Almutairi Amal Oweid, El-Readi Mahmoud Zaki, Althubiti Mohammad, Alhindi Yosra Zakariyya, Ayoub Nahla, Alzahrani Abdullah R, Al-Ghamdi Saeed S, Eid Safaa Yehia
Department of Pharmacology and Toxicology, Faculty of Medicine, Umm Al-Qura University, Al Abdeyah, Makkah 24381, Saudi Arabia.
Saudi Toxicology Society, Umm Al-Qura University, Makkah 24381, Saudi Arabia.
Trop Med Infect Dis. 2023 Feb 20;8(2):129. doi: 10.3390/tropicalmed8020129.
(1) Background: Favipiravir (FVP) is a new antiviral drug used to treat COVID-19. It has been authorized to be used in the kingdom of Saudi Arabia in the treatment of COVID-19. The mechanism of action of FVP is working as a specific inhibitor for the RNA-dependent RNA polymerase of the RNA chain virus. FVP has the potential to be hepatotoxic because of the structure similarity with pyrazinamide. This retrospective study aimed to determine the prevalence of liver injury in FVP-treated COVID-19 patients in General East Jeddah Hospital, Saudi Arabia, during the COVID-19 pandemic. (2) Methods: A total of 6000 patients infected with COVID-19 and treated at the East Jeddah Hospital were included, with a sample size of 362 patients. The participants ranged from 18 to 70 years of age, both males and females, with normal hepatic and renal function and had a confirmed diagnosis of COVID-19 infection. Patients who had gouty arthritis, hepatic and renal dysfunction, dead patients, pregnant women, and breastfeeding mothers were all excluded from this study. A retrospective cohort study compared two groups of patients treated with and without FVP and who followed the Saudi Ministry of Health protocol to manage COVID-19 infection. (3) Results: An adverse effect of FVP on the liver was found that ranged from mild to severe. Stopping treatment with FVP was associated with an observed important increase in the levels of liver enzymes AST ( < 0.001), ALT ( < 0.001), alkaline phosphatase ( < 0.03), total bilirubin ( < 0.001), and direct bilirubin ( < 0.001) in the treated compared with the untreated group. (4) Conclusion: This study showed a significant difference between the treated and the untreated groups with FVP in liver injury. FVP influences the liver, increasing the blood levels of the liver function parameters.
（1）背景：法匹拉韦（FVP）是一种用于治疗新冠肺炎的新型抗病毒药物。它已在沙特阿拉伯王国被批准用于治疗新冠肺炎。FVP的作用机制是作为RNA链病毒的RNA依赖性RNA聚合酶的特异性抑制剂。由于与吡嗪酰胺结构相似，FVP有潜在的肝毒性。这项回顾性研究旨在确定在新冠肺炎疫情期间，沙特阿拉伯吉达东部总医院接受FVP治疗的新冠肺炎患者肝损伤的发生率。（2）方法：纳入了在吉达东部医院感染新冠肺炎并接受治疗的6000名患者，样本量为362名患者。参与者年龄在18至70岁之间，男女皆有，肝肾功能正常且确诊为新冠肺炎感染。患有痛风性关节炎、肝肾功能不全的患者、死亡患者、孕妇和哺乳期母亲均被排除在本研究之外。一项回顾性队列研究比较了两组接受和未接受FVP治疗且遵循沙特卫生部新冠肺炎感染管理方案的患者。（3）结果：发现FVP对肝脏有不良影响，范围从轻度到重度。与未治疗组相比，停止使用FVP治疗后，治疗组的肝酶AST（<0.001）、ALT（<0.001）、碱性磷酸酶（<0.03）、总胆红素（<0.001）和直接胆红素（<0.001）水平出现了显著升高。（4）结论：本研究表明，接受FVP治疗组和未治疗组在肝损伤方面存在显著差异。FVP会影响肝脏，增加肝功能参数的血液水平。
