Benefits of Treatment With Favipiravir in Hospitalized Patients for COVID-19: a Retrospective Observational Case-control Study

Abstract

Background: Although more than a year past since COVID-19 was defined, there is no specific treatment yet. Since COVID-19 management differs over time, it is hard to determine which therapy is more efficacious. In this study, we aimed to evaluate the efficacy of the regimen with Favipiravir (FPV) and determine if the timing of FPV addition offers any improvement. Methods: A retrospective observational case-controlled cohort study was performed between March and Sep-tember 2020, including adults with COVID-19 in a single-center in Turkey. We categorized patients into age-sex matched three groups, group 1 (n=48) and group 2 (n=48) included patients treated with the combination of FPV plus Hydroxychloroquine (HQ) early and late, respectively. Group 3 (n=48) consisted of patients on HQ monot-herapy. In Group 2, if the respiratory or clinic condition had not improved sufficiently, FPV was added on or after day 3. Results: We found that starting FPV early had an impact on PCR negativity and the progression of the disease. 'No progression' was defined as the absence of a new finding in the control radiological examination and the absence of accompanying clinical deterioration. Also, the decrease in C-reactive protein (CRP) was greater in Group 1 than Group 3 (p <0.001). However, we found that early initiation of FPV treatment did not have a posi-tive effect on the estimated survival time. Conclusions: According to this retrospective study results, we believe that for better clinical outcomes, FPV treatment should be started promptly to enhance antiviral effects and improve clinical outcomes.

Comparison of demographic and clinical characteristics of hospitalized COVID‐19 patients with severe/critical illness in the first wave versus the second wave

“…Fourth, data on causes of death, such as venous thromboembolism, which affects the course of the disease and shows seasonal characteristics were not collected. Finally, previous studies from Turkey have reported mortality rates in the first wave varying from 4.2% to 75.8% 15–20 . This variation was possibly driven by differences in study settings and patient population characteristics.…”

The efficacy and adverse effects of favipiravir on patients with COVID-19: A systematic review and meta-analysis of published clinical trials and observational studies

“…In nearly all the included RCTs, favipiravir was used early (at day 1 of diagnosis). The benefit of early usage of favipiravir was reported in some observational studies ( Karatas et al, 2021 ;Uçan et al, 2021 ). The viral clearance was also reported to be directly related to the early initiation of antiviral therapy and before the peak of viremia, leading some practitioners to start antiviral medications in the presymptomatic phase of COVID-19 ( Goyal et al, 2020 ).…”

“…Administrating favipiravir early (at the time of diagnosis) and late (few days later) were compared in some studies. Although an RCT showed insignificant differences ( Doi et al, 2020 ), a case-control study showed better outcomes on viral negativity (p < 0.001) and disease progression (p < 0.05) ( Uçan et al, 2021 ), and another retrospective cohort showed a lower mortality rate in early favipiravir treatment group (p = 0.002) ( Karatas et al, 2021 ).…”

Comparison of the intensive care unit admission rate and mortalities of COVID-19 patients who received Hydroxychloroquine and Favipiravir in the ward

“…It has been reported that when Favipiravir is used in the early period, it can improve clinical outcomes with its antiviral effect in COVID-19 patients. 9 The aim of this retrospective study is to compare the Intensive Care Unit (ICU) admission rate and mortalities of COVID-19 patients who received Hydroxychloroquine and Favipiravir in the COVID positive wards.…”