Evidence map›Paper›PMID 35470021›Full record

SynthesisInternational journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases2022

The efficacy and adverse effects of favipiravir on patients with COVID-19: A systematic review and meta-analysis of published clinical trials and observational studies.

Dang The Hung, Suhaib Ghula, Jeza Muhamad Abdul Aziz, Abdelrahman M Makram, Gehad Mohamed Tawfik, Ali Ahmed-Fouad Abozaid, Rohan Andrew Pancharatnam, Amr Mohamed Ibrahim, Muhammad Besher Shabouk, Morgan Turnage and 13 more

Open access · goldAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 2 pooled it
5.8field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 58 citations in OpenAlex.

  1. Favipiravir for treating COVID-19.The Cochrane database of systematic reviews · 2024
    Pooled it
  2. Pooled it
  3. Trial
  4. Multicenter, single-blind, randomized controlled study of the efficacy and safety of favipiravir and nafamostat mesilate in patients with COVID-19 pneumonia.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2023
    Trial
  5. Article
  6. Antivirals in COVID-19: A Focus on Pediatric Cardiac Patients.The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2025
    Review
  7. Review
  8. Article
  9. Review
  10. Article
  11. Article
  12. Article
  13. Review
  14. Review
  15. Article
  16. Review
  17. Favipiravir for symptomatic COVID-19: A nationwide observational cohort study.Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy · 2023
    Observational
  18. Article
  19. COVID-19 Therapeutics: Use, Mechanism of Action, and Toxicity (Xenobiotics).Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2023
    Review
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors at 17 institutions in 9 countries.

Dang The HungFaculty of Medicine, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam; Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan. Electronic address: dthung.y17@gmail.com.
Suhaib GhulaOnline Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; School of Medicine, The University of Buckingham, Buckingham, UK. Electronic address: suhaib.ghula@gmail.com.
Jeza Muhamad Abdul AzizOnline Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; Department of Medical Laboratory Science, College Health Science, University of Human Development, Sulaimani, Iraq; Baxshin Research centre, Baxshin Hospital, Sulaimani, Kurdistan, Iraq. Electronic address: jeza1981@gmail.com.
Abdelrahman M MakramOnline Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; School of Public Health, Imperial College London, London, United Kingdom; Faculty of Medicine, October 6 University, Giza, Egypt. Electronic address: abd-makram@hotmail.com.
Gehad Mohamed TawfikOnline Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; Department of Otorhinolaryngology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. Electronic address: dr.gehadmohamed@hotmail.com.
Ali Ahmed-Fouad AbozaidOnline Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; Faculty of Medicine, Ain Shams University, Cairo, Egypt. Electronic address: aliahmedfouad@gmail.com.
Rohan Andrew PancharatnamOnline Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; School of Medicine, The University of Buckingham, Buckingham, UK. Electronic address: ropanch@live.com.
Amr Mohamed IbrahimOnline Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; Faculty of Medicine, South Valley University, Qena, Egypt. Electronic address: amrxzeid@gmail.com.
Muhammad Besher ShaboukOnline Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; Faculty of Medicine, University of Aleppo, Aleppo, Syria. Electronic address: mu.besher_shabouk@outlook.com.
Morgan TurnageOnline Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; Einstein Medical Center Montgomery, East Norriton, Pennsylvania, USA; American University of the Caribbean, School of Medicine, Cupecoy, Sint Maarten. Electronic address: msturnage1@gmail.com.
Saloni NakhareOnline Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; School of Medicine, The University of Buckingham, Buckingham, UK. Electronic address: nakharesaloni@gmail.com.
Zahra KarmallyOnline Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; School of Medicine, The University of Buckingham, Buckingham, UK. Electronic address: zahra.karmally@gmail.com.
Basel KouzOnline Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; Faculty of Medicine, Damascus University, Damascus, Damascus Governorate, Syria. Electronic address: baselkouz@hotmail.com.
Tran Nhat LeOnline Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; Faculty of Medicine, Hue University of Medicine and Pharmacy, Hue, Vietnam. Electronic address: nhatle.dhy@gmail.com.
Suleiman AlhijazeenOnline Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; Graduate of Faculty of Medicine, Mutah University, Karak, Jordan. Electronic address: suliemanhijazeen05@gmail.com.
Nguyen Quoc PhuongOnline Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; Faculty of Biology - Biotechnology, University of Science, Vietnam National University, Ho Chi Minh city, Vietnam. Electronic address: nguyenquocphuongkot@gmail.com.
Alaa Mohamed AdsOnline Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; Faculty of Medicine, Tanta University, Tanta, Egypt. Electronic address: alaamohamedads@gmail.com.
Ali Hussein AbdelaalOnline Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; Faculty of Medicine, Aswan University, Aswan, Egypt. Electronic address: ali170421@aswu.edu.eg.
Nguyen Hai NamOnline Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Harvard Medical School, Global Clinical Scholars Research Training Program, Boston, Massachusetts, United States of America. Electronic address: nguyenhainam@kuhp.kyoto-u.ac.jp.
Tatsuo IiyamaDepartment of International Trials, Center of Clinical Sciences, National Center for Global Health and Medicine (NCGM), Tokyo, Japan. Electronic address: tiiyama@hosp.ncgm.go.jp.
Kyoshi KitaDepartment of International Trials, Center of Clinical Sciences, National Center for Global Health and Medicine (NCGM), Tokyo, Japan. Electronic address: kitak@nagasaki-u.ac.jp.
Kenji HirayamaSchool of Tropical Medicine and Global Health, Nagasaki University, Nagasaki 852-8523, Japan. Electronic address: hiraken@nagasaki-u.ac.jp.
Nguyen Tien HuySchool of Tropical Medicine and Global Health, Nagasaki University, Nagasaki 852-8523, Japan. Electronic address: tienhuy@nagasaki-u.ac.jp.
University of Buckingham · GBAin Shams University · EGNagasaki University · JPNational Center for Global Health and Medicine · JPAswan University · EGDamascus University · SYEinstein Medical Center Montgomery · USHarvard University · USHue University · VNMutah University · JOOctober 6 University · EGSouth Valley University · EGTanta University · EGUniversity of Aleppo · SYUniversity of Human Development · IQUniversity of Medicine and Pharmacy at Ho Chi Minh City · VNVietnam National University Ho Chi Minh City · VN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThis study aimed to evaluate the efficacy and adverse events of favipiravir in patients with COVID-19.

methodsOur protocol was registered on PROSPERO (CRD42020206305). Fourteen databases were searched until February 8

resultsOverall, 157 studies (24 RCTs, 1 non-RCT, 21 observational studies, 2 case series, and 106 case reports) were included. On hospitalized patients, in comparison to standard of care, favipiravir showed a higher rate of viral clearance at day 5 (RR = 1.60, p = 0.02), defervescence at day 3-4 (RR = 1.99, p <0.01), chest radiological improvement (RR = 1.33, p <0.01), hospital discharge at day 10-11 (RR = 1.19, p <0.01), and shorter clinical improvement time (MD = -1.18, p = 0.05). Regarding adverse events, favipiravir groups had higher rates of hyperuricemia (RR = 9.42, p <0.01), increased alanine aminotransferase (RR = 1.35, p <0.01) but lower rates of nausea (RR = 0.42, p <0.01) and vomiting (R R= 0.19, p=0.02). There were no differences regarding mortality (RR=1.19, p=0.32), and increased aspartate aminotransferase (RR = 1.11, p = 0.25). On nonhospitalized patients, no significant differences were reported.

conclusionsAdding favipiravir to the standard of care provides better outcomes for hospitalized patients with COVID-19. Pregnant, lactating women, and patients with a history of hyperuricemia should avoid using favipiravir.

Indexed as

COVID-19 Drug TreatmentDrug-Related Side Effects and Adverse ReactionsHyperuricemiaAmidesFemaleHumansPyrazinesSARS-CoV-2Treatment OutcomeAmidesfavipiravirPyrazinesEfficacy, side effectsFavipiravir, COVID-19, SARS-CoV-2

Identifiers

PMID35470021
PMCPMC9023375
OpenAlexW4226147108

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.