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Efficacy of Favipiravir in treatment of mild & moderate COVID-19 infection in Nepal: a multi-center, randomized, open-labelled, phase III clinical trial

Adhikari et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2021.12.109
Mar 2022  
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Improvement -40% Improvement Relative Risk Improvement (b) -36% Improvement (c) -64% Favipiravir  Adhikari et al.  EARLY TREATMENT  RCT Is early treatment with favipiravir beneficial for COVID-19? RCT 70 patients in Nepal (May - October 2020) Worse improvement with favipiravir (not stat. sig., p=0.57) c19early.org Adhikari et al., Int. J. Infectious Di.., Mar 2022 Favorsfavipiravir Favorscontrol 0 0.5 1 1.5 2+
Preliminary report for an RCT in Nepal with 38 favipiravir patients and 32 control patients, showing no significant differences. There were no serious side effects.
Potential risks of favipiravir include the creation of dangerous variants, and mutagenicity, carcinogenicity, teratogenicity, and embryotoxicity1-5.
risk of no improvement, 40.4% higher, RR 1.40, p = 0.57, treatment 10 of 38 (26.3%), control 6 of 32 (18.8%), all.
risk of no improvement, 36.3% higher, RR 1.36, p = 0.75, treatment 8 of 27 (29.6%), control 5 of 23 (21.7%), mild cases.
risk of no improvement, 63.6% higher, RR 1.64, p = 1.00, treatment 2 of 11 (18.2%), control 1 of 9 (11.1%), moderate cases.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Adhikari et al., 1 Mar 2022, Randomized Controlled Trial, Nepal, peer-reviewed, 12 authors, study period May 2020 - October 2020.
This PaperFavipiravirAll
High SARS-CoV-2 attack rates among asymptomatic hospital workers from Ecuador
D C Morales Jadan, A P Vallejo Janeta, M A Garcia Bereguiain
International Journal of Infectious Diseases, doi:10.1016/j.ijid.2021.12.107
Purpose: To determine the SARS-CoV-2 risk of infection in Ecuadorian hospital. This study aims to describe the SARS-CoV-2 attacks rate and viral loads among patient care workers and other staff from Ecuadorian hospitals during the first wave of COVID-19 pandemic. Methods & Materials: : Study design and setting. We carried out a cross-sectional study to describe the attack rate of SARS-CoV-2 infection among patient care workers (physicians, nurses and nursing assistants) and other healthcare personnel (administrative and services staff) from 9 hospitals of the Andean and Costal Regions of Ecuador from May to October 2020. Sample collection, RNA Extraction and RT-qPCR for SARS-CoV-2 diagnosis using the CDC protocol. The samples were processed in the BSL2 certified molecular biology laboratory at Universidad de Las Americas. Nasopharyngeal swabs were collected on 0.5mL TE pH 8 buffer for SARS-CoV-2 diagnosis by RT-qPCR following an adapted version of the CDC protocol. Statistical analysis. Chi cuadrado with the statistic program SPSS Results: A total of 1243 patient care workers and 428 of other healthcare staff were tested for SARS-CoV-2 infection. The SARS-CoV-2 attack rate was 12% (145/1243) for patient care workers and 19% (80/428) for other healthcare personnel, being this difference statistically significant (p < 0.05). For each hospital, the following SARS-CoV-2 attack rates were obtained for patient care workers and other staff: 35% and 50% in "Hogar ABEI", 21% and 26% in "Clínica Nuestra Señora de Guadalupe", 15% and 18% in "Hospital de Atención Integral al Adulto Mayor", 5% and 11% in "Hospital de Especialidades Eugenio Espejo", 12% and 22% in "Hospital Geriátrico Dr. Bolívar Arguello", 13% and 22% in "Hospital Dr. Gustavo Domínguez", 22% and 12% in "Hospital General Dr. Napoleón Dávila", 9% and 14% in "Hospital Pablo Arturo" and 5% and 13% in "Hospital San Francisco de Quito". Moreover, we found 47 individuals (19 among patient care workers and 28 among other staff) with viral loads larger than 10 8 copies/mL that may be considered super spreaders. Conclusion: Ecuadorian hospital workers at a high-risk group for SARS-CoV-2 infection. Regular SARS-CoV-2 testing should be mandatory for this group as even asymptomatic SARS-CoV-2 super spreaders can be detected.
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