Introduction:After nearly two years, there is still no proven treatment for infection with severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2)-the virus that causes Covid-19. Currently, the two most widely known drugs for treating Covid-19 are remdesivir and favipiravir. Therefore, this study aimed to evaluate the effects of remdesivir and favipiravir on Covid-19 clinical outcomes. Methods: A systematic review of the literature on the PubMed and Scopus databases was undertaken to identify studies that have examined the effects of remdesivir and favipiravir on Covid-19 outcomes. To weighted group mean differences for within-and between-group comparisons, odds ratio effect sizes, and random-effects models were used. Subgroup analyses were also conducted to determine the effects of potential sources of heterogeneity, which was assessed using the I-squared (I 2 ) test. Results: Twenty-eight studies with a total of 10,871 adult participants were included in the analysis. According to pooled analysis results, there was no statistically significant difference between the remdesivir/favipiravir and control groups in terms of mortality, intensive care unit admissions, or adverse effects (p > 0.05). Mean hospitalization duration was significantly different for those receiving remdesivir (0.1-day increase) and favipiravir (0.06-day decrease), but these findings included significant levels of publication bias. Treatment duration was found to be a significant source of heterogeneity in the mortality results. Conclusion: Remdesivir and favipiravir have no effect on mortality, intensive care unit admissions, or duration of hospitalization for Covid-19 patients.
Background: COVID-19 is an international public health emergency in the world. Objectives: The aim of the present study is to determine the geographic pattern and temporal trend of Coronavirus disease 2019 incidence, fatality, and recovery rates worldwide. Methods: The present ecological study is a mixed exploratory study. The study population included Patients with COVID-19, recovered individuals, and deaths from COVID-19 from October 1, 2019, until June 30, 2021, worldwide. Descriptive analysis included the calculation cumulative incidence rate (CIR), case fatality rate (CFR), and case recovery rate (CRR) of COVID-19. Global Moran's I and Anselin Local Moran's I tests were used for spatial analysis. The joinpoint regression analysis was used to examine the time trend by ArcGIS, Joinpoint, and SPSS software. Results: The average cumulative incidence rate was 1077 in 106 individuals; also, the average case recovery rate and average case fatality rate were %72.81 and %3.21, respectively. Global Moran's I index measured for CIR was 0.159. The results of Anselin's local Moran's I, high-high cluster, consists of some countries in South America and in southern and Western Europe and central and western Asia. The temporal trend of changes in the incidence rate and CRR of COVID-19 were incremental, and the average annual percentage change from October 2019 to June 2021 increased by 44.4% and 3.2%, respectively (P < 0.001), but CFR decreased by -0.3% and was not significant (P > 0.05). Conclusions: As regards the specific spatial pattern of fatality and recovery rate of COVID-19, it seems essential to consider spatial conditions and environmental factors which are related to the incidence and fatality of COVID-19 in different regions, as well as the necessity of upgrading the care system in high-risk areas, in order to have better management and control of the pandemic and optimal function in early diagnosis, proper treatment, and high vaccination coverage.
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