Almoosa Specialist Hospital, Alhassa, Saudi Arabia; School of Nursing, University of Wollongong, Wollongong, Australia; Princess Norah Bint Abdulrhamn University, Riyadh, Saudi Arabia.
Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
J Infect Public Health. 2022 Apr;15(4):389-394. doi: 10.1016/j.jiph.2022.01.013. Epub 2022 Feb 15.
Prior to the availability of the current COVID-19 vaccine, the need to control the pandemic worldwide was focused on management of the disease using previously approved antivirals, including Favipiravir which inhibits viral replication through the RNA dependent RNA polymerase enzyme. Favipiravir's efficacy against different viral infections has made it a potential treatment for COVID-19. We are aiming in this study to assess the therapeutic efficacy and safety of Favipiravir in treating critically ill patients admitted with COVID-19 to Intensive Care Units (ICUs).
This is a retrospective cohort study was conducted in five tertiary hospitals in Riyadh, Kingdom of Saudi Arabia (KSA). The studied sample was randomized from a huge pool of data collected primarily for critically ill COVID-19 patients admitted to (ICUs) during the period between April 2020 to March 2021. Two groups of patients matched 1: 1 for age and body mass index (BMI) was enrolled in the study; one group received Favipiravir and another comparison group received other antimicrobial medications, not including Favipiravir.
A total data of 538 COVID-19 patients were analyzed, 269 (50.%) received Favipiravir and 269 (50%) the control group received different treatments. More than two-thirds 201 (74.7%) were Saudi citizens, the majority 177 (65.8%) were males and the mean age and (BMI) were; (57.23 ± 15.16) years and (31.61 ± 7.33) kg/m2 respectively. The most frequent symptoms of presentation were shortness of breath (SOB), fever, and cough, and the most frequent comorbidity was diabetes mellitus, hypertension, and ischemic heart disease. In the supplemental therapy, corticosteroid, tocilizumab and chloroquine were statistically significant (P = 0.001) when combined in the FVP group more than in the comparison group. Severe acute respiratory distress syndrome (ARDS) was more frequent among Favipiravir group, while the overall mortality rate among the Favipiravir group was not statistically significant (p-value 0.4).
According to the study's results revealing FVP is not superior to other antivirals, patients who received Favipiravir presented with more severe symptoms, more comorbidities, more complications, and is not effective in controlling the cytokine storm which negatively impact the efficacy of Favipiravir. FVP therapy had no influence on ICU and hospital length of stay in comparison with the control group as well as in the overall mortality rate among the FVP group was not statistically significant. further research is needed to understand how FVP along with other treatments can improve the length of stay among COVID-19 patients admitted to the ICU.
在当前 COVID-19 疫苗问世之前，全球控制大流行的重点是使用先前批准的抗病毒药物来管理疾病，包括通过 RNA 依赖性 RNA 聚合酶酶抑制病毒复制的法匹拉韦。法匹拉韦对不同病毒感染的疗效使其成为 COVID-19 的潜在治疗方法。我们旨在本研究中评估法匹拉韦在治疗重症监护病房 (ICU) 中 COVID-19 住院患者中的治疗效果和安全性。
这是在沙特阿拉伯王国利雅得的五所三级医院进行的回顾性队列研究。研究样本是从 2020 年 4 月至 2021 年 3 月期间主要为入住 ICU 的 COVID-19 重症患者收集的大量数据中随机抽取的。两组患者按年龄和体重指数 (BMI) 1:1 匹配，纳入研究；一组接受法匹拉韦治疗，另一组对照组接受其他抗菌药物治疗，不包括法匹拉韦。
共分析了 538 例 COVID-19 患者，269 例（50%）接受法匹拉韦治疗，269 例（50%）接受对照组治疗。超过三分之二（201 例，74.7%）为沙特公民，大多数（177 例，65.8%）为男性，平均年龄和（BMI）分别为（57.23±15.16）岁和（31.61±7.33）kg/m2。最常见的表现症状为呼吸急促（SOB）、发热和咳嗽，最常见的合并症为糖尿病、高血压和缺血性心脏病。在补充治疗中，皮质类固醇、托珠单抗和氯喹在 FVP 组联合使用时具有统计学意义（P=0.001），而在对照组中则没有。法匹拉韦组更常发生严重急性呼吸窘迫综合征（ARDS），而法匹拉韦组的总体死亡率无统计学意义（p 值 0.4）。
根据研究结果显示，法匹拉韦并不优于其他抗病毒药物，接受法匹拉韦治疗的患者出现更严重的症状、更多的合并症、更多的并发症，并且不能有效控制细胞因子风暴，这对法匹拉韦的疗效产生负面影响。与对照组相比，FVP 治疗对 ICU 和住院时间没有影响，FVP 组的总体死亡率也无统计学意义。需要进一步研究以了解法匹拉韦与其他治疗方法相结合如何改善 ICU 住院 COVID-19 患者的住院时间。
