Pan-viral efficacy profile of ribavirin: quantitative potency and safety landscape across virus families

This study quantifies ribavirin’s pan-viral efficacy across seven virus families, compares it with favipiravir and remdesivir, and evaluates viral trait predictors alongside clinical concordance. In vitro analyses showed the highest potency against Flaviviridae and Paramyxoviridae, whereas Coronaviridae and Astroviridae were less susceptible, consistent with proofreading polymerases. Compared with its peers, remdesivir was most potent in coronavirus and filovirus models, while favipiravir exhibited the widest therapeutic window in orthomyxovirus assays. Family-wise means and bootstrap trait modeling identified the presence of a proofreading polymerase as the strongest positive predictor of log EC 50 , with negative-sense genomes also associated with reduced susceptibility. Clinical evidence aligned with laboratory findings, demonstrating robust benefits in hepatitis C and Lassa fever, with mixed effects in respiratory infections. Overall, the results provide an actionable benchmark for broad-spectrum drug selection and prioritization in preparedness and outbreak response.