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Background Azovudine is a widely used antiviral drug for COVID-19 in China, but published trials on its effect on hepaticand renal function are extremely scarce. Objective To explore the changes of in hepatic and renal function in patients with COVID-19 infection after using Azovudine, so as to provide a reference for thesafe use of Azovudine in patients with renal insufficiency. Methods Inpatients ina tertiary general hospitalwho used Azovudine for COVID-19 from December 26, 2022 to December 31, 2022 were consecutively included in the retrospective study and divided into the normal group, mild injury group, moderate injury group, severe injury group, and end-stage groupaccording to estimated glomerularrate (eGFR) levels. The changes of biochemical parametersof liver and kidney including alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), albumin (ALB), total bilirubin (TB), serum creatinine (Scr), eGFR were observed in each group; the formula D_FR=D_NL×[1-F_k (1-K_f) ] was used to correct the maintenance dose of Azivudine in patients with eGFR0.05) ; because the patients with moderate and severe renal injury were dose-corrected with Azivudine, the safety of this population was not compared if the dose was not corrected. Conclusion The use of Azivudine is prone to cause the elevation of ALT level and the decrease of eGFR, but the injury with clinical significance is 2.6% and 3.7%, respectively; there was no aggravation of liver and kidney injury in patients with moderate and severe kidney injury after using the corrected dose of Azivudine, however, this conclusion needs to be confirmed in a multicenter randomized controlled study with a large sample.

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The COVID-19 pandemic has caused significant losses and suffering around the world. Although the SARS-CoV-2 vaccine has largely controlled the spread of the virus, the scientific and sustainable treatment of COVID-19 patients is still necessary to truly end the pandemic. Small-molecule drugs against COVID-19 have attracted the attention of the scientific community and industry owing to their unique advantages such as a simple delivery method, relatively high output, and immune response with lower probability. Fortunately, in the last three years, some potentially effective drugs have been proposed, and have achieved good results in clinical trials. This paper briefly introduces the research progress on small-molecule drugs since 2020 to provide reference for future SARS-CoV-2 research. [ABSTRACT FROM AUTHOR]