Favipiravir Effectiveness and Safety in Hospitalized Moderate-Severe COVID-19 Patients: Observational Prospective Multicenter Investigation in Saudi Arabia
Al-Muhsen et al.,
Favipiravir Effectiveness and Safety in Hospitalized Moderate-Severe COVID-19 Patients: Observational..,
Frontiers in Medicine, doi:10.3389/fmed.2022.826247
Prospective observational study of 598 hospitalized patients in Saudi Arabia, showing higher risk of mortality and longer hospitalization time with favipiravir.
risk of death, 263.0% higher, HR 3.63, p = 0.04, treatment 156, control 442, Cox proportional hazards.
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risk of oxygen therapy, 40.6% lower, RR 0.59, p < 0.001, treatment 52 of 156 (33.3%), control 248 of 442 (56.1%), NNT 4.4.
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hospitalization time, 40.0% higher, relative time 1.40, p = 0.03, treatment 156, control 442.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Al-Muhsen et al., 4 Mar 2022, prospective, Saudi Arabia, peer-reviewed, 11 authors, study period June 2020 - January 2021.
Contact:
almuhsen@ksu.edu.sa, rhalwani@sharjah.ac.ae, hayakbaa@gmail.com.
Abstract: ORIGINAL RESEARCH
published: 04 March 2022
doi: 10.3389/fmed.2022.826247
Favipiravir Effectiveness and Safety
in Hospitalized Moderate-Severe
COVID-19 Patients: Observational
Prospective Multicenter Investigation
in Saudi Arabia
Edited by:
Murat Akova,
Hacettepe University, Turkey
Saleh Al-Muhsen 1*† , Nouf S. Al-Numair 2† , Narjes Saheb Sharif-Askari 3† , Roaa Basamh 4 ,
Banan Alyounes 4 , Amjad Jabaan 4 , Fatemeh Saheb Sharif-Askari 3 ,
Mohammed F. Alosaimi 1 , Fahad Alsohime 1 , Rabih Halwani 1,3,5* and Haya Al-Saud 4,6*
1
Reviewed by:
Carmen Silvia Valente Barbas,
University of São Paulo, Brazil
Gökhan Metan,
Hacettepe University, Turkey
*Correspondence:
Saleh Al-Muhsen
almuhsen@ksu.edu.sa
Rabih Halwani
rhalwani@sharjah.ac.ae
Haya Al-Saud
hayakbaa@gmail.com
† These authors have contributed
equally to this work
Specialty section:
This article was submitted to
Infectious Diseases – Surveillance,
Prevention and Treatment,
a section of the journal
Frontiers in Medicine
Received: 30 November 2021
Accepted: 28 January 2022
Published: 04 March 2022
Citation:
Al-Muhsen S, Al-Numair NS, Saheb
Sharif-Askari N, Basamh R,
Alyounes B, Jabaan A, Saheb
Sharif-Askari F, Alosaimi MF,
Alsohime F, Halwani R and Al-Saud H
(2022) Favipiravir Effectiveness and
Safety in Hospitalized
Moderate-Severe COVID-19 Patients:
Observational Prospective Multicenter
Investigation in Saudi Arabia.
Front. Med. 9:826247.
doi: 10.3389/fmed.2022.826247
Frontiers in Medicine | www.frontiersin.org
Immunology Research Laboratory, Department of Pediatrics, College of Medicine and King Saud University Medical City,
King Saud University, Riyadh, Saudi Arabia, 2 The Saudi Ministry of Health and Center of Genomic Medicine, King Faisal
Specialist Hospital and Research Center, Riyadh, Saudi Arabia, 3 Sharjah Institute of Medical Research, University of Sharjah,
Sharjah, United Arab Emirates, 4 King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia, 5 Department of
Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates, 6 Hevolution Foundation, Riyadh,
Saudi Arabia
Objectives: There are limited data on the efficacy and safety of favipiravir antiviral
in coronavirus disease 2019 (COVID-19), particularly in the more progressed disease
phase. This study aims to evaluate the favipiravir effect on reducing the length
of hospital stay and in-hospital mortality among moderate and severe hospitalized
COVID-19 patients.
Methods: A prospective, multicenter observational study was conducted that included
moderate and severe hospitalized adult COVID-19 patients in four major regions (Riyadh
(Riyadh), Eastern (Dammam), Al-Qassem (Buraydah), and Macca (Jeddah) of Saudi
Arabia. For the primary outcome of all-cause mortality, a Cox proportional hazard analysis
was performed. While the association between favipiravir use and length of hospital stay
was determined using adjusted generalized linear model. This study was approved by
the Central Institutional Review Board in The Saudi Ministry of Health (MoH) with the
approval number IRB # 20-85-M.
Results: This study included 598 moderate and severe COVID-19 patients, of whom
156 (26%) received favipiravir. Favipiravir treatment was associated with more extended
hospital stays (14 vs. 10 median days, P = 0.034) and higher mortality rate (aHR 3.63;
95% CI 1.06–12.45) compared to no favipiravir regimen. Despite lack of effectiveness,
favipiravir use was only associated with higher diarrhea..
Late treatment
is less effective
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