Abstract: Early Onset Favipiravir Saves Lives Ercan KARATAS (  canertaskara@hotmail.com ) Turkiye Cumhuriyeti Saglik Bakanligi https://orcid.org/0000-0002-3133-4199 Lacin Aksoy Marmara Universitesi Tip Fakultesi, Family Practicies Pinar Elbir Kilic İstanbul Tuzla State Hospital Arzu Dogru Tuzla State Hospital: Tuzla Devlet Hastanesi Ersin Ozaslan Acibadem Hospitals Group: Acibadem Saglik Grubu Research Keywords: Favipiravir, COVID-19, coronavirus, SARS-CoV-2, pneumonia, antiviral treatment Posted Date: January 13th, 2021 DOI: https://doi.org/10.21203/rs.3.rs-142868/v1 License:   This work is licensed under a Creative Commons Attribution 4.0 International License. Read Full License Version of Record: A version of this preprint was published on April 30th, 2021. See the published version at https://doi.org/10.3947/ic.2020.0149. Page 1/14 Abstract Background Favipiravir, an antiviral recommended for use in patients with tachypnea (respiratory rate 30 / min) in COVID-19 pneumonia, with SpO2 level below 90% in room air and with bilateral diffuse pneumonia on chest X-ray or tomography, or patients with treatment-resistant fever, is a new type of RNA-dependent RNA polymerase (RdRp) inhibitor. After the administration of Favipiravir, it contributed significantly to reducing mortality in patients with severe COVID-19 positive disease. We performed this study to determine the start time in Favipiravir's covid pneumonia. Material and Method: We evaluated the effect of a total of 5 days of oral treatment as a 2 × 1600 mg loading dose and a 2 × 600 mg maintenance dose of Favipiravir added to the standard COVID-19 treatment received by patients with laboratory-radiology-clinical findings who have advanced or severe COVID 19 pneumonia. Results 180 patients hospitalized at Tuzla State Hospital and given Favipiravir treatment between 20/3/2020 and 30/5/2020 were examined. As of hospitalization, 17 of 101 patients (17%) who were given Favipiravir treatment in ≤ 3 days died, 30 of 79 patients (38%) who were given Favipiravir treatment for in > 3 days died (p:0.002). 33 of 47 patients (70%) who died were > 65 years old. Only 5 of the 47 (11%) patients who died had no comorbid disease. 35 had two or more comorbid diseases. Conclusion Patients with radiological findings indicating that COVID-19 will be severe and laboratory findings at the time of the first 3 days should be initiated with an effective dose of Favipiravir treatment without waiting for the clinical worsening. 1 Background SARS-CoV-2 is an enveloped, positive-polarity, and single-stranded RNA virus that belongs to the betacoronavirus group. SARS-CoV-2 is a zoonotic pathogen and can cause symptoms ranging from mild clinical course to severe lower respiratory tract infection (ARDS) when it infects humans [1]. SARS-CoV-2 has a genetic similarity of 79% to SARS-CoV, 50% to MERS-CoV, and ~ 96% to coronaviruses found in bats. The main feature of SARS-CoV-2, which appears to have been formed as a result of a new mutation, is that it easily binds to the ACE2 receptor, especially lung type 2 alveoli cells in humans, and uses the ACE2 receptor as the entry gate to the cells [2]. Replication of the virus, which enters the cell by binding to Page 2/14 ACE2, begins, and the inflammatory reaction chain is triggered [3]. Depending on the age of the host and the immune system, the severity of the inflammatory reaction occurs [4]. It mainly affects the natural immune system and leads to the release of..