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0 0.5 1 1.5 2+ Hospitalization time 7% Improvement Relative Risk Viral clearance time 55% Favipiravir  Shinada et al.  LATE TREATMENT Is late treatment with favipiravir beneficial for COVID-19? Retrospective 34 patients in Japan (May - September 2020) Faster viral clearance with favipiravir (p=0.039) c19early.org Shinada et al., Viruses, March 2022 Favors favipiravir Favors control

Longitudinal Analysis of Neutralizing Potency against SARS-CoV-2 in the Recovered Patients after Treatment with or without Favipiravir

Shinada et al., Viruses, doi:10.3390/v14040670
Mar 2022  
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Retrospective 17 COVID+ patients treated with favipiravir and 17 matched controls in Japan, showing faster viral clearance with treatment. Favipiravir 3600mg day one, 1600mg per day for up to 14 days.
hospitalization time, 7.5% lower, HR 0.93, p = 0.84, treatment 17, control 17.
viral clearance time, 55.2% lower, HR 0.45, p = 0.04, treatment 17, control 17.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Shinada et al., 24 Mar 2022, retrospective, Japan, peer-reviewed, 11 authors, study period 28 May, 2020 - 26 September, 2020, average treatment delay 8.9 days. Contact: takashisato1220@gmail.com (corresponding author), kanakoshinada7@gmail.com, mshinopy@gmail.com, shin.ohta0915@gmail.com, miwapicco@outlook.jp, shinkai050169@gmail.com, m-mine@marianna-u.ac.jp, sayamrym@niid.go.jp, yuadachi@niid.go.jp, matt@niid.go.jp, ytakahas@niid.go.jp.
This PaperFavipiravirAll
Longitudinal Analysis of Neutralizing Potency against SARS-CoV-2 in the Recovered Patients after Treatment with or without Favipiravir
Kanako Shinada, Takashi Sato, Saya Moriyama, Yu Adachi, Masahiro Shinoda, Shinichiro Ota, Miwa Morikawa, Masamichi Mineshita, Takayuki Matsumura, Yoshimasa Takahashi, Masaharu Shinkai
Viruses, doi:10.3390/v14040670
The effect of treatment with favipiravir, an antiviral purine nucleoside analog, for coronavirus disease 2019 (COVID-19) on the production and duration of neutralizing antibodies for SARS-CoV-2 was explored. There were 17 age-, gender-, and body mass index-matched pairs of favipiravir treated versus control selected from a total of 99 patients recovered from moderate COVID-19. These subjects participated in the longitudinal (>6 months) analysis of (i) SARS-CoV-2 spike protein's receptor-binding domain IgG, (ii) virus neutralization assay using authentic virus, and (iii) neutralization potency against original (WT) SARS-CoV-2 and cross-neutralization against B.1.351 (beta) variant carrying triple mutations of K417N, E484K, and N501Y. The results demonstrate that the use of favipiravir: (1) significantly accelerated the elimination of SARS-CoV-2 in the case vs. control groups (p = 0.027), (2) preserved the generation and persistence of neutralizing antibodies in the host, and (3) did not interfere the maturation of neutralizing potency of anti-SARS-CoV-2 and neutralizing breadth against SARS-CoV-2 variants. In conclusion, treatment of COVID-19 with favipiravir accelerates viral clearance and does not interfere the generation or maturation of neutralizing potency against both WT SARS-CoV-2 and its variants.
Institutional Review Board Statement: The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Institutional Review Board of Tokyo Shinagawa Hospital (approval number 20-A-08 and approved on 20 May 2020). Informed Consent Statement: Informed consent was obtained from all subjects involved in the study. Conflicts of Interest: The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.
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Late treatment
is less effective
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