School of Medicine, Koç University, Istanbul, Turkey.
Koç University İşBank Center for Infectious Diseases (KUISCID), Istanbul, Turkey.
Eur J Clin Microbiol Infect Dis. 2021 Dec;40(12):2575-2583. doi: 10.1007/s10096-021-04307-1. Epub 2021 Aug 4.
We performed a systematic review and meta-analysis for the effectiveness of Favipiravir on the fatality and the requirement of mechanical ventilation for the treatment of moderate to severe COVID-19 patients. We searched available literature and reported it by using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Until June 1, 2021, we searched PubMed, bioRxiv, medRxiv, ClinicalTrials.gov, Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar by using the keywords "Favipiravir" and terms synonymous with COVID-19. Studies for Favipiravir treatment compared to standard of care among moderate and severe COVID-19 patients were included. Risk of bias assessment was performed using Revised Cochrane risk of bias tool for randomized trials (RoB 2) and ROBINS-I assessment tool for non-randomized studies. We defined the outcome measures as fatality and requirement for mechanical ventilation. A total of 2702 studies were identified and 12 clinical trials with 1636 patients were analyzed. Nine out of 12 studies were randomized controlled trials. Among the randomized studies, one study has low risk of bias, six studies have moderate risk of bias, and 2 studies have high risk of bias. Observational studies were identified as having moderate risk of bias and non-randomized study was found to have serious risk of bias. Our meta-analysis did not reveal any significant difference between the intervention and the comparator on fatality rate (OR 1.11, 95% CI 0.64-1.94) and mechanical ventilation requirement (OR 0.50, 95% CI 0.13-1.95). There is no significant difference in fatality rate and mechanical ventilation requirement between Favipiravir treatment and the standard of care in moderate and severe COVID-19 patients.
我们进行了一项系统评价和荟萃分析，以评估法匹拉韦在治疗中重度 COVID-19 患者中的疗效和对机械通气的需求。我们搜索了现有文献，并按照 PRISMA（系统评价和荟萃分析的首选报告项目）指南进行了报告。截至 2021 年 6 月 1 日，我们使用关键词“Favipiravir”和 COVID-19 的同义词，在 PubMed、bioRxiv、medRxiv、ClinicalTrials.gov、Cochrane 对照试验中心注册库（CENTRAL）和 Google Scholar 中进行了搜索。纳入了比较法匹拉韦治疗与标准治疗中重度 COVID-19 患者的研究。使用修订后的 Cochrane 随机试验偏倚风险工具（RoB 2）和非随机研究的 ROBINS-I 评估工具对偏倚风险进行了评估。我们将结局指标定义为死亡率和机械通气需求。共确定了 2702 项研究，分析了 12 项临床试验共 1636 例患者。其中 9 项研究为随机对照试验。在随机研究中，有 1 项研究的偏倚风险较低，6 项研究的偏倚风险为中度，2 项研究的偏倚风险较高。观察性研究被认为具有中度偏倚风险，非随机研究被认为具有严重偏倚风险。我们的荟萃分析并未显示干预组与对照组在死亡率（OR 1.11，95%CI 0.64-1.94）和机械通气需求（OR 0.50，95%CI 0.13-1.95）方面有显著差异。在中重度 COVID-19 患者中，法匹拉韦治疗与标准治疗在死亡率和机械通气需求方面没有显著差异。
