Safety Analysis of Antiviral Drugs Approved for COVID-19 in Saudi Arabia

Background and Objective: The Coronavirus Disease 2019 (COVID-19) continues to spread in several regions worldwide. Some antiviral drugs have been approved for clinical indication but are associated with several unwanted effects. The present study analyzed four antivirals, namely, remdesivir (Remd), molnupiravir (Moln), ritonavir (Rito) and nirmatrelvir (Nirm), which have been approved for COVID-19 in Saudi Arabia for incidences of adverse effects. Materials and Methods: Safety information of these agents was retrieved from electronic databases such as PubMed, SCOPUS, Web of Science and BIOSIS by using the keywords COVID-19, antivirals, safety, side effects and human trials as per the procedures described in the literature. The study analyzed eighteen articles and their data was statistically evaluated, including logistic regression analysis for incidences of side effects categorized under important human body systems. Results: Data analysis indicated that Remd significantly (p<0.05) increased the incidences of anxiety, apnea, alanine transaminase elevation, hepatitis, diarrhea and hypersensitivity compared to placebo. While Moln increased (p<0.05) the frequency of apnea, oliguria, constipation and hypersensitivity. Rito was associated with anemia, headache and Nirm-enhanced hypertension, diarrhea and hypersensitivity. The correlation analysis indicated that the odd ratio for Remd (OR = 0.41, P = 0.039, 95% CI = 0.106/0.086) and Moln (OR = 0.31, P = 0.045, 96% CI = 0.18/0.077) was significantly varied compared with placebo. Conclusion: The observation from the study indicated that the administration of Remd was mild-moderately correlated with the side effects, while Moln is mildly and Rito and Nirm weakly associated with side effects. Although the incidences of serious adverse events were found to be enhanced with Remd the treatment also reduced the mortality rate. Further, the long-term effects of these antivirals need regular updates.