COVID-19 continues to pose a significant threat to public health worldwide. The purpose of this study by Vegivinti, et al. (2022) was to review current evidence obtained from randomized clinical trials on the efficacy of antivirals for COVID-19 treatment.

A systematic literature search was performed using PubMed to identify randomized controlled trials published up to Sept. 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.

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.

Although select antivirals have exhibited efficacy to improve clinical outcomes in COVID-19 patients, none demonstrated efficacy in reducing mortality, the researchers say, adding that larger RCTs are needed to conclusively establish efficacy.

Reference: Vegivinti CTR, et al. Efficacy of antiviral therapies for COVID-19: a systematic review of randomized controlled trials. BMC Infectious Diseases. Vol. 22, article number 107. (2022).