Therapeutic mechanisms of early oseltamivir administration in the management of mild COVID-19 through the sympathetic nervous system: A scoping review.

PURPOSE: This scoping review summarizes the proposed mechanisms by which oseltamivir may improve clinical outcomes in COVID-19. Although SARS-CoV-2 lacks neuraminidase, several studies have reported reduced fever duration, shorter hospitalization, and faster viral clearance with oseltamivir administration. This review integrates current evidence regarding antiviral, immunomodulatory, and autonomic-nervous-system-related mechanisms.

METHODS

A structured literature search was conducted in PubMed, Scopus, and Google Scholar. Studies addressing oseltamivir's antiviral activity, neutrophil modulation, antipyretic effects, or influence on sympathetic nervous system activity in COVID-19 were included.

RESULTS

Oseltamivir may exert therapeutic effects through inhibition of SARS-CoV-2 proliferation, reduction of neutrophil overactivation, attenuation of sympathetic nervous system hyperactivity, and modulation of fever pathways.

CONCLUSION

This scoping review identifies multiple mechanisms through which oseltamivir may influence COVID-19 pathophysiology. Although evidence remains heterogeneous, findings suggest that oseltamivir may have broader biological effects beyond neuraminidase inhibition. Further clinical studies are needed to clarify its therapeutic role, optimal timing, and potential benefits in unvaccinated or high-risk populations.