Abstract
Arbidol (ARB) is efficacious for the treatment of influenza, and has been recommended for COVID-19. The present systematic review was performed to assess the existing knowledge on ARB therapy for acute respiratory viral infections, especially COVID-19. Subsequently, six databases were searched for publications reporting clinical outcomes of ARB therapy, and registered clinical trials up to May 6, 2022. The available literature was rigorously appraised. Based on the inclusion and exclusion criteria, 20 articles were identified for the final review. The result of meta-analysis showed that there was no significant difference in the negative rate of PCR day 7 [risk ratio (RR), 1.1; 95% CI, 0.87-1.40], negative rate of PCR day 14 (RR, 1.24; 95% CI, 0.92-1.67), PCR negative conversion time [mean difference (MD), -0.26; 95% CI, -1.41-0.90], time of clinical improvement (MD, 1.11; 95% CI, 0.01-2.22), hospital stay (MD, 0.16; 95% CI, -1.62-1.93), rate of improvement on chest computed tomography (CT) (RR, 1.19; 95% CI, 0.74-1.91), duration of CT absorption (MD, -1.43; 95% CI, -10.28-7.42), disease progression (RR, 1.05; 95% CI, 0.64-1.71) and mortality (RR, 0.68; 95% CI, 0.42-1.11). ARB demonstrated significant difference in the rate of clinical improvement (RR, 0.81; 95% CI, 0.67-0.97), duration of fever (MD, -0.38; 95% CI, -0.74- -0.02) and adverse events (RR, 0.65; 95% CI, 0.45-0.94). Although past clinical studies indicates notable results of ARB on influenza, there is no consensus on the drug for therapeutic and prophylaxis of COVID-19. The safety of ARB should be carefully monitored. High quality randomized controlled studies are urgently needed to thoroughly evaluate the efficacy and safety of ARB in patients with acute respiratory viral infections, especially COVID-19.