Efficiency of antiviral drugs
| Type of antiviral drugs | Antiviral drugs | Dosage | Duration (day) | Outcomes | References |
|---|---|---|---|---|---|
| Polymerase inhibitors | Remdesivir | 200 mg intravenously on day 1, plus 100 mg daily for the following 9 days | 10 | Significantly reduced the need for oxygen supportAdverse effects: increased hepatic enzymes, diarrhea, rash, renal impairment, and hypotension; multiple organ-dysfunction syndrome, septic shock, and acute kidney injury | [29] |
| 200 mg on day 1, followed by 100 mg daily | 5 or 10 | Improved clinical symptoms, over half cases were recovery clinically and over half cases were dischargedAdverse effects: nausea and acute respiratory failure | [30] | ||
| 200 mg on day 1 followed by 100 mg on days 2–10 in single daily infusions | 10 | No benefit in reducing the duration time of clinical symptoms and viral load, decreasing mortality, and decreasing the incidence of adverse eventsAdverse effects: gastrointestinal symptoms (anorexia, nausea, and vomiting), aminotransferase or bilirubin increases, and worsened cardiopulmonary status | [31] | ||
| Molnupiravir | 800 mg twice daily | 5 | The risk of hospitalization or death in the placebo group was 9.7% (68/699), and the risk of hospitalization or death in the molnupiravir group was reduced to 6.8 % (48/709) | NCT04405739 | |
| 200 mg, 400 mg, or 800 mg, twice daily | 5 | 7.3% of patients (28/385) on molnupiravir as compared to 14.1% of patients on placebo (53/377) had either been admitted to the hospital or died, and no death was reported in the molnupiravir group as compared to 8 deaths in the placebo group on day 29Adverse effects: headache, insomnia, and increased levels of alanine aminotransferase (ALT) were the only adverse events reported by more than 4 participants, and 5% and 8.1% of molnupiravir and placebo groups, respectively showed grade 3 level of adverse events | NCT04575597 | ||
| Ribavirin | 500 mg/time for adults, 2 to 3 intravenous infusions per day | < 10 | Contraindications and precautions: patients with cardiac diseases are forbidden treating with this drug; pay attention to the adverse effects and drug-drug interactions during treating with this drug | [54] | |
| 400 mg every 12 h | 14 | Accelerated the negative conversion time for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) significantly | [55] | ||
| 600 mg, twice daily | 14 | No benefit for reducing the number of ICU admissions and the number of deaths, increased the cumulative incidence od recovery significantly | [56] | ||
| 500 mg every 12 h | - | No benefit for reducing the negative conversion time for SARS-CoV-2 and the mortality of the patients with severe COVID-19 | [57] | ||
| 600 mg every 12 h | 9 | One-third mortality of severe COVID-19Adverse effects: anemia, gastrointestinal disorders, liver enzymes increased, and sepsis | [58] | ||
| Sofosbuvir/daclatasvir | 400/60 mg daily | 14 | Clinical recovery within 14 days was achieved by 29/33 (88%) in the treatment arm and 22/33 (67%) in the control arm (P = 0.076). The treatment arm had a significantly shorter median duration of hospitalization (6 days [Interquartile Range (IQR) 4–8]) than the control group [8 days (IQR 5–13)]; P = 0.029. The cumulative incidence of hospital discharge was significantly higher in the treatment arm versus the control (Gray’s P = 0.041). Three patients died in the treatment arm and five in the control arm. No serious adverse events were reported | [56] | |
| 400/60 mg daily with ribavirin 60 mg twice daily | 14 | The median duration of hospital stay for all patients was 5 days for the treatment arm and 9 days for the control arm. The need to admit patients to the ICU was lower in the treatment arm (17%) than the control arm (48%). The relative risk of ICU admission for the treatment arm versus the control arm was 0.36 [95% confidence interval (CI) 0.16–0.81, P = 0.014]. The median duration for ICU stay was 3.5 days for the treatment arm and 5 days for the control arm | [58] | ||
| Protease inhibitors | PF-07321332 | 300 mg with ritonavir 100 mg every 12 h | 5 | The interim analysis showed an 89% reduction in risk of COVID-19-related hospitalization or death from any cause compared to placebo in patients treated within three days of symptom onset | [66] |
| Lopinavir/ritonavir (LPV/r) | 400/100 mg | 10 | Improved clinical symptoms, decreased the need for oxygen support, improved pneumonia | [73] | |
| 400/100 mg, twice daily, or 800/200 mg daily | 10 | Shorter the duration time of fever and virus nucleic acid turned negative, decreased the denormalized rate of white blood cells, lymphocytes, C-reactive protein (CRP), and platelets | [74] | ||
| 400/100 mg, twice daily | 5–10 | Accelerated time of virus nucleic acid turned negative significantly, improved cheat computed tomography (CT) manifestations significantly, reduced the exacerbation rate, decreased the incidence of adverse events significantlyAdverse effects: elevated transaminase, elevated bilirubin, nausea, vomiting, abdominal pain, diarrhea, rash, etc. | [75] | ||
| 400/100 mg, twice daily | 10 | Reduced viral loads, improved clinical symptoms | [76] | ||
| Darunavir | Darunavir/cobicistat: 800/150 mg daily | - | Reduced mortality significantly, increased the rate of cases discharged from ICU significantly, reduced the incidence of acute respiratory distress syndrome (ARDS) significantly | [78] | |
| 10 | SARS-CoV-2 nucleic acid test showed still maintained positive, chest X-ray showed pneumonia still existed, no benefit for improving the clinical symptoms of COVID-19 | [79] | |||
| Darunavir/ritonavir: 800/100 mg daily | 5–10 | Adverse effects: liver enzyme elevations and mild diarrhea | [80] | ||
| Type I interferons (IFNs) | Type I IFNs | 3 million IU/time, qod | Until two consecutive viral detections turned negative | The combination treatment shortened the average duration time of hospitalization significantly, accelerated the time of viral shedding of the upper respiratory tract | [86] |
-: no accurate datum