Background Coronavirus disease 2019 (COVID-19) continues to pose a significant threat to public health worldwide. The purpose of this study was to review current evidence obtained from randomized clinical trials on the efficacy of antivirals for COVID-19 treatment. Methods A systematic literature search was performed using PubMed to identify randomized controlled trials published up to September 4, 2021 that examined the efficacy of antivirals for COVID-19 treatment. Studies that were not randomized controlled trials or that did not include treatment of COVID-19 with approved antivirals were excluded. Risk of bias was assessed using the Scottish Intercollegiate Guidelines Network (SIGN) method. Due to study heterogeneity, inferential statistics were not performed and data were expressed as descriptive statistics. Results Of the 2,284 articles retrieved, 31 (12,440 patients) articles were included. Overall, antivirals were more effective when administered early in the disease course. No antiviral treatment demonstrated efficacy at reducing COVID-19 mortality. Sofosbuvir/daclatasvir results suggested clinical improvement, although statistical power was low. Remdesivir exhibited efficacy in reducing time to recovery, but results were inconsistent across trials. Conclusions Although select antivirals have exhibited efficacy to improve clinical outcomes in COVID-19 patients, none demonstrated efficacy in reducing mortality. Larger RCTs are needed to conclusively establish efficacy. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07068-0.
【저자키워드】 COVID-19, Randomized controlled trial, SARS-CoV-2, Antiviral, systematic review, therapeutic, 【초록키워드】 Treatment, coronavirus disease, public health, randomized clinical trial, Coronavirus disease 2019, Efficacy, Randomized controlled trials, Remdesivir, Antiviral treatment, sofosbuvir, guideline, heterogeneity, RCT, clinical outcomes, COVID-19 treatment, controlled trials, Clinical improvement, Statistical power, network, Time to recovery, randomized clinical trials, patients, trials, COVID-19 patients, Evidence, COVID-19 mortality, daclatasvir, inferential statistics, not performed, supplementary material, Descriptive statistics, disease course, reducing mortality, study heterogeneity, article, systematic literature search, sofosbuvir/daclatasvir, Administered, effective, Course, Result, identify, performed, examined, include, the disease, approved, was performed, exhibited, reducing, demonstrated, suggested, were expressed, improve clinical outcome, retrieved, Scottish, were excluded, 【제목키워드】 antiviral therapy,