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0 0.5 1 1.5 2+ Mortality 3% Improvement Relative Risk Favipiravir  Abdulrahman et al.  ICU PATIENTS Is very late treatment with favipiravir beneficial for COVID-19? Retrospective 1,699 patients in Saudi Arabia (Jun - Aug 2020) No significant difference in mortality Abdulrahman et al., J. Ayub Medical Co.., Jun 2022 Favors favipiravir Favors control

Favipiravir efficacy and safety for the treatment of severe coronavirus 2019: a retrospective study

Abdulrahman et al., Journal of Ayub Medical College Abbottabad, doi:10.55519/JAMC-03-10305
Jun 2022  
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Retrospective 1,699 ICU patients in Saudi Arabia, 193 treated with favipiravir, showing no significant difference in mortality. This study is excluded in the after exclusion results of meta analysis: very late stage, ICU patients.
risk of death, 2.6% lower, RR 0.97, p = 0.81, treatment 74 of 193 (38.3%), control 593 of 1,506 (39.4%), NNT 97.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Abdulrahman et al., 21 Jun 2022, retrospective, Saudi Arabia, peer-reviewed, 15 authors, study period June 2020 - August 2020.
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This PaperFavipiravirAll
Waleed Aletreby, Basheer Abdulrahman, Ahmed Mady, Mohammed Al-Odat, Ashraf Al Tayar, Muhammad Asim Rana, Abdulrahman Alharthy, Alyaa Alhazmi, Ahmed S Abdelmoaty, Muhammad Mansoor Hafeez, Ahmed Kuhail, Alfateh M Noor, Mohammed Haddad, Anas Mady, Noor Ali
Journal of Ayub Medical College Abbottabad, doi:10.55519/jamc-03-10305
Background: Corona virus disease is caused by the enveloped, single stranded RNA virus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) becoming the deadliest disease of the century. Its global outbreak has led researchers to develop drugs or vaccines to prevent the spread of the disease. Favipiravir is an approved orally administered antiviral drug that selectively inhibits RNAdependent RNA polymerase, used off-label to treat COVID-19. Objectives: The purpose of this study was to assess the efficacy and safety of this drug for severe COVID-19 infection. Methods: This was an observational retrospective study, carried out at the ICU of King Saud Medical City (KSMC) from June 2020 to August 2020. Including a total of one thousand six hundred and ninety-nine patients (n=1699). Categorized into a treatment group (193 patients) who received Favipiravir along with standard care, and non-treatment group (1506 patients) who received standard care only. Results: ICU all-cause mortality was similar in both groups i.e., (Treated group 38.3% Vs Untreated group 39.4%, 95% CI of difference: -6.6% to +8.4%; p = 0.8). The subgroup analysis of survivors as compared to deceased in the treatment group showed that survivors had significantly lower age, international normalising ratio (INR), blood urea nitrogen (BUN), and creatinine. The mean ICU length of stay (LOS) was shorter for survivors compared to deceased (11.2± 8.03 Vs 16.7±9.8 days respectively), while hospital LOS was almost similar between the two groups. Advanced age (OR 1.03 [95% CI: 1.01-1.06]; p=0.004), higher INR and BUN were significantly associated with increased odds of mortality. Comparison of lab investigations at day 1 and day 10 in the treatment group (regardless of outcome) showed that there was a significant increase in Alanine transaminase (ALT), alkaline phosphatase (ALK), and Bilirubin, while an insignificant trend of increase in Aspartate transaminase (AST) and creatinine was recorded. Conclusion: In this study, Favipiravir showed better therapeutic responses in patients with severe COVID-19 infection, in terms of average duration of stay in the intensive care unit and was well tolerated in the younger age, but showed no mortality benefit. However, elevated levels of inflammatory markers, including increased ALT, AST, BUN, bilirubin, and creatinine, needs to be carefully examined.
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Food, Administration, FDA approves first treatment for COVID-19
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Late treatment
is less effective
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