Clinical outcomes of sofosbuvir-based antivirals in patients with COVID-19: a systematic review and meta-analysis of randomized trials.

2021 
Background Few randomized trials have evaluated the effect of combination therapy of Sofosbuvir-based direct-acting antivirals on mortality risk in patients with COVID-19. Methods A systematic literature search with no language restriction was performed in electronic databases and preprint repositories to identify eligible randomized trials published up to July 8, 2021. A random-effects model was used to estimate the pooled odds ratio (OR) for outcomes of interest using sofosbuvir combined with direct-acting antiviral agents relative to non-use of sofosbuvir-based direct-acting antiviral agents at 95% confidence intervals (CI). Results The meta-analysis revealed statistically significant reduction in the odds of mortality (pooled odds ratio = 0.59; 95% confidence interval 0.36 to 0.99) but no statistically significant difference in the odds of development of composite endpoint of severe illness (pooled odds ratio = 0.79; 95% confidence interval 0.43 to 1.44), with the administration of a combination of sofosbuvir-based direct-acting antiviral agents among patients with COVID-19, relative to non-administration of sofosbuvir-based direct-acting antiviral agents. Conclusion The sofosbuvir-based direct-acting antiviral agents have no protective effects against the development of severe illness in patients with COVID-19 with the current dosing regimen. Whether sofosbuvir-based direct-acting antiviral agents could offer mortality benefits would require further investigations.
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