Antiviral Treatment in COVID-19 Outpatients: A Systematic Review of Randomized Controlled Trials

Background: Most COVID-19 patients have mild or moderate illnesses that can progress to severe illness, leading to hospitalization and/or mortality. The use of antivirals to prevent the progression of COVID-19 in non-hospitalized patients shows conflicting result and efficacy remain unclear. This st...

Full description

Saved in:
Bibliographic Details
Main Authors: David Setyo Budi, Puguh Oktavian, Tri Pudy Asmarawati, Pudji Lestari, Fauziah Ariviani, Raka Ihsanulhaj, Tamara Tsania, Danise Febiola, Naomi Lesmana Putri
Format: Article
Language:English
Published: Interna Publishing 2023-01-01
Series:Acta Medica Indonesiana
Subjects:
Online Access:http://www.actamedindones.org/index.php/ijim/article/view/2136
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849721404596944896
author David Setyo Budi
Puguh Oktavian
Tri Pudy Asmarawati
Pudji Lestari
Fauziah Ariviani
Raka Ihsanulhaj
Tamara Tsania
Danise Febiola
Naomi Lesmana Putri
author_facet David Setyo Budi
Puguh Oktavian
Tri Pudy Asmarawati
Pudji Lestari
Fauziah Ariviani
Raka Ihsanulhaj
Tamara Tsania
Danise Febiola
Naomi Lesmana Putri
author_sort David Setyo Budi
collection DOAJ
description Background: Most COVID-19 patients have mild or moderate illnesses that can progress to severe illness, leading to hospitalization and/or mortality. The use of antivirals to prevent the progression of COVID-19 in non-hospitalized patients shows conflicting result and efficacy remain unclear. This study evaluates the efficacy and safety of antivirals therapy in COVID-19 outpatients. Methods: Search were conducted in Pubmed, ScienceDirect, Cochrane Library, Springer, medRxiv, Journal Storage [JSTOR], and Directory of Open Access Journals [DOAJ] for articles investigating antivirals in COVID-19 outpatients. In addition, clinical and virological outcomes, COVID-19 hospitalization, all caused mortality, and adverse events were assessed. Results: Thirteen studies were included in this review. The consecutive data from these studies suggested that favipiravir is more optimally used in early disease, but improvement in symptoms shows inconsistent results. Meanwhile, molnupiravir shows consistent results, which can reduce hospitalization and mortality risk. In addition, remdesivir and nirmatrelvir-ritonavir have the potential to prevent the progression of COVID-19 in outpatients, but the data provided in this study are very limited. Finally, there is no significant difference in serious and non-serious adverse events, highlighting that antivirals have a good safety profile. Conclusion: This study provides an overview of the role of various antivirals therapy in COVID-19 outpatients. Molnupiravir, remdesivir, and nirmatrelvir-ritonavir have shown potential to prevent the progression of COVID-19 in early disease. However, this review was based on very limited data. Therefore, further clinical trials are needed to confirm this finding.
format Article
id doaj-art-d831c1bc80434050ab3298a3c09b7be7
institution DOAJ
issn 0125-9326
2338-2732
language English
publishDate 2023-01-01
publisher Interna Publishing
record_format Article
series Acta Medica Indonesiana
spelling doaj-art-d831c1bc80434050ab3298a3c09b7be72025-08-20T03:11:40ZengInterna PublishingActa Medica Indonesiana0125-93262338-27322023-01-01544Antiviral Treatment in COVID-19 Outpatients: A Systematic Review of Randomized Controlled TrialsDavid Setyo Budi0Puguh Oktavian1Tri Pudy Asmarawati2Pudji Lestari3Fauziah Ariviani4Raka Ihsanulhaj5Tamara Tsania6Danise Febiola7Naomi Lesmana Putri8Faculty of Medicine Universitas Airlangga, Surabaya, IndonesiaFaculty of Medicine Universitas Airlangga, Surabaya, IndonesiaDepartment of Internal Medicine, Faculty of Medicine Universitas Airlangga - Universitas Airlangga Hospital, Surabaya, Indonesia.Department of Public Health, Faculty of Medicine Universitas Airlangga, Surabaya, IndonesiaFaculty of Medicine Universitas Airlangga, Surabaya, IndonesiaFaculty of Medicine Universitas Airlangga, Surabaya, IndonesiaFaculty of Medicine Universitas Airlangga, Surabaya, IndonesiaFaculty of Medicine Universitas Airlangga, Surabaya, IndonesiaFaculty of Medicine Universitas Airlangga, Surabaya, IndonesiaBackground: Most COVID-19 patients have mild or moderate illnesses that can progress to severe illness, leading to hospitalization and/or mortality. The use of antivirals to prevent the progression of COVID-19 in non-hospitalized patients shows conflicting result and efficacy remain unclear. This study evaluates the efficacy and safety of antivirals therapy in COVID-19 outpatients. Methods: Search were conducted in Pubmed, ScienceDirect, Cochrane Library, Springer, medRxiv, Journal Storage [JSTOR], and Directory of Open Access Journals [DOAJ] for articles investigating antivirals in COVID-19 outpatients. In addition, clinical and virological outcomes, COVID-19 hospitalization, all caused mortality, and adverse events were assessed. Results: Thirteen studies were included in this review. The consecutive data from these studies suggested that favipiravir is more optimally used in early disease, but improvement in symptoms shows inconsistent results. Meanwhile, molnupiravir shows consistent results, which can reduce hospitalization and mortality risk. In addition, remdesivir and nirmatrelvir-ritonavir have the potential to prevent the progression of COVID-19 in outpatients, but the data provided in this study are very limited. Finally, there is no significant difference in serious and non-serious adverse events, highlighting that antivirals have a good safety profile. Conclusion: This study provides an overview of the role of various antivirals therapy in COVID-19 outpatients. Molnupiravir, remdesivir, and nirmatrelvir-ritonavir have shown potential to prevent the progression of COVID-19 in early disease. However, this review was based on very limited data. Therefore, further clinical trials are needed to confirm this finding. http://www.actamedindones.org/index.php/ijim/article/view/2136COVID-19SARS-COV-2antiviraloutpatientssystematic review
spellingShingle David Setyo Budi
Puguh Oktavian
Tri Pudy Asmarawati
Pudji Lestari
Fauziah Ariviani
Raka Ihsanulhaj
Tamara Tsania
Danise Febiola
Naomi Lesmana Putri
Antiviral Treatment in COVID-19 Outpatients: A Systematic Review of Randomized Controlled Trials
Acta Medica Indonesiana
COVID-19
SARS-COV-2
antiviral
outpatients
systematic review
title Antiviral Treatment in COVID-19 Outpatients: A Systematic Review of Randomized Controlled Trials
title_full Antiviral Treatment in COVID-19 Outpatients: A Systematic Review of Randomized Controlled Trials
title_fullStr Antiviral Treatment in COVID-19 Outpatients: A Systematic Review of Randomized Controlled Trials
title_full_unstemmed Antiviral Treatment in COVID-19 Outpatients: A Systematic Review of Randomized Controlled Trials
title_short Antiviral Treatment in COVID-19 Outpatients: A Systematic Review of Randomized Controlled Trials
title_sort antiviral treatment in covid 19 outpatients a systematic review of randomized controlled trials
topic COVID-19
SARS-COV-2
antiviral
outpatients
systematic review
url http://www.actamedindones.org/index.php/ijim/article/view/2136
work_keys_str_mv AT davidsetyobudi antiviraltreatmentincovid19outpatientsasystematicreviewofrandomizedcontrolledtrials
AT puguhoktavian antiviraltreatmentincovid19outpatientsasystematicreviewofrandomizedcontrolledtrials
AT tripudyasmarawati antiviraltreatmentincovid19outpatientsasystematicreviewofrandomizedcontrolledtrials
AT pudjilestari antiviraltreatmentincovid19outpatientsasystematicreviewofrandomizedcontrolledtrials
AT fauziahariviani antiviraltreatmentincovid19outpatientsasystematicreviewofrandomizedcontrolledtrials
AT rakaihsanulhaj antiviraltreatmentincovid19outpatientsasystematicreviewofrandomizedcontrolledtrials
AT tamaratsania antiviraltreatmentincovid19outpatientsasystematicreviewofrandomizedcontrolledtrials
AT danisefebiola antiviraltreatmentincovid19outpatientsasystematicreviewofrandomizedcontrolledtrials
AT naomilesmanaputri antiviraltreatmentincovid19outpatientsasystematicreviewofrandomizedcontrolledtrials