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0 0.5 1 1.5 2+ Mortality 33% Improvement Relative Risk Clinical improvement -2% primary Days to clinical improv.. -6% Viral clearance 44% Favipiravir  Alattar et al.  EARLY TREATMENT Is early treatment with favipiravir beneficial for COVID-19? PSM retrospective 774 patients in Qatar (May - July 2020) Improved viral clearance with favipiravir (p=0.0000014) c19early.org Alattar et al., J. Infection and Publi.., Nov 2021 Favors favipiravir Favors control

Favipiravir for the Treatment of Coronavirus Disease 2019 Pneumonia; a Propensity Score-matched Cohort Study

Alattar et al., Journal of Infection and Public Health, doi:10.1016/j.jiph.2022.08.011 (date from preprint)
Nov 2021  
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PSM retrospective with 1,493 patients, showing significantly improved viral clearance with favipiravir. There were no significant differences in clinical improvement or mortality. Mortality was lower (2.1% vs 3.1%), without statistical significance with the small number of events.
risk of death, 33.3% lower, RR 0.67, p = 0.50, treatment 8 of 387 (2.1%), control 12 of 387 (3.1%), NNT 97, propensity score matching, day 28.
risk of no clinical improvement, 2.2% higher, RR 1.02, p = 0.73, treatment 26 of 387 (6.7%), control 28 of 387 (7.2%), NNT 194, adjusted per study, inverted to make RR<1 favor treatment, day 28, Cox proportional hazards, propensity score matching, primary outcome.
days to clinical improvement, 6.2% higher, relative time 1.06, p = 0.07, treatment 387, control 387, propensity score matching.
risk of no viral clearance, 43.9% lower, RR 0.56, p < 0.001, treatment 78 of 387 (20.2%), control 139 of 387 (35.9%), NNT 6.3, propensity score matching.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Alattar et al., 30 Nov 2021, retrospective, Qatar, peer-reviewed, median age 46.0, 25 authors, study period 23 May, 2020 - 18 July, 2020, average treatment delay 5.0 days. Contact: aomrani@hamad.qa.
This PaperFavipiravirAll
Favipiravir for the treatment of coronavirus disease 2019 pneumonia; a propensity score-matched cohort study
Rand A Alattar, Shiema Abdalla, Tasneem Abdallah, Rashid Kazman, Aseelah Qadmour, Tawheeda Ibrahim, Bassem Alhariri, Shahd H Shaar, Abeer Bajwa, Abeir Alimam, Rabia Qazi, Fatma Ben Abid, Joanne Daghfal, Ali Eldeeb, Kinda Shukri, Ahmed Elsayed, Fatima Rustom, Musaed Alsamawi, Alaaeldin Abdelmajid, Miguel A P Basulto, Armando A R Cobian, Mohamed Abukhattab, Abdullatif Alkhal, Muna A Almaslamani, Ali S Omrani
Journal of Infection and Public Health, doi:10.1016/j.jiph.2022.08.011
This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Ethical approval The study was approved by the Institutional Review Board at Hamad Medical Corporation (MRC-01-20-994), with a waiver of informed consent. Funding The publication of this article was funded by the Qatar National Library. J o u r n a l P r e -p r o o f Declaration of Interest None
References
Beigel, Tomashek, Dodd, Mehta, Zingman et al., Remdesivir for the Treatment of Covid-19 -Final Report, N Engl J Med, doi:10.1056/NEJMoa2007764
Cevik, Kuppalli, Kindrachuk, Peiris, Virology, transmission, and pathogenesis of SARS-CoV-2, BMJ, doi:10.1136/bmj.m3862
Doi, Hibino, Hase, Yamamoto, Kasamatsu et al., A Prospective, Randomized, Open-Label Trial of Early versus Late Favipiravir Therapy in Hospitalized Patients with COVID-19, Antimicrob Agents Chemother, doi:10.1128/AAC.01897-20
Furuta, Komeno, Nakamura, Favipiravir (T-705), a broad spectrum inhibitor of viral RNA polymerase, Proc Jpn Acad Ser B Phys Biol Sci, doi:10.2183/pjab.93.027
Ivashchenko, Dmitriev, Vostokova, Azarova, Blinow et al., AVIFAVIR for Treatment of Patients with Moderate COVID-19: Interim Results of a Phase II/III Multicenter Randomized Clinical Trial, Clin Infect Dis, doi:10.1093/cid/ciaa1176
J O U R N A L P R E, -p r o o f
Kumagai, Murakawa, Hasunuma, Aso, Yuji et al., Lack of effect of favipiravir, a novel antiviral agent, on QT interval in healthy Japanese adults, Int J Clin Pharmacol Ther, doi:10.5414/cp202388
Lagocka, Dziedziejko, Kłos, Pawlik, Favipiravir in Therapy of Viral Infections, J Clin Med, doi:10.3390/jcm10020273
Manabe, Kambayashi, Akatsu, Kudo, Favipiravir for the treatment of patients with COVID-19: a systematic review and meta-analysis, BMC Infect Dis, doi:10.1186/s12879-021-06164-x
Özlüşen, Kozan, Akcan, Kalender, Yaprak et al., Effectiveness of favipiravir in COVID-19: a live systematic review, Eur J Clin Microbiol Infect Dis, doi:10.1007/s10096-021-04307-1
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