, 0.13–3.57). There are 31 randomized controlled trials (RCTs) registered in different parts of the world focusing FVP for COVID-19 treatment. Conclusion There is a significant clinical and radiological improvement following treatment with FVP in comparison to the standard of care with no significant differences on viral clearance, oxygen support requirement and side effect profiles.
【저자키워드】 COVID-19, COVID-19 drug treatment, Favipiravir, severe acute respiratory syndrome coronavirus-2, Antiviral agents, 【초록키워드】 Randomized controlled trial, Treatment, Meta-analysis, coronavirus, Antiviral, systematic review, RT-PCR, database, viral clearance, RNA, Replication, adverse effects, Deterioration, clinical, Clinical improvement, non-invasive ventilation, Efficacy and safety, RNA polymerase, RNA virus, RCTs, supportive care, criteria, Google Scholar, Standard of care, adverse effect, Side effect, not significant, Endpoint, control group, 95% CI, no significant difference, Negative conversion, radiological improvement, enzyme, profiles, Registered, treatment group, purine, oxygen support, Oxygen requirement, quantitative synthesis, Result, inhibit, conducted, less, searched, two group, statistically, was done, FVP, treatment for COVID-19, 【제목키워드】 Meta-analysis, Antiviral, systematic review, Standard of care,