Effectiveness of Early Favipiravir Therapy in Hospitalised COVID-19 Patients
et al., Advances in Virology, doi:10.1155/2022/9240941, Jun 2022
Retrospective 103 hospitalized patients in Saudi Arabia, showing lower mortality with favipiravir in unadjusted results, and greater efficacy for treatment within 3 days of admission.
Potential risks of favipiravir include kidney injury1-3, liver injury2-4, and mutagenicity, carcinogenicity, teratogenicity, embryotoxicity, and the creation of dangerous variants5-11.
This study is excluded in the after exclusion results of meta
analysis:
unadjusted results with minimal group details.
|
risk of death, 96.5% lower, RR 0.04, p < 0.001, treatment 1 of 103 (1.0%), control 17 of 62 (27.4%), NNT 3.8.
|
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risk of ICU admission, 21.0% lower, RR 0.79, p = 0.45, treatment 21 of 103 (20.4%), control 16 of 62 (25.8%), NNT 18.
|
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hospitalization time, 15.8% lower, relative time 0.84, p < 0.001, treatment mean 9.6 (±1.2) n=102, control mean 11.4 (±1.7) n=58.
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| Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates |
1.
Abdulaziz et al., Clinical Features and Prognosis of Acute Kidney Injury in Hospital-Admitted Patients with COVID-19 in Egypt: A Single-Center Experience, Mansoura Medical Journal, doi:10.58775/2735-3990.1433.
2.
Ülger et al., Experimental evaluation of favipiravir (T-705)-induced liver and kidney toxicity in rats, Food and Chemical Toxicology, doi:10.1016/j.fct.2025.115472.
3.
El-Fetouh et al., Experimental Studies on Some Drugs Used in Covid-19 Treatment (Favipiravir and Dexamethasone) in Albino Rats, Journal of Advanced Veterinary Research, 13:10, www.advetresearch.com/index.php/AVR/article/view/1635.
4.
Almutairi et al., Liver Injury in Favipiravir-Treated COVID-19 Patients: Retrospective Single-Center Cohort Study, Tropical Medicine and Infectious Disease, doi:10.3390/tropicalmed8020129.
5.
Zhirnov et al., Favipiravir: the hidden threat of mutagenic action, Journal of microbiology, epidemiology and immunobiology, doi:10.36233/0372-9311-114.
6.
Waters et al., Human genetic risk of treatment with antiviral nucleoside analog drugs that induce lethal mutagenesis: the special case of molnupiravir, Environmental and Molecular Mutagenesis, doi:10.1002/em.22471.
7.
Hadj Hassine et al., Lethal Mutagenesis of RNA Viruses and Approved Drugs with Antiviral Mutagenic Activity, Viruses, doi:10.3390/v14040841.
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Shum, C., An investigational study into the drug-associated mutational signature in SARS-CoV-2 viruses, The University of Hong Kong, PhD Thesis, hub.hku.hk/handle/10722/344396.
9.
Shiraki et al., Convenient screening of the reproductive toxicity of favipiravir and antiviral drugs in Caenorhabditis elegans, Heliyon, doi:10.1016/j.heliyon.2024.e35331.
Tawfik et al., 29 Jun 2022, retrospective, Saudi Arabia, peer-reviewed, mean age 60.1, 8 authors, study period 3 June, 2020 - 3 November, 2020.
Contact: abdrahmankamal2@gmail.com, drsami61@gmail.com.
Effectiveness of Early Favipiravir Therapy in Hospitalised COVID-19 Patients
Advances in Virology, doi:10.1155/2022/9240941
COVID-19 is a disease caused by a novel coronavirus with no speci c, standard treatment. We investigated the clinical data of COVID-19 patients admitted to King Fahad Specialist Hospital (KFSH) in Buraydah by comparing the patients who were treated early with favipiravir (within 3 days of admission) to patients who were treated after three days of admission or not treated. 165 patients were con rmed with PCR tests and admitted to KFSH for treatment. Comorbidities contributed signi cantly to increasing the length of stay in hospital at 11.4 ± 0.8 days compared to patients with no comorbidities at 8.6 ± 0.9 days (p 0.041). A total of 103 patients were treated with favipiravir, and we found that early treatment with favipiravir (within 3 days) reduced the length of stay in hospital signi cantly (8.8 ± 1.4 days) compared to patients who were treated after 3 days (13.3 ± 4.6 days) (p 0.0015). Moreover, patients with comorbidities in both early and late treatment groups had signi cantly higher average lengths of stay in hospital (11.2 ± 0.9 days) compared to patients with no comorbidities (7.9 ± 0.7 days) (p 0.017). Interestingly, patients treated early with favipiravir (with comorbidities and without) stayed fewer days in hospital compared to those with late treatment (p 0.021; a di erence of 4.5 ± 1.9 days; and p 0.018; a di erence of 4.2 ± 1.7 days, respectively). In conclusion, our analysis indicates that early treatment with favipiravir can reduce the length of stay in hospital and improve clinical manifestations of COVID-19 patients.
Disclosure Abdulrahman Tawfik and Abdulrahman Alzahrani are cofirst authors.
Conflicts of Interest e authors declare no conflicts of interest.
References
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"abstract": "<jats:p>COVID-19 is a disease caused by a novel coronavirus with no specific, standard treatment. We investigated the clinical data of COVID-19 patients admitted to King Fahad Specialist Hospital (KFSH) in Buraydah by comparing the patients who were treated early with favipiravir (within 3 days of admission) to patients who were treated after three days of admission or not treated. 165 patients were confirmed with PCR tests and admitted to KFSH for treatment. Comorbidities contributed significantly to increasing the length of stay in hospital at 11.4 ± 0.8 days compared to patients with no comorbidities at 8.6 ± 0.9 days (<jats:inline-formula>\n <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M1\">\n <mi>p</mi>\n <mo>=</mo>\n <mn>0.041</mn>\n </math>\n </jats:inline-formula>). A total of 103 patients were treated with favipiravir, and we found that early treatment with favipiravir (within 3 days) reduced the length of stay in hospital significantly (8.8 ± 1.4 days) compared to patients who were treated after 3 days (13.3 ± 4.6 days) (<jats:inline-formula>\n <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M2\">\n <mi>p</mi>\n <mo>=</mo>\n <mn>0.0015</mn>\n </math>\n </jats:inline-formula>). Moreover, patients with comorbidities in both early and late treatment groups had significantly higher average lengths of stay in hospital (11.2 ± 0.9 days) compared to patients with no comorbidities (7.9 ± 0.7 days) (<jats:inline-formula>\n <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M3\">\n <mi>p</mi>\n <mo>=</mo>\n <mn>0.017</mn>\n </math>\n </jats:inline-formula>). Interestingly, patients treated early with favipiravir (with comorbidities and without) stayed fewer days in hospital compared to those with late treatment (<jats:inline-formula>\n <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M4\">\n <mi>p</mi>\n <mo>=</mo>\n <mn>0.021</mn>\n </math>\n </jats:inline-formula>; a difference of 4.5 ± 1.9 days; and <jats:inline-formula>\n <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M5\">\n <mi>p</mi>\n <mo>=</mo>\n <mn>0.018</mn>\n </math>\n </jats:inline-formula>; a difference of 4.2 ± 1.7 days, respectively). In conclusion, our analysis indicates that early treatment with favipiravir can reduce the length of stay in hospital and improve clinical manifestations of COVID-19 patients.</jats:p>",
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Late treatment
is less effective
is less effective
