According to a meta-analysis published in "Annals of Medicine", oral antiviral agents such as molnupiravir, fluvoxamine and paxlovid have a good overall safety profile and lead to a significant decrease in mortality and hospitalization rates in COVID-19 patients. Wen Wen et al. aimed to comprehensively assess the safety and effectiveness of the three novel oral antivirals for COVID-19 management.

Medical and scientific databases including Web of Science, Cochrane Library, Embase and PubMed were searched to find relevant articles on COVID-19. Notably, 8 studies were incorporated. The drug group and the control group included 2440 (including 54 people who died or were hospitalized) and 2348 (including 118 people who died or were hospitalized) COVID-19 patients respectively.

For statistical analysis, review manager version 5.2 software was utilized. For the calculation of the number of hospitalizations, deaths and incidence of adverse effects, a binary controlled study was used. The overall odds ratio (OR) of death or hospital admission for SARS-CoV-2 infected people in the drug versus placebo arm was 0.33. This implied that these oral medications effectively lowered mortality or hospitalization by about 67% in infected patients.

For COVID-19 people, the OR of death in the drug vs placebo group was 0.41, depicting a 56% reduction in mortality. The OR of hospital admission was 0.20, depicting an 80% decrease in the hospital admission rate. All three drugs exhibited a good overall safety profile without any increase in the incidence of adverse events. To sum up, molnupiravir, fluvoxamine and paxlovid exhibit good therapeutic effects and have the potential to be a breakthrough and promising treatment for coronavirus disease.