1
|
Al Sulaiman K, Aljuhani O, Korayem GB, Altebainawi AF, AlFaifi M, Nahari M, Almagthali A, Thabit AK, Alhajaji R, Alharbi R, Kahtani K, Alenazi AA, Alharbi A, Alghwainm MM, Alotaibi SM, Alghamdi YS, Alotaibi S, Alonazi SH, Almutairi JM, Vishwakarma R. When antivirals backfire: An evaluation of favipiravir's clinical outcomes in critically ill patients with COVID-19: A multicenter cohort study. J Infect Public Health 2023; 16:1492-1499. [PMID: 37355406 PMCID: PMC10265931 DOI: 10.1016/j.jiph.2023.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/30/2023] [Accepted: 06/11/2023] [Indexed: 06/26/2023] Open
Abstract
BACKGROUND Favipiravir is an oral antiviral, that might treat COVID-19 by enhancing viral eradication, particularly in patients with mild-to-moderate disease. Yet, the findings on the use of favipiravir in critically ill patients with COVID-19 are inconsistent. Therefore, this study aimed to assess the effectiveness and safety of favipiravir in critically ill patients with COVID-19. METHOD A multicenter retrospective cohort study includes critically ill adult patients with COVID-19 admitted to the intensive care units (ICUs) was conducted from March 2020 to July 2021. Patients were categorized based on favipiravir use (control vs. favipiravir). The primary outcome was in-hospital mortality. Secondary outcomes included mechanical ventilation (MV) duration, 30-day mortality, ICU length of stay (LOS), hospital LOS, and complications during the stay. RESULTS After propensity score (PS) matching (1:1 ratio), 146 patients were included in the final analysis. A higher in-hospital and 30-day mortality were observed in patients receiving favipiravir compared to the control group at crude analysis (65.3% vs. 43.8%; P-value=0.009 and 56.3% vs. 40.3; P-value=0.06, respectively); however, no differences were observed using multivariable Cox proportional hazards regression analysis (HR 1.17; 95% CI 0.73, 1.87; P-value =0.51 and HR 0.86; 95% CI 0.53, 1.39; P-value=0.53, respectively). Conversely, the MV duration and ICU LOS were longer in patients who received favipiravir than the control group (β coefficient 0.51; CI 0.09, 0.92; P-value = 0.02, β coefficient 0.41; CI 0.17, 0.64; P-value = 0.0006, respectively). Complications during the stay were comparable between the two groups. CONCLUSION The use of favipiravir in critically ill patients with COVID-19 did not demonstrate a reduction in mortality; instead, it was linked with longer MV duration and ICU stay. This finding suggests limiting favipiravir use to infections where it is more effective, other than COVID-19. Further randomized clinical trials are needed to confirm these findings.
Collapse
Affiliation(s)
- Khalid Al Sulaiman
- Pharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia; College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center-King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia; Saudi Critical Care Pharmacy Research (SCAPE) Platform, Riyadh, Saudi Arabia; Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.
| | - Ohoud Aljuhani
- Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ghazwa B Korayem
- Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ali F Altebainawi
- Pharmaceutical Care Services, King Salman Specialist Hospital, Hail Health Cluster, Ministry of Health, Hail, Saudi Arabia; Department of Clinical Pharmacy, College of Pharmacy, University of Hail, Hail, Saudi Arabia
| | - Mashael AlFaifi
- Pharmaceutical Care Department, King Saud Medical City, Riyadh, Saudi Arabia
| | - Majed Nahari
- Pharmaceutical Care Services, King Abdullah bin Abdulaziz University Hospital, Riyadh, Saudi Arabia
| | - Alaa Almagthali
- Pharmaceutical Care Department, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Abrar K Thabit
- Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Raghad Alhajaji
- Department of Family Medicine, Ministry of Health, Makkah, Saudi Arabia
| | - Reham Alharbi
- Pharmaceutical Care Department, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Khawla Kahtani
- Pharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia; College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Abeer A Alenazi
- Pharmaceutical Care Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Aisha Alharbi
- Pharmaceutical Care Department, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Munirah M Alghwainm
- Pharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Sara M Alotaibi
- College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Yazeed S Alghamdi
- College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Samar Alotaibi
- Pharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center-King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Shaden H Alonazi
- College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Jumanah M Almutairi
- College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Ramesh Vishwakarma
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| |
Collapse
|
2
|
Siripongboonsitti T, Tawinprai K, Cheirsilpa K, Ungtrakul T, Krisorakun W, Chotipanich C, Wimolsiri N, Noitun P, Srirattana N, Mahanonda N. The Real-World Clinical Outcomes of Favipiravir Treatment with Telemedicine Monitoring in Preventing Disease Progression in Mild to Moderate COVID-19 Patients; A Retrospective Cohort Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1098. [PMID: 37374302 DOI: 10.3390/medicina59061098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 05/26/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023]
Abstract
Background: Favipiravir has complex pharmacokinetics, and varied efficacy has been reported in treating COVID-19. Telehealth and telemonitoring are disruptive challenges used for COVID-19 care during pandemics. Objective: This study aimed to assess the outcome of favipiravir treatment to prevent clinical deterioration in mild to moderate COVID-19 cases with adjunctive telemonitoring during the COVID-19 surge. Methods: This was a retrospective observational study of PCR-confirmed mild to moderate COVID-19 cases subjected to home isolation. Chest computed tomography (CT) was performed in all cases, and favipiravir was administrated. Results: This study involved 88 PCR-confirmed COVID-19 cases. In addition, 42/42 (100%) cases were Alpha variants. COVID-19 pneumonia was found in 71.5% of the cases, according to chest X-rays and chest CT on the first visit. Favipiravir started 4 days after symptoms, which was part of the standard of care. The 12.5% of the patients required supplemental oxygen and intensive care unit admission rate was 1.1%; 1.1% required mechanical ventilation, and the rate of all-cause mortality was 1.1%, with a value of 0% of severe COVID-19 deaths. All mild illness cases showed no clinical deterioration or requirement for supplemental oxygen. No significant deterioration in either obesity or diabetes mellitus was observed. Conclusions: Favipiravir treatment for mild to moderate COVID-19 cases in outpatient settings, coupled with telemonitoring, was both safe and effective in preventing clinical deterioration, including the need for oxygen supplementation. This approach proved valuable during surges of COVID-19 cases.
Collapse
Affiliation(s)
- Taweegrit Siripongboonsitti
- Division of Infectious Diseases, Department of Medicine, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok 10210, Thailand
- Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok 10210, Thailand
| | - Kriangkrai Tawinprai
- Division of Infectious Diseases, Department of Medicine, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok 10210, Thailand
| | - Kunsuda Cheirsilpa
- Division of Gastroenterology, Department of Medicine, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok 10210, Thailand
| | - Teerapat Ungtrakul
- Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok 10210, Thailand
| | - Wasanai Krisorakun
- Department of Obstetrics & Gynecology, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok 10210, Thailand
| | - Chanisa Chotipanich
- National Cyclotron and PET Center, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok 10210, Thailand
| | - Nat Wimolsiri
- Department of Radiology, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok 10210, Thailand
| | - Permpen Noitun
- Cardiovascular Center, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok 10210, Thailand
| | - Netnapis Srirattana
- Cardiovascular Center, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok 10210, Thailand
| | | |
Collapse
|
3
|
Asadi J, Rasouli MA, Ghaderi E, Roshani D, Mohsenpour B, Moradi Y, Moradi G. Effectiveness of different treatment regimens on patients with COVID-19, hospitalized in Sanandaj hospitals: a retrospective cohort study. J Pharm Policy Pract 2023; 16:4. [PMID: 36647128 PMCID: PMC9841691 DOI: 10.1186/s40545-023-00511-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 01/04/2023] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVES Different drugs have different effects on the prognosis of patients with COVID-19. This study aimed to evaluate the effect of different drug regimens on patients with COVID-19, hospitalized in Sanandaj city. METHODS In this retrospective cohort study, 660 patients with COVID-19, hospitalized in the Tohid, Kowsar and Besat hospitals located Sanandaj (Kurdistan Province, Iran) were studied from February 2020 to February 2021 with clinical symptoms and positive test results. RESULTS The results of multivariate regression analysis showed the days of hospitalization for patients who had received the drug regimen 2 (Interferons (ReciGen/Ziphron) or Interferon Vectra (lopinavir/ritonavir)) was 1.92 times higher than those who had received the drug regimen 1 (hydroxychloroquine group or a combination of chloroquine and azithromycin) while a significant association was observed (OR = 1.92, 95% CI: 1.16-3.16, P = 0.011). Also, the hospitalization in ICU was longer in patients treated by the drug regimen 2 (Interferons (ReciGen/Ziphron) or Interferon Vectra (lopinavir/ritonavir)) (OR = 4.63, 95% CI: 1.80-11.82, P = 0.001), however, drug regimens did not show a significant effect on mortality and use of ventilator in patients (P > 0.05). CONCLUSION The study results showed the drug regimens 2 and 5 increased the days of hospitalization and hospitalization in ICU, respectively, while the other drug regimens had no significant effect on mortality and use a ventilator in the studied patients and none of the drug regimens had an effect on reducing mortality compared to other ones.
Collapse
Affiliation(s)
- Jalal Asadi
- grid.484406.a0000 0004 0417 6812Department of Epidemiology and Biostatistics, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mohammad Aziz Rasouli
- grid.484406.a0000 0004 0417 6812Department of Epidemiology and Biostatistics, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran ,grid.484406.a0000 0004 0417 6812Clinical Research Development Unit, Kowsar Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Ebrahim Ghaderi
- grid.484406.a0000 0004 0417 6812Department of Epidemiology and Biostatistics, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran ,grid.484406.a0000 0004 0417 6812Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Daem Roshani
- grid.484406.a0000 0004 0417 6812Department of Epidemiology and Biostatistics, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran ,grid.484406.a0000 0004 0417 6812Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Behzad Mohsenpour
- grid.484406.a0000 0004 0417 6812Department of Infectious Diseases, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Yousef Moradi
- grid.484406.a0000 0004 0417 6812Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Ghobad Moradi
- grid.484406.a0000 0004 0417 6812Department of Epidemiology and Biostatistics, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran ,grid.484406.a0000 0004 0417 6812Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| |
Collapse
|
4
|
Leventoğlu E, Atikel YÖ, Nalçacıoğlu H, Dursun İ, Dursun H, Yıldırım ZNY, Yıldız N, Aksoy GK, Taşdemir M, Çelakıl M, Kılıç BD, Selçuk ŞZ, Canpolat N, Çakıcı EK, Özlü SG, Tülpar S, Yüksel S, Atmış B, Döven SS, Taner S, Ertan P, Tufan AK, Bayram MT, Kalyoncu M, Gülleroğlu KS, Kabasakal SC, Demir BK, Gülşan RYÇ, Bilge I, Dönmez O, Kara A, Yavaşcan Ö, Özçelik G, Yıldırım DG, Güler MA, Sönmez F, Poyrazoğlu MH, Akman S, Topaloğlu R, Alpay H, Ezgü SAB. COVID-19 in pediatric nephrology centers in Turkey. Turk J Med Sci 2022; 52:1762-1770. [PMID: 36945974 PMCID: PMC10390129 DOI: 10.55730/1300-0144.5521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 07/24/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND There is limited data on COVID-19 disease in children with kidney disease. We aimed to investigate the characteristics and prognosis of COVID-19 in pediatric nephrology patients in Turkey. METHODS This was a national, multicenter, retrospective cohort study based on an online survey evaluating the data between 11th March 2020 and 11th March 2021 as an initial step of a detailed pediatric nephrology COVID-19 registry. RESULTS Two hundred and three patients (89 girls and 114 boys) were diagnosed with COVID-19. One-third of these patients (36.9%) were between 10-15 years old. Half of the patients were on kidney replacement therapy: kidney transplant (KTx) recipients (n = 56, 27.5%), patients receiving chronic hemodialysis (n = 33, 16.3%) and those on peritoneal dialysis (PD) (n = 18, 8.9%). Fifty-four (26.6%) children were asymptomatic. Eighty-two (40.3%) patients were hospitalized and 23 (28%) needed intensive care unit admission. Fifty-five percent of the patients were not treated, while the remaining was given favipiravir (20.7%), steroid (16.3%), and hydroxychloroquine (11.3%). Acute kidney injury developed in 19.5% of hospitalized patients. Five (2.4%) had MIS-C. Eighty-three percent of the patients were discharged without any apparent sequelae, while 7 (3.4%) died. One hundred and eight health care staff were infected during the study period. DISCUSSION COVID-19 was most commonly seen in patients who underwent KTx and received HD. The combined immunosuppressive therapy and frequent exposure to the hospital setting may increase these patients' susceptibility. Staff infections before vaccination era were alarming, various precautions should be taken for infection control, particularly optimal vaccination coverage.
Collapse
Affiliation(s)
- Emre Leventoğlu
- Departments of Pediatric Nephrology and Rheumatology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Yeşim Özdemir Atikel
- Department of Pediatric Nephrology, Eskişehir City Training and Research Hospital, Eskişehir, Turkey
| | - Hülya Nalçacıoğlu
- Department of Pediatric Nephrology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - İsmail Dursun
- Department of Pediatric Nephrology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Hasan Dursun
- Department of Pediatric Nephrology, Prof. Dr. Cemil Taşçıoğlu City Hospital, University of Health Sciences, İstanbul, Turkey
| | | | - Nurdan Yıldız
- Department of Pediatric Nephrology, İstanbul Pendik Education and Research Hospital, Marmara University, İstanbul, Turkey
| | - Gülşah Kaya Aksoy
- Department of Pediatric Nephrology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Mehmet Taşdemir
- Departments of Pediatric Nephrology and Rheumatology, Faculty of Medicine, Koç University, İstanbul, Turkey
| | - Mehtap Çelakıl
- Department of Pediatric Nephrology, Hatay State Hospital, Hatay, Turkey
| | | | - Şenay Zırhlı Selçuk
- Department of Pediatric Nephrology, Turgut Özal Medical Center, İnönü University, Malatya, Turkey
| | - Nur Canpolat
- Department of Pediatric Nephrology, Cerrahpaşa Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Evrim Kargın Çakıcı
- Department of Pediatric Nephrology, Dr. Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Sare Gülfem Özlü
- Department of Pediatric Nephrology, Ankara City Training and Research Hospital, Ankara, Turkey
| | - Sebahat Tülpar
- Department of Pediatric Nephrology, İstanbul Bakırköy Dr. Sadi Konuk Research and Training Hospital, University of Health Sciences, İstanbul, Turkey
| | - Selçuk Yüksel
- Department of Pediatric Nephrology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Bahriye Atmış
- Department of Pediatric Nephrology, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Serra Sürmeli Döven
- Department of Pediatric Nephrology, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Sevgin Taner
- Department of Pediatric Nephrology, Adana City Training and Research Hospital, University of Health Sciences, Adana, Turkey
| | - Pelin Ertan
- Department of Pediatric Nephrology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Aslı Kavaz Tufan
- Department of Pediatric Nephrology, Faculty of Medicine, Osmangazi University, Eskişehir, Turkey
| | - Meral Torun Bayram
- Department of Pediatric Nephrology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Mukaddes Kalyoncu
- Departments of Pediatric Nephrology and Rheumatology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Kaan Savaş Gülleroğlu
- Department of Pediatric Nephrology, Faculty of Medicine, Başkent University, Ankara, Turkey
| | | | - Belde Kasap Demir
- Departments of Pediatric Nephrology and Rheumatology, Faculty of Medicine, İzmir Katip Çelebi University, İzmir, Turkey
| | | | - Ilmay Bilge
- Departments of Pediatric Nephrology and Rheumatology, Faculty of Medicine, Koç University, İstanbul, Turkey
| | - Osman Dönmez
- Departments of Pediatric Nephrology and Rheumatology, Faculty of Medicine, Uludağ University, Bursa, Turkey
| | - Aslıhan Kara
- Departments of Pediatric Nephrology and Rheumatology, Faculty of Medicine, Fırat University, Elazığ, Turkey
| | - Önder Yavaşcan
- Department of Pediatric Nephrology, Faculty of Medicine, Medipol University, İstanbul, Turkey
| | - Gül Özçelik
- Department of Pediatric Nephrology, Şisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, İstanbul, Turkey
| | - Deniz Gezgin Yıldırım
- Departments of Pediatric Nephrology and Rheumatology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Muhammet Akif Güler
- Department of Pediatric Nephrology, Faculty of Medicine, Atatürk University, Erzurum, Turkey
| | - Ferah Sönmez
- Department of Pediatric Nephrology, Faculty of Medicine, Adnan Menderes University, Aydın, Turkey
| | | | - Sema Akman
- Department of Pediatric Nephrology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Rezan Topaloğlu
- Department of Pediatric Nephrology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Harika Alpay
- Department of Pediatric Nephrology, İstanbul Pendik Education and Research Hospital, Marmara University, İstanbul, Turkey
| | | |
Collapse
|
5
|
Babayigit C, Kokturk N, Kul S, Cetinkaya PD, Atis Nayci S, Argun Baris S, Karcioglu O, Aysert P, Irmak I, Akbas Yuksel A, Sekibag Y, Baydar Toprak O, Azak E, Mulamahmutoglu S, Cuhadaroglu C, Demirel A, Kerget B, Baran Ketencioglu B, Ozger HS, Ozkan G, Ture Z, Ergan B, Avkan Oguz V, Kilinc O, Ercelik M, Ulukavak Ciftci T, Alici O, Nurlu Temel E, Ataoglu O, Aydin A, Cetiner Bahcetepe D, Gullu YT, Fakili F, Deveci F, Kose N, Tor MM, Gunluoglu G, Altin S, Turgut T, Tuna T, Ozturk O, Dikensoy O, Yildiz Gulhan P, Basyigit I, Boyaci H, Oguzulgen IK, Borekci S, Gemicioglu B, Bayraktar F, Elbek O, Hanta I, Kuzu Okur H, Sagcan G, Uzun O, Akgun M, Altinisik G, Dursun B, Cakir Edis E, Gulhan E, Oner Eyuboglu F, Gultekin O, Havlucu Y, Ozkan M, Sakar Coskun A, Sayiner A, Kalyoncu AF, Itil O, Bayram H. The association of antiviral drugs with COVID-19 morbidity: The retrospective analysis of a nationwide COVID-19 cohort. Front Med (Lausanne) 2022; 9:894126. [PMID: 36117966 PMCID: PMC9471091 DOI: 10.3389/fmed.2022.894126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 08/11/2022] [Indexed: 11/29/2022] Open
Abstract
Background and objectives Although several repurposed antiviral drugs have been used for the treatment of COVID-19, only a few such as remdesivir and molnupiravir have shown promising effects. The objectives of our study were to investigate the association of repurposed antiviral drugs with COVID-19 morbidity. Methods Patients admitted to 26 different hospitals located in 16 different provinces between March 11–July 18, 2020, were enrolled. Case definition was based on WHO criteria. Patients were managed according to the guidelines by Scientific Board of Ministry of Health of Turkey. Primary outcomes were length of hospitalization, intensive care unit (ICU) requirement, and intubation. Results We retrospectively evaluated 1,472 COVID-19 adult patients; 57.1% were men (mean age = 51.9 ± 17.7years). A total of 210 (14.3%) had severe pneumonia, 115 (7.8%) were admitted to ICUs, and 69 (4.7%) were intubated during hospitalization. The median (interquartile range) of duration of hospitalization, including ICU admission, was 7 (5–12) days. Favipiravir (n = 328), lopinavir/ritonavir (n = 55), and oseltamivir (n = 761) were administered as antiviral agents, and hydroxychloroquine (HCQ, n = 1,382) and azithromycin (n = 738) were used for their immunomodulatory activity. Lopinavir/ritonavir (β [95% CI]: 4.71 [2.31–7.11]; p = 0.001), favipiravir (β [95% CI]: 3.55 [2.56–4.55]; p = 0.001) and HCQ (β [95% CI]: 0.84 [0.02–1.67]; p = 0.046) were associated with increased risk of lengthy hospital stays. Furthermore, favipiravir was associated with increased risks of ICU admission (OR [95% CI]: 3.02 [1.70–5.35]; p = 0.001) and invasive mechanical ventilation requirement (OR [95% CI]: 2.94 [1.28–6.75]; p = 0.011). Conclusion Our findings demonstrated that antiviral drugs including lopinavir, ritonavir, and favipiravir were associated with negative clinical outcomes such as increased risks for lengthy hospital stay, ICU admission, and invasive mechanical ventilation requirement. Therefore, repurposing such agents without proven clinical evidence might not be the best approach for COVID-19 treatment.
Collapse
Affiliation(s)
- Cenk Babayigit
- Department of Pulmonary Medicine, Faculty of Medicine, Mustafa Kemal University, Antakya, Turkey
| | - Nurdan Kokturk
- Department of Pulmonary Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Seval Kul
- Department of Biostatistics, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Pelin Duru Cetinkaya
- Department of Pulmonary Medicine, Adana City Training and Research Hospital, University of Health Sciences, Adana, Turkey
- Department of Pulmonary Medicine, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Sibel Atis Nayci
- Department of Pulmonary Medicine, Faculty of Medicine, Mersin University, Yenişehir, Turkey
| | - Serap Argun Baris
- Department of Pulmonary Medicine, Faculty of Medicine, Kocaeli University, İzmit, Turkey
| | - Oguz Karcioglu
- Department of Pulmonary Medicine, Halil Şıvgın Cubuk State Hospital, Ankara, Turkey
| | - Pinar Aysert
- Department of Infectious Disease, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ilim Irmak
- Department of Pulmonary Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Aycan Akbas Yuksel
- Department of Pulmonary Medicine, Faculty of Medicine, Ufuk University, Ankara, Turkey
| | - Yonca Sekibag
- Department of Pulmonary Disease, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Oya Baydar Toprak
- Department of Pulmonary Medicine, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Emel Azak
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Kocaeli University, İzmit, Turkey
| | - Sait Mulamahmutoglu
- Department of Pulmonary Disease, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Caglar Cuhadaroglu
- Department of Pulmonary Medicine, Faculty of Medicine, Altunizade Acibadem Hospital, Acibadem University, Istanbul, Turkey
| | - Aslihan Demirel
- Department of Infectious Disease, Kadıköy Florence Nightingale Hospital, Istanbul, Turkey
| | - Bugra Kerget
- Department of Pulmonary Medicine, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | | | - Hasan Selcuk Ozger
- Department of Infectious Disease, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Gulcihan Ozkan
- Department of Pulmonary Medicine, Acibadem Maslak Hospital, Istanbul, Turkey
- Operating Room Services Department, Vocational School, Nişantaşı University, Istanbul, Turkey
| | - Zeynep Ture
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Begum Ergan
- Department of Pulmonary Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Vildan Avkan Oguz
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Oguz Kilinc
- Department of Pulmonary Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Merve Ercelik
- Department of Pulmonary Medicine, Faculty of Medicine, Düzce University, Düzce, Turkey
| | - Tansu Ulukavak Ciftci
- Department of Pulmonary Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ozlem Alici
- Department of Infectious Disease, Turkiye Gazetesi Private Hospital, Istanbul, Turkey
| | - Esra Nurlu Temel
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
| | - Ozlem Ataoglu
- Department of Pulmonary Medicine, Faculty of Medicine, Düzce University, Düzce, Turkey
| | - Asena Aydin
- Department of Pulmonary Medicine, Kestel State Hospital, Bursa, Turkey
| | | | - Yusuf Taha Gullu
- Department of Pulmonary Medicine, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Fusun Fakili
- Department of Pulmonary Medicine, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Figen Deveci
- Department of Pulmonary Medicine, Faculty of Medicine, Firat University, Elazıg˘, Turkey
| | - Neslihan Kose
- Department of Pulmonary Medicine, Bilecik Training and Research Hospital, Bilecik, Turkey
| | - Muge Meltem Tor
- Department of Pulmonary Medicine, Faculty of Medicine, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
| | - Gulsah Gunluoglu
- Department of Pulmonary Medicine, Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, University of Health Science, Istanbul, Turkey
| | - Sedat Altin
- Department of Pulmonary Medicine, Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, University of Health Science, Istanbul, Turkey
| | - Teyfik Turgut
- Department of Pulmonary Medicine, Faculty of Medicine, Firat University, Elazıg˘, Turkey
| | - Tibel Tuna
- Department of Pulmonary Medicine, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Onder Ozturk
- Department of Pulmonary Medicine, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
| | - Oner Dikensoy
- Department of Pulmonary Medicine, Faculty of Medicine, Taksim, Acibadem University, Istanbul, Turkey
| | - Pinar Yildiz Gulhan
- Department of Pulmonary Medicine, Faculty of Medicine, Düzce University, Düzce, Turkey
| | - Ilknur Basyigit
- Department of Pulmonary Medicine, Faculty of Medicine, Kocaeli University, İzmit, Turkey
| | - Hasim Boyaci
- Department of Pulmonary Medicine, Faculty of Medicine, Kocaeli University, İzmit, Turkey
| | | | - Sermin Borekci
- Department of Pulmonary Disease, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Bilun Gemicioglu
- Department of Pulmonary Disease, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Firat Bayraktar
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Osman Elbek
- Department of Pulmonary Medicine, Kadıköy Florence Nightingale Hospital, Istanbul, Turkey
| | - Ismail Hanta
- Department of Pulmonary Medicine, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Hacer Kuzu Okur
- Department of Pulmonary Medicine, Faculty of Medicine, Altunizade Acibadem Hospital, Acibadem University, Istanbul, Turkey
| | - Gulseren Sagcan
- Department of Pulmonary Medicine, Faculty of Medicine, Altunizade Acibadem Hospital, Acibadem University, Istanbul, Turkey
| | - Oguz Uzun
- Department of Pulmonary Medicine, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Metin Akgun
- Department of Pulmonary Medicine, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Goksel Altinisik
- Department of Pulmonary Medicine, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Berna Dursun
- Department of Pulmonary Medicine, Ankara Memorial Hospital, Ankara, Turkey
| | - Ebru Cakir Edis
- Department of Pulmonary Medicine, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Erkmen Gulhan
- Department of Thoracic Surgery, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Fusun Oner Eyuboglu
- Department of Pulmonary Medicine, School of Medicine, Başkent University, Ankara, Turkey
| | - Okkes Gultekin
- Department of Pulmonary Medicine, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Yavuz Havlucu
- Department of Pulmonary Medicine, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Metin Ozkan
- Department of Pulmonary Medicine, Ankara Memorial Hospital, Ankara, Turkey
| | - Aysin Sakar Coskun
- Department of Pulmonary Medicine, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Abdullah Sayiner
- Department of Pulmonary Medicine, Faculty of Medicine, Ege University, Izmir, Turkey
| | - A. Fuat Kalyoncu
- Department of Pulmonary Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Oya Itil
- Department of Pulmonary Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Hasan Bayram
- Department of Pulmonary Medicine, Koç University School of Medicine, Istanbul, Turkey
- Koç University Research Center for Translational Medicine (KUTTAM), Koç University School of Medicine, Istanbul, Turkey
- *Correspondence: Hasan Bayram,
| |
Collapse
|
6
|
Antiviral Used among Non-Severe COVID-19 Cases in Relation to Time till Viral Clearance: A Retrospective Cohort Study. Antibiotics (Basel) 2022; 11:antibiotics11040498. [PMID: 35453248 PMCID: PMC9030807 DOI: 10.3390/antibiotics11040498] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/26/2022] [Accepted: 04/04/2022] [Indexed: 02/06/2023] Open
Abstract
(1) Background: The WHO identified COVID-19 as a fast-growing epidemic worldwide. A few antivirals have shown promising effectiveness in treating COVID-19. This study aimed to assess the correlation between antiviral drugs and the time until viral clearance of SARS-CoV-2. (2) Methods: This was a retrospective cohort study that included 1731 non-severe COVID-19 patients treated in NMC Royal Hospital, UAE. (3) Results: A total of 1446 patients received symptomatic treatment only (mean age of 35.6 ± 9.0 years). The analyzed antiviral treatment protocols were azithromycin, hydroxychloroquine, lopinavir/ritonavir, and favipiravir. The produced Kaplan–Meier plots showed no significant differences in the time until viral clearance among the compared protocols, which showed overlapping confidence intervals, which were determined by performing the log-rank and adjusted pairwise log-rank tests (p = 0.2, log-rank = 9.3). The age and gender of patients did not significantly affect the rate of viral clearance regardless of the antiviral therapy administered, even when compared to patients who received symptomatic treatment only, with the exception of hydroxychloroquine (HCQ), azithromycin, and favipiravir, which increased the odds of a faster rate of viral clearance by 46% after adjustments. (4) Conclusions: No significant differences were observed regarding the time until viral clearance among non-severe COVID-19 patients following the prescription of different antiviral drugs.
Collapse
|
7
|
Kayaaslan B, Guner R. COVID-19 and the liver: A brief and core review. World J Hepatol 2021; 13:2013-2023. [PMID: 35070005 PMCID: PMC8727220 DOI: 10.4254/wjh.v13.i12.2013] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/23/2021] [Accepted: 10/27/2021] [Indexed: 02/06/2023] Open
Abstract
Coronavirus disease 2019 has a wide range of clinical spectrum from asymptomatic infection to severe infection resulting in death within a short time. Currently, it is known that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) does not only cause a respiratory tract infection but a more complicated disease that can lead to multiple system involvement including the liver. Herein, we evaluate the epidemiology, the impact of liver injury/ dysfunction on disease prognosis, the pathophysiological mechanisms and management of liver injury. More than one-fourth of the patients have abnormal liver function tests, mostly a mild-to-moderate liver dysfunction. Liver injury is significantly associated with a poor clinical outcome. Direct cytotoxic effect of SARS-CoV-2, the immune response (“cytokine storm”), the complications related to the disease, and drugs used in the treatments are the pathophysiological mechanisms responsible for liver injury. However, the exact mechanism is not yet clearly explained. The binding of SARS-CoV-2 to the angiotensin-converting enzyme 2 receptors and entering the hepatocyte and cholangiocytes can cause cytotoxic effects on the liver. Excessive immune response has an important role in disease progression and causes acute respiratory distress syndrome and multi-organ failures accompanied by liver injury. Treatment drugs, particularly lopinavir/ritonavir, remdesivir and antibiotics are a frequent reason for liver injury. The possible reasons should be meticulously investigated and resolved.
Collapse
Affiliation(s)
- Bircan Kayaaslan
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara Yildirim Beyazit University, Ankara 06800, Turkey
| | - Rahmet Guner
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara Yildirim Beyazit University, Ankara 06800, Turkey
| |
Collapse
|
8
|
Demir C, Demir AU. Letter to the editor: The effect of hydroxychloroquine on COVID-19. J Infect Public Health 2021; 15:68. [PMID: 34922225 PMCID: PMC8660129 DOI: 10.1016/j.jiph.2021.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Canan Demir
- Ankara Occupational and Environmental Diseases Hospital Occupational Medicine Clinic, Osmangazi Mahallesi, Atlilar Cad. No: 45, 06280 Kecioren, Ankara, Turkey.
| | - Ahmet Ugur Demir
- Hacettepe University, School of Medicine, Department of Chest Diseases, 06100 Sihhiye, Ankara, Turkey.
| |
Collapse
|
9
|
ICU admission and favipiravir. North Clin Istanb 2021; 8:544. [PMID: 34909598 PMCID: PMC8630721 DOI: 10.14744/nci.2021.60234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 07/13/2021] [Indexed: 11/20/2022] Open
|
10
|
Hossain MJ, Jannat T, Brishty SR, Roy U, Mitra S, Rafi MO, Islam MR, Nesa ML, Islam MA, Emran TB. Clinical Efficacy and Safety of Antiviral Drugs in the Extended Use against COVID-19: What We Know So Far. BIOLOGICS 2021; 1:252-284. [DOI: 10.3390/biologics1020016] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Human beings around the globe have been suffering from a devastating novel pandemic and public health emergency, coronavirus disease 2019 (COVID-19), for more than one and a half years due to the deadly and highly pathogenic severe acute respiratory coronavirus 2 (SARS-CoV-2) infection worldwide. Notably, no effective treatment strategy has been approved for the complete recovery of COVID-19 patients, though several vaccines have been rolled out around the world upon emergency use authorization. After the emergence of the COVID-19 outbreak globally, plenty of clinical investigations commenced to screen the safety and efficacy of several previously approved drugs to be repurposed against the SARS-CoV-2 pathogen. This concise review aims at exploring the current status of the clinical efficacy and safety profile of several antiviral medications for the treatment of patients with COVID-19 and other respiratory complications caused by SARS-CoV-2 infection. The paper covers all kinds of human studies (January 2020 to June 2021) except case reports/series to highlight the clear conclusion based on the current clinical evidence. Among the promising repositioned antivirals, remdesivir has been recommended in critical conditions to mitigate the fatality rate and improve clinical conditions. In addition, boosting the immune system is believed to be beneficial in treating COVID-19 patients, so interferon type I might exert immunomodulation through its antiviral effects by stimulating interferon-stimulated gene (ISG). However, more extensive clinical studies covering all ethnic groups globally are warranted based on current data to better understand the clinical efficacy of the currently proposed repurposed drugs against COVID-19.
Collapse
|
11
|
Alotaibi M, Ali A, Bakhshwin D, Alatawi Y, Alotaibi S, Alhifany A, Alharthi B, Alharthi N, Alyazidi A, Alharthi Y, Alrafiah A. Effectiveness and Safety of Favipiravir Compared to Hydroxychloroquine for Management of Covid-19: A Retrospective Study. Int J Gen Med 2021; 14:5597-5606. [PMID: 34548811 PMCID: PMC8449635 DOI: 10.2147/ijgm.s329881] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/01/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Coronavirus disease (COVID-19) is an infectious disease due to SARS-COV-2. Patients with risk factors are vulnerable to severe morbidity and mortality. Favipiravir (FPV) and hydroxychloroquine (HCQ) are considered possible COVID-19 treatments. OBJECTIVE To investigate the effectiveness and safety of FPV compared to HCQ in patients with COVID-19 as the standard of care approved by the national protocol there. METHODS This is a retrospective cohort study on patients with COVID-19 who were administered either FPV or HCQ at King Faisal Medical Complex, Taif, Saudi Arabia, from June 2020 to August 2020. RESULTS In total, 508 patients were included in the analysis. Patients were categorized into three groups by medication. Patients enrolled in this study were 244 (55.8%) on FPV, 193 (44.2%) on HCQ and 71 (13.81%) on neither medication. Patients who received FPV had higher age and greater comorbidity. Most of the patients were discharged on day 14 (n = 303, 59.6%), 26 (36.6%) in neither med, 154 (63.1%) in FPV and 123 (63.7%) in HCQ groups with significant difference between groups (P < 0.0001). Mortality rate was 8.2% (n = 20) in FPV and 7.3% (n = 14) in HCQ groups with significant difference between groups (P = 0.048). Regarding drug safety, 19.7% of patients treated with FPV vs 7.8% HCQ have adverse effects with significant difference between groups (P < 0.0001). Most of the side effects were increase ALT and AST. Meanwhile, prolonged Q-T interval was reported only in the HCQ group (2.6%). From Cox regression modeling, only mechanical ventilation due to Covid 19 was predictive for mortality (HR: 16.598, 95% CI: 7.095-38.828, P < 0.0001). Meanwhile, there was no significant difference in the prediction of discharge of FPV (vs HCQ) (HR: 0.933, 95% CI: 0.729-1.195, P = 0.5843), predictors of mortality were HCQ (vs FPV) (HR: 2.3, 95% CI: 0.994-5.487, P = 0.0518). Kaplan-Meier survival curves showed improved survival time and discharged time among patients in the HCQ versus FPV group with an insignificant difference between them (P = 0.85, P = 0.06, respectively). CONCLUSION The present study concluded that FPV and HCQ showed comparable efficacy in decrease mortality and oxygen requirements. FPV likely has a more favorable safety profile regarding cardiac toxicity. A randomized clinical trial with large patient numbers is recommended to confirm the effectiveness of these drugs in COVID-19 patients.
Collapse
Affiliation(s)
- Musim Alotaibi
- Department of Pharmacology, King Abdulaziz University, Jeddah City, Kingdom of Saudi Arabia
- Department of Pharmacy, King Faisal Medical Complex, Taif City, Kingdom of Saudi Arabia
| | - Ahmed Ali
- Department of Pharmacology, King Abdulaziz University, Jeddah City, Kingdom of Saudi Arabia
- Department of Pharmaceutics, Assiut University, Assiut City, Egypt
| | - Duaa Bakhshwin
- Department of Pharmacotherapy and Outcomes Science, King Abdulaziz University, Jeddah City, Kingdom of Saudi Arabia
| | - Yasser Alatawi
- Department of Pharmacy Practice, University of Tabuk, Tabuk City, Kingdom of Saudi Arabia
| | - Sultan Alotaibi
- Department of Pharmacy, King Abdul-Aziz Medical, Jeddah City, Kingdom of Saudi Arabia
| | - Abdullah Alhifany
- Department of Clinical Pharmacy College of Pharmacy, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia
| | - Badr Alharthi
- Department of Pharmacy, King Faisal Medical Complex, Taif City, Kingdom of Saudi Arabia
| | - Nasser Alharthi
- Department of Pharmacy, King Faisal Medical Complex, Taif City, Kingdom of Saudi Arabia
| | - Awatef Alyazidi
- Department of Pharmacy, King Faisal Medical Complex, Taif City, Kingdom of Saudi Arabia
| | - Yasmeen Alharthi
- Department of Pharmacy, King Faisal Medical Complex, Taif City, Kingdom of Saudi Arabia
| | - Aziza Alrafiah
- Department of Medical Laboratory Technology, King Abdulaziz University, Jeddah City, Kingdom of Saudi Arabia
| |
Collapse
|
12
|
Favipiravir versus standard of care in patients with severe COVID-19 infections: A retrospective comparative study. J Infect Public Health 2021; 14:1247-1253. [PMID: 34464921 PMCID: PMC8382493 DOI: 10.1016/j.jiph.2021.08.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 08/17/2021] [Accepted: 08/22/2021] [Indexed: 12/12/2022] Open
Abstract
Objective To assess the efficacy of Favipiravir compared to the standard therapy in treating patients with severe COVID-19 infection. Methods This is a retrospective cohort of patients with COVID-19 pneumonia who were treated with favipiravir, versus comparison group that received the standard of care. Results A total of 226 patients were included; 110 patients received favipiravir and 116 patients received standard of care. Patients who received favipiravir had longer time to recovery (14.2 ± 8.8 versus 12.8 ± 5.2, p = 0.17). Favipiravir was associated with an improved early day 14 mortality (4 [3.6%] versus 11 [9.5%]), p = 0.008), but was associated with a higher day 28 mortality (26 [23.6%] versus 11 [9.5%], p = 0.02). The overall mortality was higher in the favipiravir versus the standard of care group but difference was not statistically significant (33 [30.0%] versus 24 [20.7%], p = 0.10). Conclusion The addition of favipiravir to standard of care was not associated with any improvement in clinical outcomes or mortality. Larger randomized controlled clinical trials are needed to further assess the efficacy of favipiravir.
Collapse
|