Role of Antiviral Drugs in Management of Mild and Moderate Coronavirus Disease-19: A Systematic Review
Abstract
This study was conducted to determine the objective role of antiviral drugs such as arbidol, lopinavir/ritonavir, and others in improving clinical symptoms, decreasing duration of hospitalization, and decreasing duration of viral shedding in patients with mild and moderate COVID-19 infection. A systematic literature search was carried out on Google Scholar and PubMed databases, using the keywords “COVID-19”, “Antiviral”, “Treatment”, and “Symptomatic” in various combinations. Observational studies, cohort and case control studies, and clinical trials published in English with full-text available were included in the study. Data extraction was carried out from selected studies, and all statistical analysis for the study was carried out using Microsoft Excel. The key outcomes studied were time to negative PCR, duration of clinical stay, time to clinical improvement, and occurrence of adverse events. Seven studies were selected for final review after rigorous selection process. Data of total 4734 participants was analyzed, the majority of which were females (n=2810, 59.3%). The majority of participants had mild disease (n=4197, 88.65%). Average time for negative RT-PCR in the included treatment groups was 13.5 days, whereas the average duration of hospitalization was 14.9 days for the treatment groups. Adverse reactions such as ECG changes, gastrointestinal symptoms, secondary bacterial infections, and hepatic and renal dysfunction were scarcely reported in the included studies. There is no clear benefit in terms of duration of hospitalization and time to negative PCR with the use of various antiviral regimens in mild disease; however, these drugs did play a role in limiting disease progression in the participant population. Pending further evidence, the use of these drugs for the management of COVID-19 is not recommend in patients with mild disease.
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