The efficacy and safety of Favipiravir in treatment of COVID-19: a systematic review and meta-analysis of clinical trials

Abstract 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 Favi...

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Autores principales:	Soheil Hassanipour, Morteza Arab-Zozani, Bahman Amani, Forough Heidarzad, Mohammad Fathalipour, Rudolph Martinez-de-Hoyo
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/1c848e5c102c42d3ac75d1b6a3f145a3
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spelling	oai:doaj.org-article:1c848e5c102c42d3ac75d1b6a3f145a32021-12-02T15:49:50ZThe efficacy and safety of Favipiravir in treatment of COVID-19: a systematic review and meta-analysis of clinical trials10.1038/s41598-021-90551-62045-2322https://doaj.org/article/1c848e5c102c42d3ac75d1b6a3f145a32021-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-90551-6https://doaj.org/toc/2045-2322Abstract 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.Soheil HassanipourMorteza Arab-ZozaniBahman AmaniForough HeidarzadMohammad FathalipourRudolph Martinez-de-HoyoNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Soheil Hassanipour Morteza Arab-Zozani Bahman Amani Forough Heidarzad Mohammad Fathalipour Rudolph Martinez-de-Hoyo The efficacy and safety of Favipiravir in treatment of COVID-19: a systematic review and meta-analysis of clinical trials
description	Abstract 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.
format	article
author	Soheil Hassanipour Morteza Arab-Zozani Bahman Amani Forough Heidarzad Mohammad Fathalipour Rudolph Martinez-de-Hoyo
author_facet	Soheil Hassanipour Morteza Arab-Zozani Bahman Amani Forough Heidarzad Mohammad Fathalipour Rudolph Martinez-de-Hoyo
author_sort	Soheil Hassanipour
title	The efficacy and safety of Favipiravir in treatment of COVID-19: a systematic review and meta-analysis of clinical trials
title_short	The efficacy and safety of Favipiravir in treatment of COVID-19: a systematic review and meta-analysis of clinical trials
title_full	The efficacy and safety of Favipiravir in treatment of COVID-19: a systematic review and meta-analysis of clinical trials
title_fullStr	The efficacy and safety of Favipiravir in treatment of COVID-19: a systematic review and meta-analysis of clinical trials
title_full_unstemmed	The efficacy and safety of Favipiravir in treatment of COVID-19: a systematic review and meta-analysis of clinical trials
title_sort	efficacy and safety of favipiravir in treatment of covid-19: a systematic review and meta-analysis of clinical trials
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/1c848e5c102c42d3ac75d1b6a3f145a3
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The efficacy and safety of Favipiravir in treatment of COVID-19: a systematic review and meta-analysis of clinical trials

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