tetano
Editor, Senior Moderator
Curr Med Res Opin
. 2021 Apr 23;1.
doi: 10.1080/03007995.2021.1920900. Online ahead of print.
Effectiveness and safety of favipiravir compared to supportive care in moderately to critically ill COVID-19 patients: A retrospective study with propensity score matching sensitivity analysis
Ahmad Alamer[SUP] 1 2 [/SUP], Ahmed A Alrashed[SUP] 3 [/SUP], Mashael Alfaifi[SUP] 4 [/SUP], Bandar Alosaimi[SUP] 5 [/SUP], Fatimah AlHassar[SUP] 6 [/SUP], Malak M Almutairi[SUP] 7 [/SUP], Jude Howaidi[SUP] 3 [/SUP], Wedad Almutairi[SUP] 8 [/SUP], Yahya Mohzari[SUP] 4 [/SUP], Tarek Sulaiman[SUP] 9 [/SUP], Ahmed AlJedai[SUP] 10 [/SUP], Hamdan N Alajami[SUP] 11 [/SUP], Fatima Alkharji[SUP] 3 [/SUP], Ali Alsaeed[SUP] 12 [/SUP], Alaa H Alali[SUP] 13 [/SUP], Abdullah A Baredhwan[SUP] 13 [/SUP], Ivo Abraham[SUP] 1 14 [/SUP], Abdulaziz S Almulhim[SUP] 15 [/SUP]
Affiliations
Abstract
Introduction: Favipiravir is a repurposed drug to treat coronavirus 2019 (COVID-19). Due to a lack of available real-world data, we assessed its effectiveness and safety in moderately to critically ill COVID-19 patients.
Methods: This retrospective study was conducted in two public/specialty hospitals in Saudi Arabia. We included patients (? 18 years) admitted April-August 2020 with confirmed SARS-CoV-2 diagnosed by real-time polymerase chain reaction (RT-PCR) from nasopharyngeal swab. Patients received either favipiravir (1800 mg or 1600 mg BID loading dose, followed by 800 mg or 600 mg QD) or supportive-care treatment. Patients were excluded if they were outside the study period, classified as having a mild form of the disease per WHO criteria, or had an incomplete patient file. Kaplan-Meier (KM) models were used to estimate median time to discharge. Discharge ratios, progression to mechanical ventilation, and mortality outcomes were estimated across the severity spectrum using Cox proportional-hazards models. As a sensitivity analysis, we performed propensity score-matching (PSM) analysis.
Results: Overall, median time to discharge was 10 days (95%CI =9-10) in the favipiravir arm versus 15 days (95%CI =14-16) in the supportive-care arm. The accelerated discharge benefit was seen across the COVID-19 spectrum of severity. The adjusted discharge ratio was 1.96 (95%CI =1.56-2.46). Progression to mechanical ventilation was slower with favipiravir (HR[SUB]adj[/SUB]=0.10, 95%CI =0.04-0.29). There was no significant effect on mortality (HR[SUB]adj[/SUB]=1.56, 95%CI =0.73-3.36). There was a statistically non-significant trend toward worse outcomes in the critical category (HR[SUB]adj[/SUB]=2.80, 95%CI =0.99-7.89). Age was an independent risk factor for mortality in mechanically ventilated patients. PSM analyses confirmed these findings.
Conclusion: Favipiravir was associated with clinical benefits, including accelerated discharge rate and less progression to mechanical ventilation; however, no overall mortality benefits were seen across the severity spectrum.
Keywords: COVID-19; Favipiravir; discharge; effectiveness; mortality; retrospective; supportive care; trial.
. 2021 Apr 23;1.
doi: 10.1080/03007995.2021.1920900. Online ahead of print.
Effectiveness and safety of favipiravir compared to supportive care in moderately to critically ill COVID-19 patients: A retrospective study with propensity score matching sensitivity analysis
Ahmad Alamer[SUP] 1 2 [/SUP], Ahmed A Alrashed[SUP] 3 [/SUP], Mashael Alfaifi[SUP] 4 [/SUP], Bandar Alosaimi[SUP] 5 [/SUP], Fatimah AlHassar[SUP] 6 [/SUP], Malak M Almutairi[SUP] 7 [/SUP], Jude Howaidi[SUP] 3 [/SUP], Wedad Almutairi[SUP] 8 [/SUP], Yahya Mohzari[SUP] 4 [/SUP], Tarek Sulaiman[SUP] 9 [/SUP], Ahmed AlJedai[SUP] 10 [/SUP], Hamdan N Alajami[SUP] 11 [/SUP], Fatima Alkharji[SUP] 3 [/SUP], Ali Alsaeed[SUP] 12 [/SUP], Alaa H Alali[SUP] 13 [/SUP], Abdullah A Baredhwan[SUP] 13 [/SUP], Ivo Abraham[SUP] 1 14 [/SUP], Abdulaziz S Almulhim[SUP] 15 [/SUP]
Affiliations
- PMID: 33890544
- DOI: 10.1080/03007995.2021.1920900
Abstract
Introduction: Favipiravir is a repurposed drug to treat coronavirus 2019 (COVID-19). Due to a lack of available real-world data, we assessed its effectiveness and safety in moderately to critically ill COVID-19 patients.
Methods: This retrospective study was conducted in two public/specialty hospitals in Saudi Arabia. We included patients (? 18 years) admitted April-August 2020 with confirmed SARS-CoV-2 diagnosed by real-time polymerase chain reaction (RT-PCR) from nasopharyngeal swab. Patients received either favipiravir (1800 mg or 1600 mg BID loading dose, followed by 800 mg or 600 mg QD) or supportive-care treatment. Patients were excluded if they were outside the study period, classified as having a mild form of the disease per WHO criteria, or had an incomplete patient file. Kaplan-Meier (KM) models were used to estimate median time to discharge. Discharge ratios, progression to mechanical ventilation, and mortality outcomes were estimated across the severity spectrum using Cox proportional-hazards models. As a sensitivity analysis, we performed propensity score-matching (PSM) analysis.
Results: Overall, median time to discharge was 10 days (95%CI =9-10) in the favipiravir arm versus 15 days (95%CI =14-16) in the supportive-care arm. The accelerated discharge benefit was seen across the COVID-19 spectrum of severity. The adjusted discharge ratio was 1.96 (95%CI =1.56-2.46). Progression to mechanical ventilation was slower with favipiravir (HR[SUB]adj[/SUB]=0.10, 95%CI =0.04-0.29). There was no significant effect on mortality (HR[SUB]adj[/SUB]=1.56, 95%CI =0.73-3.36). There was a statistically non-significant trend toward worse outcomes in the critical category (HR[SUB]adj[/SUB]=2.80, 95%CI =0.99-7.89). Age was an independent risk factor for mortality in mechanically ventilated patients. PSM analyses confirmed these findings.
Conclusion: Favipiravir was associated with clinical benefits, including accelerated discharge rate and less progression to mechanical ventilation; however, no overall mortality benefits were seen across the severity spectrum.
Keywords: COVID-19; Favipiravir; discharge; effectiveness; mortality; retrospective; supportive care; trial.