Vaccines and drugs are the cornerstones in the fight against the SARS-CoV-2 pandemic. While vaccines were a success story, the development of antiviral drugs against SARS-CoV-2 turned out to be difficult. For an accelerated use of antivirals in the clinic, most SARS-CoV-2 antivirals represented repurposed drugs. The present article summarizes the outcomes of clinical trials with antiviral drugs in COVID-19 patients. Many antiviral drugs failed to demonstrate beneficial effects or showed mixed results. One reason for the low success rate of clinical trials was shortcomings of antiviral tests in cell culture systems and another reason was the abundance of ill-coordinated and underpowered clinical trials. However, large pragmatic clinical trials particularly of the British RECOVERY trial series demonstrated that even under emergency situation drug trials can be conducted in a timely way such that the therapy of COVID-19 patients can be based on evidence basis instead on expert opinion or even worse on political pressure.

中文翻译：

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针对 COVID-19 的抗病毒药物临床试验：取得一些进展，但许多希望破灭

疫苗和药物是抗击 SARS-CoV-2 大流行的基石。虽然疫苗取得了成功，但针对 SARS-CoV-2 的抗病毒药物的开发却很困难。为了加速临床上抗病毒药物的使用，大多数 SARS-CoV-2 抗病毒药物都是重新调整用途的药物。本文总结了抗病毒药物在 COVID-19 患者中的临床试验结果。许多抗病毒药物未能表现出有益效果或显示出不同的结果。临床试验成功率低的原因之一是细胞培养系统抗病毒试验的缺陷，另一个原因是大量临床试验缺乏协调和动力不足。然而，大型实用临床试验尤其是英国的RECOVERY系列试验表明，即使在紧急情况下也可以及时进行药物试验，从而使COVID-19患者的治疗可以基于证据而不是专家意见甚至更糟出于政治压力。