Early favipiravir treatment was associated with early defervescence in non-severe COVID-19 patients

Abstract

Introduction The antiviral drug favipiravir has been shown to have in vitro antiviral activity against severe-acute-respiratory-syndrome-coronavirus-2 (SARS-CoV-2). In this study, we investigated the clinical benefits and initiation of favipiravir treatment in patients with non-severe coronavirus-disease-2019 (COVID-19). Methods This study was a single-center retrospective cohort study. Receiver operating characteristic curves were drawn to calculate the area under the curve, and the optimal cut-off values for the time to initiate favipiravir treatment were calculated to predict defervescence within seven days. Univariate and multivariate Cox regression analyses were performed to identify potential influencing factors of defervescence. This was defined as a body temperature of less than 37 °C for at least 2 days. Results Data from 41 patients were used for the efficacy assessment. The days from the onset of fever to defervescence showed a positive correlation with the duration from the onset of fever to initiation of favipiravir treatment (r=0.548, P <0.001). The optimal cut-off value was the administration of favipiravir on day 4. Patients were assigned to two groups based on the optimal cut-off value from onset to initiation of favipiravir treatment: early treatment group (within 4-days) and late treatment group (more than 4-days). In the multivariate analysis, when adjusted for age, sex, and days from onset to initiation of favipiravir treatment, the significant factors were male sex and days of initiation of the favipiravir treatment. Conclusions We recommend that if favipiravir is to be used for treatment, it should be initiated as early as possible.

Early Treatment of Favipiravir in COVID-19 Patients Without Pneumonia: A Multicentre, Open-Labelled, Randomized Control Study

“…Sawanpanyalert et al (2021) demonstrated that the 140 Thai patients admitted and treated with FPV within 4 days upon symptomatic onset, in conjunction to other treatment modalities, had significantly lower odds of experiencing poor outcomes compared to those initiated treatment after 4 days of onset. Similarly, other studies also showed that early treatment, particularly by 4 days of onset, was associated with earlier defervescence [8,45]. These reports highlight the importance of early intervention and its clinical benefits, as observed in our study.…”

SARS-CoV-2-Triggered Mast Cell Rapid Degranulation Induces Alveolar Epithelial Inflammation and Lung Injury

“…The limitation of our study is that the administration of Eba or Lor significantly reduced SARS-CoV-2-induced inflammation and lung injury, but showed limitation in suppressing viral replication in lungs of ACE2 humanized mice. A combination of MC stabilizers with antiviral drugs such as the RNA polymerase inhibitors Remdesivir and Favipiravir 6,78–80 , may provide more optimal treatment strategy that dampening inflammation and clearing viruses at the same time.…”

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“…At present, antiviral drugs, such as areplivir and favipiravir, are being used in trials. The days from the onset of fever to defervescence were shown to be positively correlated with the duration from the onset of fever to the initiation of favipiravir treatment ( 35 ). However, no specific antiviral drugs have been approved for the treatment of COVID-19 ( 36 ).…”