Gil Martínez Victoria, Avedillo Salas Ana, Santander Ballestín Sonia
Department of Pharmacology, Physiology and Legal and Forensic Medicine, Faculty of Medicine, University of Zaragoza, 50009 Zaragoza, Spain.
Pharmaceuticals (Basel). 2021 Jul 28;14(8):736. doi: 10.3390/ph14080736.
Due to the lack of an etiologic treatment for SARS-CoV-2 and the difficulties involved in developing new drugs, some drugs already approved for other diseases or with efficacy against SARS and MERS, have been used in patients with COVID-19. This systematic review aims to summarize evidence on the efficacy and safety of five antivirals applied to patients with COVID-19, that have proven to be effective either in vitro studies or in studies on SARS-CoV and MERS.; An intensive search of different databases (Pub Med, WoS, MEDLINE and Cochrane COVID-19 Study Register) has been carried out until the end of April 2021. This systematic review has been conducted according to the PRISMA statement. From each of the included studies, the characteristics of the intervention and comparison groups, demographic data and results were extracted independently; Remdesivir is well tolerated and helps to accelerate clinical improvement but is ineffective in reducing mortality. Favipiravir is safe and shows promising results regarding symptom resolution but does not improve viral clearance. The use of lopinavir/ritonavir has been associated with an increased risk of gastrointestinal adverse events and it has not proven to be effective. No significant differences were observed between patients treated with ribavirin or umifenovir and their respective control groups; Remdesivir and favipiravir are well tolerated and effective in accelerating clinical improvement. This systematic review does not support the use of lopinavir/ritonavir, ribavirin and umifenovir in hospitalized patients with COVID-19.
由于缺乏针对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的病因治疗方法以及开发新药存在困难，一些已被批准用于其他疾病或对SARS和中东呼吸综合征（MERS）有效的药物已用于2019冠状病毒病（COVID-19）患者。本系统评价旨在总结五种抗病毒药物应用于COVID-19患者的疗效和安全性证据，这些药物已在体外研究或针对SARS-CoV和MERS的研究中证明有效。；截至2021年4月底，对不同数据库（PubMed、WoS、MEDLINE和Cochrane COVID-19研究注册库）进行了全面检索。本系统评价是根据系统评价和Meta分析的首选报告项目（PRISMA）声明进行的。从每项纳入研究中，独立提取干预组和对照组的特征、人口统计学数据和结果；瑞德西韦耐受性良好，有助于加速临床改善，但在降低死亡率方面无效。法匹拉韦安全，在症状缓解方面显示出有希望的结果，但不能改善病毒清除率。洛匹那韦/利托那韦的使用与胃肠道不良事件风险增加有关，且尚未证明有效。在接受利巴韦林或乌米芬ovir治疗的患者与其各自的对照组之间未观察到显著差异；瑞德西韦和法匹拉韦耐受性良好，在加速临床改善方面有效。本系统评价不支持在住院COVID-19患者中使用洛匹那韦/利托那韦、利巴韦林和乌米芬ovir。
