Background: Few studies compared the efficacy of remdesivir and favipiravir in moderate COVID19 pneumonia.

Aims: To determine whether the type of antiviral treatment is associated with 29-day mortality. The secondary outcomes were the effects regarding 15-day recovery rate, length of ICU and hospital stay.

Methods: We performed a retrospective cohort study including adult hospitalized COVID-19 pneumonia patients with hypoxemia. Patients were classified into 2 groups regarding the antiviral therapy; before 1st July 2021, 150 patients received favipiravir, and from 1st July 2021, 150 patients received remdesivir. Age, SpO2, FIO2, and the Charlson comorbidity index were used for propensity score matching.

Results: Of 300 patients, 249 moderate COVID-19  pneumonia patients were included. After propensity score matching, 102 patients in each group were included for further analysis. There was no difference in baseline characteristics between the 2 groups. 29-day mortality was not significantly different between both groups(25.49% in the remdesivir group vs. 27.45% in the favipiravir group, P=0.75). There was no difference in the proportion of patient who recovered on day 15, the length of ICU and hospital stay between remdesivir and favipiravir groups (60.78% vs. 54.90%, P= 0.40; 11.48±11.88 days vs. 10.87±9.31 days, P=0.69 and 16.64±14.28 days vs. 16.59±11.31 days, P=0.98 respectively).

Conclusion: Remdesivir did not have higher benefit in mortality rate, the proportion of patient who recovered on day 15, and the length of ICU or hospital stay compared to favipiravir in moderate COVID-19 pneumonia.