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Meta-Analysis
. 2022 Dec;54(1):516-523.
doi: 10.1080/07853890.2022.2034936.

Efficacy and safety of three new oral antiviral treatment (molnupiravir, fluvoxamine and Paxlovid) for COVID-19：a meta-analysis

Wen Wen  1   2 , Chen Chen  1   2 , Jiake Tang  1   2 , Chunyi Wang  1   2 , Mengyun Zhou  3 , Yongran Cheng  4 , Xiang Zhou  1 , Qi Wu  1 , Xingwei Zhang  1 , Zhanhui Feng  5 , Mingwei Wang  1 , Qin Mao  1
Affiliations
Meta-Analysis

Efficacy and safety of three new oral antiviral treatment (molnupiravir, fluvoxamine and Paxlovid) for COVID-19：a meta-analysis

Wen Wen et al. Ann Med. 2022 Dec.

Abstract

Background: The coronavirus disease (COVID-19) epidemic has not been completely controlled. Although great achievements have been made in COVID-19 research and many antiviral drugs have shown good therapeutic effects against COVID-19, a simple oral antiviral drug for COVID-19 has not yet been developed. We conducted a meta-analysis to investigate the improvement in mortality or hospitalization rates and adverse events among COVID-19 patients with three new oral antivirals (including molnupiravir, fluvoxamine and Paxlovid).

Methods: We searched scientific and medical databases, such as PubMed, Web of Science, Embase and Cochrane Library for relevant articles and screened the references of retrieved studies on COVID-19.

Results: A total of eight studies were included in this study. The drug group included 2440 COVID-19 patients, including 54 patients who died or were hospitalized. The control group included a total of 2348 COVID-19 patients, including 118 patients who died or were hospitalized. The overall odds ratio (OR) of mortality or hospitalization was 0.33 (95% confidence interval [CI], 0.22-0.49) for COVID-19 patients in the drug group and placebo group, indicating that oral antiviral drugs were effective for COVID-19 patients and reduced the mortality or hospitalization by approximately 67%.

Conclusions: This study showed that three novel oral antivirals (molnupiravir, fluvoxamine and Paxlovid) are effective in reducing the mortality and hospitalization rates in patients with COVID-19. In addition, the three oral drugs did not increase the occurrence of adverse events, thus exhibiting good overall safety. These three oral antiviral drugs are still being studied, and the available data suggest that they will bring new hope for COVID-19 recovery and have the potential to be a breakthrough and very promising treatment for COVID-19.KEY MESSAGESMany antiviral drugs have shown good therapeutic effects, and there is no simple oral antiviral drug for COVID-19 patients.Meta-analysis was conducted for three new oral antivirals to evaluate the improvement in mortality or hospitalization rates and adverse events among COVID-19 patients.We focussed on three new oral Coronavirus agents (molnupiravir, fluvoxamine and Paxlovid) and hope to provide guidance for the roll-out of oral antivirals.

Keywords: COVID-19; Paxlovid™; fluvoxamine; molnupiravir.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Study screening flow chart.
Figure 2.
Figure 2.
Analysis of overall death or hospitalization rates between the oral antiviral group and the placebo group.
Figure 3.
Figure 3.
Subgroup analysis: impact of oral antiviral drugs on mortality and hospitalization rates of COVID-19 patients.
Figure 4.
Figure 4.
Subgroup analysis: impact of different oral antiviral drugs on mortality or hospitalization rate of COVID-19 patients.
Figure 5.
Figure 5.
Incidence of adverse events in drug group and placebo group.
See this image and copyright information in PMC

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