CLINICAL EFFICACY OF THE ANTIVIRAL DRUG FAVIPIRAVIR IN THE COMPLEX TREATMENT OF PATIENTS WITH COVID-19 CORONAVIRUS INFECTION
Sholpan A Kulzhanova, Nurlan Е Aukenov, Maiya E Konkayeva, Zauresh K Smagulova, Gulnara T Tuleshova, Saule B Maukayeva, Nazira Ye Beisenbieva, Gulsimzhan O Turebaeva, Gaukhar A Nurakhmetova, Aigul M Utegenova, Kulzhanova Sholpan Adlgazyevna
doi:10.34689/SH.2021.23.4.001
Introduction. It is known that most patients with COVID-19 have a disease of mild to moderate severity and can be treated at home. A potential etiotropic drug in the treatment of such patients is favipiravir. To finally decide on the inclusion of this drug in the international recommendations for the treatment of COVID-19, further studies are needed to assess its effectiveness and safety in patients with COVID-19. The aim of the study was to study the clinical efficacy of favipiravir in the complex therapy of patients with moderateseverity COVID-19 coronavirus infection. Materials and methods. A retrospective analysis of 468 medical records of an inpatient patient with a moderate form of coronavirus infection COVID-19, who were treated at the State Clinical Hospital at the Multi-Specialty Medical Center of the Akimat of Nur-Sultan, the Semey Infectious Diseases Hospital, for the period August-October 2020, was carried out. The experimental (main) group consisted of 40 patients with COVID-19 of moderate severity, who, in addition to standard therapy in accordance with the Clinical Protocol for Diagnosis and Treatment "COVID-19 Coronavirus infection (10th edition with changes from 15.07.2020), were prescribed oral favipiravir at a dose of 1600 mg/12 h on day 1, then 600 mg/12 h on the following days, for a total of 7 days. The comparison group (control group) consisted of 40 patients with moderate CVI who did not receive favipiravir. Descriptive statistics were performed with the calculation of the mean (M) and standard deviation (SD) for quantitative variables; percentages were calculated for qualitative variables. Statistical analysis was performed using Microsoft Excel and IBM SPSS Statistics 20.0. P <0.05 was considered statistically significant. Results and discussion. The present study showed that the early initiation of antiviral therapy with Favipiravir, compared with standard therapy without an antiviral drug, in patients with a moderate form of COVID-19 is associated with a statistically significant clinical improvement and a large percentage of virus elimination from the mucous membranes of the upper respiratory tract according to molecular genetic research. In the group of patients receiving favipiravir, complete remission of the disease with normalization of the main clinical parameters and the absence of complaints for 7 days of hospitalization was significantly more often than in the comparison group. Conclusions. The results obtained showed that Favipiravir is an effective antiviral drug in the complex treatment of COVID-19 coronavirus infection of moderate severity. Early administration of the drug in patients with a moderate form of the disease can prevent the progression of the disease to a more severe condition and the development of complications that require additional medical interventions.
References
Chan, Kok, Zhu, Chu, To et al., Genomic characterization of the 2019 novel humanpathogenic coronavirus isolated from a patient with atypical pneumonia after visiting Wuhan, Emerg Microbes Infect
Chen, Liu, Guo, Emerging coronaviruses: Genome structure, replication and pathogenesis, J Med Virol
Cock, Felton, Hites, Le, Luque et al., Pharmacokinetics / Pharmacodynamics of Antiviral Agents Used to Treat SARS-CoV-2 and Their Potential Interaction with Drugs and Other Supportive Measures: A Comprehensive Review by the PK/PD of Anti-Infectives Study Group of the European Society of Antimicr, Clinical Pharmacokinetics,
doi:10.1007/s40262-020-00924-9
Erdem, Korkma, Çağlayan, Işıkgöz
Eroglu, Toprak, Overview of favipiravir and remdesivir treatment for COVID-19, International Journal of Pharmaceutical Sciences and Research
Guo, Cao, Hong, Tan, Chen et al., The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak -an update on the status, Military Medical Research,
doi:10.1186/s40779-020-00240-0
Hassanipour, Arab-Zozani, Amani, Heidarzad, Fathalipour et al., The efficacy and safety of Favipiravir in treatment of COVID-19: a systematic review and meta-analysis of clinical trials, Scientific reports,
doi:10.1038/s41598-021-90551-6
Hayden, Shindo, Julander, Shafer, Smee et al., Activity of T-705 in a hamster model of yellow fever virus infection in comparison with that of a chemically related compound, T-1106, Current opinion in infectious diseases,
doi:10.1128/AAC.01074-08
Julander, Smee, Morrey, Furuta, Dziedziejko et al., Effect of T-705 treatment on western equine encephalitis in a mouse model, Journal of clinical medicine,
doi:10.3390/jcm10020273
Kamiyama, Kozaki, Nomura, Egawa, Minami et al., Treatment of late stage disease in a model of arenaviral hemorrhagic fever: T-705 efficacy and reduced toxicity suggests an alternative to ribavirin, Antimicrobial agents and chemotherapy,
doi:10.1128/AAC.00356-07
Leyssen, Nascimento, Neyts, Shiraki, Daikoku et al., Favipiravir versus other antiviral or standard of care for COVID-19 treatment: a rapid systematic review and meta-analysis, Pharmacology & therapeutics,
doi:10.1186/s12985-020-01412-z
Manabe, Kambayashi, Akatsu, Kudo, Mehta et al., Insights into SARS-CoV-2 genome, structure, evolution, pathogenesis and therapies: Structural genomics approach, Disaster medicine and public health preparedness,
doi:10.1017/dmp.2014.151
Naqvi, Fatima, Mohammad, Fatima, Singh et al., Insights into SARS-CoV-2 genome, structure, evolution, pathogenesis and therapies: Structural genomics approach, Biochim Biophys Acta Mol Basis Dis
Nasir, Perveen, Saha, Talha, Selina et al., Systematic Review on Repurposing Use of Favipiravir Against SARS-CoV-2, Mymensingh medical journal: MMJ
Pascarella, Strumia, Piliego, Bruno, Buono et al., COVID-19 diagnosis and management: a comprehensive review, J Int Med
Rangwala, Pendse, Kadam, Wu, Caracta et al., Efficacy and safety of favipiravir, an oral RNAdependent RNA polymerase inhibitor, in mild-to-moderate COVID-19: A randomized, comparative, open-label, multicenter, phase 3 clinical trial, official publication of the International Society for Infectious Diseases,
doi:10.1038/s41422-020-0282-0
Rocha-Pereira, Jochmans, Dallmeier, None
Taşbakan, Yamazhan, Taşbakan, Sayıner, Gökengin, Treatment of SARS-CoV-2 pneumonia with favipiravir: early results from the Ege University cohort, Turkey, Turkishjournalofmedicalsciences,
doi:10.3906/sag-2008-33
Udwadia, Singh, Barkate, Patil, Using Remdesivir and Favipiravir as Therapeutic Options, Chembiochem : a European journal of chemical biology,
doi:10.1002/cbic.202000595
Wang, Cao, Zhang, Yang, Liu et al., Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro, Cell research,
doi:10.1186/s13054-020-03137-5
Zeitlinger, Koch, Bruggemann, None, De