COVID-19 pneumonia has spread across China and globally since late 2019, becoming a pandemic. Its extremely contagious nature as well as high morbidity and mortality rates have attracted widespread attention globally. For the treatment of SARS-CoV-2 pneumonia, two commonly used antiviral drugs in the clinic are nirmatrelvir/ritonavir(Paxlovid) and Azvudine, while the therapeutic efficacy of the two drugs and their impact on patient prognosis remain inconclusive. Therefore, the aim of this study is to investigate the effects of two antiviral drugs, Azvudine and Paxlovid, on the disease development and prognosis of patients with COVID-19.This study collected and analyzed in Inner Mongolia hospital treated 267 cases of COVID - 19 patients. According to the use of antiviral medications, the participants in this experiment were split into the Azvudine and Paxlovid groups. The effectiveness of the medications was evaluated using the length of hospitalization, Nucleic acid into negative time for the first time, and laboratory indices such as total protein, lymphocytes, leukocytes, albumin, creatinine, and platelets.Compared with the Azvudine group, patients in the Paxlovid group had a shorter recovery time, a higher degree of rise in lymphocytes, a faster recovery of the immune system, a lower rise in creatinine, and a lesser renal burden, but patients in the Paxlovid group had a greater decrease in total protein.In assessing patient conditions for treatment selection, Paxlovid may be preferable for individuals with renal insufficiency or those exhibiting compromised immune responses. Conversely, for patients experiencing malnutrition or cirrhotic hypoproteinemia, Azvudine could be considered to mitigate the reduction in protein levels.