Efficacy and safety of azvudine in patients with COVID-19: A systematic review and meta-analysis

INTRODUCTION: Azivudine has undergone a few randomized controlled trials (RCTs) as of late. This study aimed to assess the COVID-19 treatment with azvudine's efficacy and safety. METHODS: Through January 20, 2023, systematic searches of PubMed, Embase, ClinicalTrials.gov, International Clinical Trials Registry Platform (ICTRP), Cochrane Central Register of Controlled Trials (CENTRAL), and MedRxiv were conducted to find the RCTs. The included studies' bias risk was evaluated using the Cochrane Handbook for Systematic Reviews of Interventions. Meta-analysis was performed using Revman 5.4 (PROSPERO Code: CRD42023395022). RESULTS: A total of five RCTs with 1142 COVID-19 patients, 575 of whom received azvudine, were included. Additionally, seven RCTs are currently being conducted. In terms of clinical improvement and PT-PCR (reverse transcription polymerase chain reaction) negativity, the azvudine group had a greater patient percentage than the usual treatment or placebo group. It also took less time for the PT-PCR to become negative. In comparison to the placebo or standard treatment groups, the frequency of adverse events was reduced in the azvudine group (risk ratio [RR] = 0.89, 95% confidence interval [CI]: 0.80 to 0.99) and major adverse events (RR = 0.63, 95% CI: 0.22 to 1.79) groups. CONCLUSIONS: Without the burden of side effects, azvudine can hasten the clinical symptoms of COVID-19 patients and PT-PCR negative. It will take more extensive research to confirm these conclusions.