Meta Analysis of Efficacy and Safety of Ribavirin in the Treatment of COVID-19

OBJECTIVE: To evaluate the efficacy and safety of ribavirin for COVID-19 by systematically reviewing previous clinical studies of coronavirus pneumonia. METHODS: Such databases as Pubmed, EMbase, Cochrane Library, Google Scholar, CNKI, Wanfang Data, VIP and CBM were searched. The date of the latest search was April 29, 2020. Clinical studies on ribavirin used in the severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) were included. The literature was screened according to the inclusion and exclusion criteria and the methodological quality of the included studies was assessed by two reviewers independently. Meta-analysis was performed using Review Manager 5.3 software. RESULTS: In total, 7 studies were included, resulting in a sample size of 870 cases. The overall pooled data demonstrated that the difference in mortality rates between the ribavirin group and control group was not statistically significant in the treatment of SARS and MERS[OR=1.10,95％CI（0.79,1.55）,P=0.57]. In the subgroup analysis, the mortality rate was not significantly different between the ribavirin group and control group in the treatment of SARS and MERS whether ribavirin was combined with interferon or not. CONCLUSION: Ribavirin does not make much difference to mortality in the treatment of SARS and MERS, but it can increase drug safety risks. Thus, the applicability of ribavirin in the treatment of COVID-19 remains to be investigated