# Effectiveness and safety of azvudine in the treatment of COVID-19 patients: a retrospective cohort study using propensity score matching

**Authors:** Jing Zhang, Fang Wang, Ying Xie, Qianyu Li, Zhenzhen Zhu, Yuan Dong

PMC · DOI: 10.3389/fcimb.2025.1584261 · Frontiers in Cellular and Infection Microbiology · 2025-06-18

## TL;DR

This study found that azvudine shortened hospital stays for mild-to-moderate COVID-19 patients without significant side effects.

## Contribution

The study provides real-world evidence on azvudine's effectiveness and safety in treating COVID-19 patients.

## Key findings

- Azvudine reduced hospitalization duration by 2 days compared to non-azvudine treatment.
- No significant differences were found in time to RNA negativity or symptom resolution.
- Azvudine had a favorable safety profile with only one case of mild gastrointestinal discomfort.

## Abstract

Clinical trials have demonstrated the efficacy of azvudine in alleviating clinical symptoms among patients with coronavirus disease 2019 (COVID-19). However, evidence regarding its real-world effectiveness and safety profile remains limited.

To evaluate the effectiveness and safety of azvudine in COVID-19 patients.

This retrospective cohort study included 192 COVID-19 patients hospitalized in Fengtai District, Beijing, from November 1 to December 31, 2022. Patients were divided into azvudine (n=118) and non-azvudine (n=74) groups. Propensity score matching (PSM) was applied to balance baseline characteristics (age, sex, vaccination status, etc.), yielding 48 matched pairs. Outcomes included time to SARS-CoV-2 RNA negativity, hospitalization duration, and symptom resolution (fever, cough). Adverse events were recorded.

After PSM, 48 pairs of COVID-19 patients were identified. The azvudine group exhibited significantly shorter hospitalization than the non-azvudine group (median: 8 vs. 10 days, P ≤ 0.05). No significant differences were observed in time to RNA negativity (4.23 vs. 4.52 days, P>0.05), fever duration (2 vs. 2 days, P>0.05), or cough duration (4.5 vs. 5 days, P>0.05). One case of mild gastrointestinal discomfort was reported in the azvudine group.

Azvudine significantly reduced hospitalization duration in mild-to-moderate COVID-19 patients with a favorable safety profile.

## Linked entities

- **Chemicals:** azvudine (PubChem CID 24769759)
- **Diseases:** coronavirus disease 2019 (MONDO:0100096), COVID-19 (MONDO:0100096)

## Full-text entities

- **Diseases:** fever (MESH:D005334), gastrointestinal discomfort (MESH:D005767), cough (MESH:D003371), COVID-19 (MESH:D000086382)
- **Chemicals:** Azvudine (MESH:C540945)
- **Species:** Homo sapiens (human, species) [taxon 9606], Severe acute respiratory syndrome coronavirus 2 (no rank) [taxon 2697049]

## Full text

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## Figures

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## References

18 references — full list in the complete paper: https://tomesphere.com/paper/PMC12213512/full.md

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Source: https://tomesphere.com/paper/PMC12213512