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40 favipiravir COVID-19 controlled studies, 22 RCTs
https://c19favipiravir.com/meta.html
0
0.5
1
1.5+
All studies 23% 40
17,123
Improvement, Studies, Patients Relative Risk Mortality 8% 21
13,597
Ventilation 14% 6
9,313
ICU admission -28% 14
2,986
Hospitalization 1% 10
1,495
Progression 47% 5
8,239
Recovery 16% 17
3,566
Viral clearance 30% 19
3,921
RCTs 22% 22
3,431
Peer-reviewed 27% 35
15,522
Early 29% 9
9,302
Late 21% 31
7,821
Favipiravir for COVID-19 c19favipiravir.com May 2022
Favors favipiravir Favors control after exclusions
• Statistically significant improvements are seen for
progression ,
recovery , and
viral clearance . 20 studies from 20 independent teams in 14 different countries show statistically significant
improvements in isolation (10 for the most serious outcome).
0
0.5
1
1.5+
All studies 23% 40
17,123
Improvement, Studies, Patients Relative Risk Mortality 8% 21
13,597
Ventilation 14% 6
9,313
ICU admission -28% 14
2,986
Hospitalization 1% 10
1,495
Progression 47% 5
8,239
Recovery 16% 17
3,566
Viral clearance 30% 19
3,921
RCTs 22% 22
3,431
Peer-reviewed 27% 35
15,522
Early 29% 9
9,302
Late 21% 31
7,821
Favipiravir for COVID-19 c19favipiravir.com May 2022
Favors favipiravir Favors control after exclusions
• Studies to date do not show a significant benefit for mortality.
Potential risks of the mechanism of action include the creation of dangerous variants, and mutagenicity, carcinogenicity, teratogenicity, and embryotoxicity
[Hadj Hassine , Waters , Zhirnov ] .
• While many treatments have some level
of efficacy, they do not replace vaccines and other measures to avoid
infection.
Only 5% of favipiravir
studies show zero events in the treatment arm.
Multiple treatments are typically used
in combination, and
other treatments
are more effective.
• No treatment, vaccine, or intervention is 100%
available and effective for all variants. All practical, effective, and safe
means should be used.
Denying the efficacy of treatments increases mortality, morbidity, collateral
damage, and endemic risk.
• All data to reproduce this paper and
sources are in the
appendix .
Other meta analyses for favipiravir can be found in
[Hung , Lan ] , showing significant improvements for viral clearance, improvement, and hospital discharge.
Highlights
Favipiravir reduces
risk for COVID-19 with very high confidence for
viral clearance and in
pooled analysis , and high confidence for
progression and
recovery , however increased risk is seen with very high confidence for
ICU admission .
Potential risks include the creation of dangerous variants, carcinogenicity, and genotoxicity.
We show traditional outcome specific analyses and combined
evidence from all studies, incorporating treatment delay, a primary
confounding factor in COVID-19 studies.
A
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Ruzhentsova (RCT) 6%
0.94 [0.78-1.14]
hosp.
3/112
2/56
Improvement, RR [CI] Treatment Control Udwadia (RCT) 40%
0.60 [0.38-0.95]
recov. time
75 (n)
75 (n)
Sawanpanyalert 68%
0.32 [0.15-0.66]
progression
n/a
n/a
Holubar (DB RCT) 89%
0.11 [0.01-2.02]
hosp.
0/75
4/74
Alattar (PSM) 33%
0.67 [0.28-1.61]
death
8/387
12/387
Bosaeed (DB RCT) -619%
7.19 [0.38-138]
ICU
3/112
0/119
Lowe (DB RCT) -196%
2.96 [0.12-71.1]
ICU
1/54
0/52
Adhikari (RCT) -40%
1.40 [0.57-3.44]
no improv.
10/38
6/32
Tsuzuki 13%
0.87 [0.52-1.46]
death
2,532 (n)
5,122 (n)
Tau2 = 0.11, I2 = 35.9%, p = 0.092
Early treatment 29%
0.71 [0.48-1.06]
25/3,385
24/5,917
29% improvement Cai 69%
0.31 [0.10-0.96]
pneumonia
35 (n)
45 (n)
Improvement, RR [CI] Treatment Control Ivashchenko (RCT) 46%
0.54 [0.33-0.88]
viral+
15/40
14/20
Lou (RCT) -422%
5.22 [0.28-96.2]
ICU
2/9
0/10
Pushkar (RCT) 14%
0.86 [0.74-0.99]
no recov.
73/100
85/100
Khamis (RCT) 15%
0.85 [0.28-2.59]
death
5/44
6/45
OT1 CT2
Solaymani.. (RCT) -19%
1.19 [0.70-2.04]
death
26/190
21/183
OT1
Zhao (RCT) 59%
0.41 [0.18-0.93]
viral+
7/36
9/19
Aghajani 26%
0.74 [0.43-1.27]
death
40 (n)
951 (n)
Alamer -56%
1.56 [0.73-3.36]
death
12/233
21/223
Almoosa -42%
1.42 [0.90-2.25]
death
33/110
24/116
Shinkai (SB RCT) 37%
0.63 [0.40-0.98]
imp. time
107 (n)
49 (n)
Assiri (ICU) -79%
1.79 [0.33-8.02]
death
11/67
3/51
ICU patients
Kulzhanova 88%
0.12 [0.04-0.37]
no improv.
3/40
25/40
Chen (RCT) -3%
1.03 [0.15-7.22]
ICU
2/116
2/120
OT1
Alotaibi 57%
0.43 [0.18-1.01]
death
244 (n)
193 (n)
OT1
Tabarsi (RCT) 30%
0.70 [0.17-2.88]
death
3/32
4/30
OT1
Atipornwa.. (RCT) 23%
0.77 [0.35-1.67]
death
10/100
13/100
OT1 CT2
Damayanti 54%
0.46 [0.22-0.92]
no recov.
96 (n)
96 (n)
Shenoy (DB RCT) -29%
1.29 [0.60-2.77]
death
14/175
11/178
Chuah (RCT) -1154%
12.54 [0.76-208]
death
5/250
0/250
Finberg (RCT) -200%
3.00 [0.13-70.3]
death
1/25
0/25
Al Mutair (ICU) 7%
0.93 [0.77-1.12]
death
119/269
128/269
ICU patients OT1
Kurniyanto 48%
0.52 [0.22-1.25]
death
10/325
9/152
Cilli 38%
0.62 [0.24-1.63]
death
5/23
8/23
Yulia 85%
0.15 [0.02-1.02]
death
n/a
n/a
Uyaroğlu (PSM) 67%
0.33 [0.01-7.96]
death
0/42
1/42
OT1
AlQahtani (RCT) -196%
2.96 [0.12-71.1]
death
1/54
0/52
Shinada 7%
0.93 [0.45-1.89]
hosp.
17 (n)
17 (n)
Hassaniazad (RCT) 68%
0.32 [0.07-1.48]
death
2/32
6/31
OT1
Hafez -3%
1.03 [0.68-1.56]
viral+
59 (n)
1,446 (n)
CT2
Rahman (DB RCT) 89%
0.11 [0.01-0.75]
no improv.
1/19
8/16
Tau2 = 0.06, I2 = 61.6%, p = 0.0033
Late treatment 21%
0.79 [0.67-0.92]
360/2,929
398/4,892
21% improvement All studies 23%
0.77 [0.66-0.89]
385/6,314
422/10,809
23% improvement 40 favipiravir COVID-19 studies c19favipiravir.com May 2022
Tau2 = 0.06, I2 = 60.1%, p = 0.00053
Effect extraction pre-specified (most serious outcome, see appendix) 1 OT: comparison with other treatment 2 CT: study uses combined treatment Favors favipiravir
Favors control
B
C
Figure 1. A. Random effects
meta-analysis. This plot shows pooled effects, discussion can be found in the heterogeneity section,
and results for specific outcomes can be found in the individual outcome analyses.
Effect extraction is pre-specified, using the most serious outcome reported.
For details of effect extraction see the
appendix .
B. Scatter plot showing the
distribution of effects reported in studies.
C. History of all reported
effects (chronological within treatment stages).
Introduction
We analyze all significant studies
concerning the use of
favipiravir
for COVID-19.
Search methods, inclusion criteria, effect
extraction criteria (more serious outcomes have priority), all individual
study data, PRISMA answers, and statistical methods are detailed in
Appendix 1 . We present random effects meta-analysis results for all
studies, for studies within each treatment stage, for individual outcomes, for
peer-reviewed studies, for Randomized Controlled Trials (RCTs), and after
exclusions.
Figure 2 shows stages of possible treatment for
COVID-19.
Prophylaxis refers to regularly taking medication before
becoming sick, in order to prevent or minimize infection.
Early
Treatment refers to treatment immediately or soon after symptoms appear,
while
Late Treatment refers to more delayed treatment.
Preclinical Research
An
In Vitro study supports the efficacy of favipiravir
[Unal ] .
Preclinical research is an important part of the development of
treatments, however results may be very different in clinical trials.
Preclinical results are not used in this paper.
Results
Figure 3 shows a visual overview of the results, with details in
Table 1 and
Table 2 .
Figure
4 ,
5 ,
6 ,
7 ,
8 ,
9 ,
10 ,
11 , and
12
show forest plots for a random effects meta-analysis of
all studies with pooled effects, mortality results, ventilation, ICU admission, hospitalization, progression, recovery, viral clearance, and peer reviewed studies.
0
0.5
1
1.5+
ALL STUDIES
MORTALITY
VENTILATION
ICU ADMISSION
HOSPITALIZATION
PROGRESSION
RECOVERY
VIRAL CLEARANCE
RCTS
PEER-REVIEWED
After Exclusions
ALL STUDIES
All
Early
Late
Favipiravir for COVID-19
C19FAVIPIRAVIR.COM MAY 2022
Treatment time Number of studies reporting positive effects
Total number of studies Percentage of studies reporting positive effects
Random effects meta-analysis results
Early treatment
6
9
66.7%
29% improvement
Late treatment
20
31
64.5%
21% improvement
All studies
26
40
65.0%
23% improvement
Table 1. Results by treatment stage.
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Ruzhentsova (RCT) 6%
0.94 [0.78-1.14]
hosp.
3/112
2/56
Improvement, RR [CI] Treatment Control Udwadia (RCT) 40%
0.60 [0.38-0.95]
recov. time
75 (n)
75 (n)
Sawanpanyalert 68%
0.32 [0.15-0.66]
progression
n/a
n/a
Holubar (DB RCT) 89%
0.11 [0.01-2.02]
hosp.
0/75
4/74
Alattar (PSM) 33%
0.67 [0.28-1.61]
death
8/387
12/387
Bosaeed (DB RCT) -619%
7.19 [0.38-138]
ICU
3/112
0/119
Lowe (DB RCT) -196%
2.96 [0.12-71.1]
ICU
1/54
0/52
Adhikari (RCT) -40%
1.40 [0.57-3.44]
no improv.
10/38
6/32
Tsuzuki 13%
0.87 [0.52-1.46]
death
2,532 (n)
5,122 (n)
Tau2 = 0.11, I2 = 35.9%, p = 0.092
Early treatment 29%
0.71 [0.48-1.06]
25/3,385
24/5,917
29% improvement Cai 69%
0.31 [0.10-0.96]
pneumonia
35 (n)
45 (n)
Improvement, RR [CI] Treatment Control Ivashchenko (RCT) 46%
0.54 [0.33-0.88]
viral+
15/40
14/20
Lou (RCT) -422%
5.22 [0.28-96.2]
ICU
2/9
0/10
Pushkar (RCT) 14%
0.86 [0.74-0.99]
no recov.
73/100
85/100
Khamis (RCT) 15%
0.85 [0.28-2.59]
death
5/44
6/45
OT1 CT2
Solaymani.. (RCT) -19%
1.19 [0.70-2.04]
death
26/190
21/183
OT1
Zhao (RCT) 59%
0.41 [0.18-0.93]
viral+
7/36
9/19
Aghajani 26%
0.74 [0.43-1.27]
death
40 (n)
951 (n)
Alamer -56%
1.56 [0.73-3.36]
death
12/233
21/223
Almoosa -42%
1.42 [0.90-2.25]
death
33/110
24/116
Shinkai (SB RCT) 37%
0.63 [0.40-0.98]
imp. time
107 (n)
49 (n)
Assiri (ICU) -79%
1.79 [0.33-8.02]
death
11/67
3/51
ICU patients
Kulzhanova 88%
0.12 [0.04-0.37]
no improv.
3/40
25/40
Chen (RCT) -3%
1.03 [0.15-7.22]
ICU
2/116
2/120
OT1
Alotaibi 57%
0.43 [0.18-1.01]
death
244 (n)
193 (n)
OT1
Tabarsi (RCT) 30%
0.70 [0.17-2.88]
death
3/32
4/30
OT1
Atipornwa.. (RCT) 23%
0.77 [0.35-1.67]
death
10/100
13/100
OT1 CT2
Damayanti 54%
0.46 [0.22-0.92]
no recov.
96 (n)
96 (n)
Shenoy (DB RCT) -29%
1.29 [0.60-2.77]
death
14/175
11/178
Chuah (RCT) -1154%
12.54 [0.76-208]
death
5/250
0/250
Finberg (RCT) -200%
3.00 [0.13-70.3]
death
1/25
0/25
Al Mutair (ICU) 7%
0.93 [0.77-1.12]
death
119/269
128/269
ICU patients OT1
Kurniyanto 48%
0.52 [0.22-1.25]
death
10/325
9/152
Cilli 38%
0.62 [0.24-1.63]
death
5/23
8/23
Yulia 85%
0.15 [0.02-1.02]
death
n/a
n/a
Uyaroğlu (PSM) 67%
0.33 [0.01-7.96]
death
0/42
1/42
OT1
AlQahtani (RCT) -196%
2.96 [0.12-71.1]
death
1/54
0/52
Shinada 7%
0.93 [0.45-1.89]
hosp.
17 (n)
17 (n)
Hassaniazad (RCT) 68%
0.32 [0.07-1.48]
death
2/32
6/31
OT1
Hafez -3%
1.03 [0.68-1.56]
viral+
59 (n)
1,446 (n)
CT2
Rahman (DB RCT) 89%
0.11 [0.01-0.75]
no improv.
1/19
8/16
Tau2 = 0.06, I2 = 61.6%, p = 0.0033
Late treatment 21%
0.79 [0.67-0.92]
360/2,929
398/4,892
21% improvement All studies 23%
0.77 [0.66-0.89]
385/6,314
422/10,809
23% improvement 40 favipiravir COVID-19 studies c19favipiravir.com May 2022
Tau2 = 0.06, I2 = 60.1%, p = 0.00053
Effect extraction pre-specified (most serious outcome, see appendix) 1 OT: comparison with other treatment 2 CT: study uses combined treatment Favors favipiravir
Favors control
Figure 4. Random effects meta-analysis for all studies with pooled effects.
This plot shows pooled effects, discussion can be found in the heterogeneity section,
and results for specific outcomes can be found in the individual outcome analyses.
Effect extraction is pre-specified, using the most serious outcome reported.
For details of effect extraction see the
appendix .
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Alattar (PSM) 33%
0.67 [0.28-1.61]
8/387
12/387
Improvement, RR [CI] Treatment Control Tsuzuki 13%
0.87 [0.52-1.46]
2,532 (n)
5,122 (n)
Tau2 = 0.00, I2 = 0.0%, p = 0.36
Early treatment 19%
0.81 [0.53-1.26]
8/2,919
12/5,509
19% improvement Khamis (RCT) 15%
0.85 [0.28-2.59]
5/44
6/45
OT1 CT2
Improvement, RR [CI] Treatment Control Solaymani.. (RCT) -19%
1.19 [0.70-2.04]
26/190
21/183
OT1
Aghajani 26%
0.74 [0.43-1.27]
40 (n)
951 (n)
Alamer -56%
1.56 [0.73-3.36]
12/233
21/223
Almoosa -42%
1.42 [0.90-2.25]
33/110
24/116
Assiri (ICU) -79%
1.79 [0.33-8.02]
11/67
3/51
ICU patients
Alotaibi 57%
0.43 [0.18-1.01]
244 (n)
193 (n)
OT1
Tabarsi (RCT) 30%
0.70 [0.17-2.88]
3/32
4/30
OT1
Atipornwa.. (RCT) 23%
0.77 [0.35-1.67]
10/100
13/100
OT1 CT2
Shenoy (DB RCT) -29%
1.29 [0.60-2.77]
14/175
11/178
Chuah (RCT) -1154%
12.54 [0.76-208]
5/250
0/250
Finberg (RCT) -200%
3.00 [0.13-70.3]
1/25
0/25
Al Mutair (ICU) 7%
0.93 [0.77-1.12]
119/269
128/269
ICU patients OT1
Kurniyanto 48%
0.52 [0.22-1.25]
10/325
9/152
Cilli 38%
0.62 [0.24-1.63]
5/23
8/23
Yulia 85%
0.15 [0.02-1.02]
n/a
n/a
Uyaroğlu (PSM) 67%
0.33 [0.01-7.96]
0/42
1/42
OT1
AlQahtani (RCT) -196%
2.96 [0.12-71.1]
1/54
0/52
Hassaniazad (RCT) 68%
0.32 [0.07-1.48]
2/32
6/31
OT1
Tau2 = 0.05, I2 = 26.9%, p = 0.53
Late treatment 7%
0.93 [0.75-1.16]
257/2,255
255/2,914
7% improvement All studies 8%
0.92 [0.76-1.11]
265/5,174
267/8,423
8% improvement 21 favipiravir COVID-19 mortality results c19favipiravir.com May 2022
Tau2 = 0.03, I2 = 21.0%, p = 0.38
1 OT: comparison with other treatment 2 CT: study uses combined treatment Favors favipiravir
Favors control
Figure 5. Random effects meta-analysis for mortality results.
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Tsuzuki -2%
1.02 [0.65-1.60]
2,532 (n)
5,122 (n)
Improvement, RR [CI] Treatment Control Tau2 = 0.00, I2 = 0.0%, p = 0.93
Early treatment -2%
1.02 [0.65-1.60]
0/2,532
0/5,122
-2% improvement Solaymani.. (RCT) -53%
1.53 [0.86-2.71]
27/190
17/183
OT1
Improvement, RR [CI] Treatment Control Alamer 90%
0.10 [0.04-0.29]
4/218
27/165
Shenoy (DB RCT) -33%
1.33 [0.67-2.66]
17/175
13/178
Chuah (RCT) -20%
1.20 [0.36-3.97]
6/250
5/250
Finberg (RCT) -200%
3.00 [0.13-70.3]
1/25
0/25
Tau2 = 1.02, I2 = 82.2%, p = 0.72
Late treatment 18%
0.82 [0.29-2.32]
55/858
62/801
18% improvement All studies 14%
0.86 [0.43-1.73]
55/3,390
62/5,923
14% improvement 6 favipiravir COVID-19 mechanical ventilation results c19favipiravir.com May 2022
Tau2 = 0.50, I2 = 77.8%, p = 0.69
1 OT: comparison with other treatment Favors favipiravir
Favors control
Figure 6. Random effects meta-analysis for ventilation.
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Bosaeed (DB RCT) -619%
7.19 [0.38-138]
3/112
0/119
Improvement, RR [CI] Treatment Control Lowe (DB RCT) -196%
2.96 [0.12-71.1]
1/54
0/52
Tau2 = 0.00, I2 = 0.0%, p = 0.16
Early treatment -377%
4.77 [0.55-41.5]
4/166
0/171
-377% improvement Lou (RCT) -422%
5.22 [0.28-96.2]
2/9
0/10
Improvement, RR [CI] Treatment Control Khamis (RCT) -2%
1.02 [0.42-2.48]
8/44
8/45
OT1 CT2
Solaymani.. (RCT) -19%
1.19 [0.73-1.94]
31/190
25/183
OT1
Almoosa -90%
1.90 [1.11-3.26]
110 (n)
116 (n)
Chen (RCT) -3%
1.03 [0.15-7.22]
2/116
2/120
OT1
Tabarsi (RCT) 41%
0.59 [0.22-1.59]
5/32
8/30
OT1
Shenoy (DB RCT) -2%
1.02 [0.57-1.82]
20/175
20/178
Chuah (RCT) -9%
1.09 [0.49-2.31]
13/250
12/250
Al Mutair (ICU) -34%
1.34 [1.13-1.59]
269 (n)
269 (n)
ICU patients OT1
Uyaroğlu (PSM) -200%
3.00 [0.13-71.6]
1/42
0/42
OT1
AlQahtani (RCT) 76%
0.24 [0.03-2.08]
1/54
4/52
Hassaniazad (RCT) 35%
0.65 [0.20-2.07]
4/32
6/31
OT1
Tau2 = 0.00, I2 = 0.0%, p = 0.00081
Late treatment -28%
1.28 [1.11-1.47]
87/1,323
85/1,326
-28% improvement All studies -28%
1.28 [1.11-1.48]
91/1,489
85/1,497
-28% improvement 14 favipiravir COVID-19 ICU results c19favipiravir.com May 2022
Tau2 = 0.00, I2 = 0.0%, p = 0.0006
1 OT: comparison with other treatment 2 CT: study uses combined treatment Favors favipiravir
Favors control
Figure 7. Random effects meta-analysis for ICU admission.
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Ruzhentsova (RCT) 6%
0.94 [0.78-1.14]
hosp.
3/112
2/56
Improvement, RR [CI] Treatment Control Holubar (DB RCT) 89%
0.11 [0.01-2.02]
hosp.
0/75
4/74
Bosaeed (DB RCT) -219%
3.19 [0.66-15.5]
hosp.
6/112
2/119
Lowe (DB RCT) -196%
2.96 [0.12-71.1]
hosp.
1/54
0/52
Tau2 = 0.57, I2 = 31.6%, p = 0.78
Early treatment -22%
1.22 [0.33-4.56]
10/353
8/301
-22% improvement Ivashchenko (RCT) -300%
4.00 [0.20-79.6]
hosp.
2/40
0/20
Improvement, RR [CI] Treatment Control Tabarsi (RCT) 25%
0.75 [0.58-0.97]
hosp. time
32 (n)
30 (n)
OT1
Al Mutair (ICU) -37%
1.37 [1.14-1.64]
hosp. time
269 (n)
269 (n)
ICU patients OT1
Uyaroğlu (PSM) -11%
1.11 [0.24-5.08]
hosp. time
42 (n)
42 (n)
OT1
Shinada 7%
0.93 [0.45-1.89]
hosp.
17 (n)
17 (n)
Hassaniazad (RCT) 25%
0.75 [0.51-1.10]
hosp. time
32 (n)
31 (n)
OT1
Tau2 = 0.11, I2 = 72.3%, p = 0.83
Late treatment 4%
0.96 [0.67-1.37]
2/432
0/409
4% improvement All studies 1%
0.99 [0.70-1.39]
12/785
8/710
1% improvement 10 favipiravir COVID-19 hospitalization results c19favipiravir.com May 2022
Tau2 = 0.11, I2 = 60.3%, p = 0.96
1 OT: comparison with other treatment Favors favipiravir
Favors control
Figure 8. Random effects meta-analysis for hospitalization.
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Sawanpanyalert 68%
0.32 [0.15-0.66]
n/a
n/a
Improvement, RR [CI] Treatment Control Holubar (DB RCT) 30%
0.70 [0.23-2.12]
5/75
7/74
Tsuzuki 18%
0.82 [0.66-1.04]
2,532 (n)
5,122 (n)
Tau2 = 0.20, I2 = 64.4%, p = 0.11
Early treatment 40%
0.60 [0.32-1.13]
5/2,607
7/5,196
40% improvement Chen (RCT) 74%
0.26 [0.03-2.28]
1/116
4/120
OT1
Improvement, RR [CI] Treatment Control Atipornwa.. (RCT) 60%
0.40 [0.20-0.79]
10/100
25/100
OT1 CT2
Tau2 = 0.00, I2 = 0.0%, p = 0.0039
Late treatment 62%
0.38 [0.20-0.74]
11/216
29/220
62% improvement All studies 47%
0.53 [0.32-0.88]
16/2,823
36/5,416
47% improvement 5 favipiravir COVID-19 progression results c19favipiravir.com May 2022
Tau2 = 0.17, I2 = 58.2%, p = 0.014
1 OT: comparison with other treatment 2 CT: study uses combined treatment Favors favipiravir
Favors control
Figure 9. Random effects meta-analysis for progression.
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Ruzhentsova (RCT) 39%
0.61 [0.43-0.88]
no recov.
112 (n)
56 (n)
Improvement, RR [CI] Treatment Control Udwadia (RCT) 40%
0.60 [0.38-0.95]
recov. time
75 (n)
75 (n)
Holubar (DB RCT) -19%
1.19 [0.78-1.85]
no recov.
65 (n)
70 (n)
Alattar (PSM) -2%
1.02 [0.90-1.16]
no recov.
26/387
28/387
Bosaeed (DB RCT) -12%
1.12 [0.80-1.56]
no recov.
112 (n)
119 (n)
Tau2 = 0.07, I2 = 63.5%, p = 0.38
Early treatment 13%
0.87 [0.64-1.18]
26/751
28/707
13% improvement Ivashchenko (RCT) -67%
1.67 [0.52-5.39]
no disch.
10/40
3/20
Improvement, RR [CI] Treatment Control Pushkar (RCT) 14%
0.86 [0.74-0.99]
no recov.
73/100
85/100
Khamis (RCT) -10%
1.10 [0.60-1.99]
no recov.
15/44
14/45
OT1 CT2
Alamer 49%
0.51 [0.41-0.64]
no disch.
221 (n)
201 (n)
Almoosa -11%
1.11 [0.96-1.29]
recov. time
110 (n)
116 (n)
Shinkai (SB RCT) 37%
0.63 [0.40-0.98]
imp. time
107 (n)
49 (n)
Chen (RCT) 20%
0.80 [0.60-1.08]
no recov.
45/116
58/120
OT1
Tabarsi (RCT) 6%
0.94 [0.72-1.23]
CT imp.
24/32
24/30
OT1
Damayanti 54%
0.46 [0.22-0.92]
no recov.
96 (n)
96 (n)
Shenoy (DB RCT) -1%
1.01 [0.78-1.30]
no recov.
157 (n)
158 (n)
Finberg (RCT) 58%
0.42 [0.16-1.10]
no recov.
25 (n)
25 (n)
AlQahtani (RCT) -42%
1.42 [0.50-4.04]
no recov.
8/53
5/47
Tau2 = 0.06, I2 = 75.3%, p = 0.039
Late treatment 18%
0.82 [0.68-0.99]
175/1,101
189/1,007
18% improvement All studies 16%
0.84 [0.72-0.97]
201/1,852
217/1,714
16% improvement 17 favipiravir COVID-19 recovery results c19favipiravir.com May 2022
Tau2 = 0.06, I2 = 71.2%, p = 0.022
1 OT: comparison with other treatment 2 CT: study uses combined treatment Favors favipiravir
Favors control
Figure 10. Random effects meta-analysis for recovery.
