Siripongboonsitti Taweegrit, Muadchimkaew Marisa, Tawinprai Kriangkrai, Issaranon Ornisa, Meepholkij Wichuda, Arttawejkul Pureepat, Vararungzarit Apiradee, Dhissayakamol Onwalee, Preeyachit Wilaiporn, Soonklang Kamonwan, Mahanonda Nithi
Division of Infectious Diseases, Department of Medicine, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand.
Infection Control Unit, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand.
J Virus Erad. 2024 Dec 12;10(4):100576. doi: 10.1016/j.jve.2024.100576. eCollection 2024 Dec.
While certain studies have demonstrated that antiviral treatment administered to index patients with influenza can mitigate the transmission within households, the efficacy of anti-SARS-CoV-2 agents in curtailing household transmission remains to be conclusively established.
A retrospective study conducted from April 2021 to May 2022 across multiple centers in Thailand compared 892 individuals treated with favipiravir to 84 who received standard treatment among mild to moderate COVID-19 index patients. The study focused on the impact of favipiravir treatment in reducing household SARS-CoV-2 transmission by examining the secondary attack rate.
Favipiravir significantly reduced household SARS-CoV-2 transmission, comparing 1836 household contacts with favipiravir-treated index cases to 170 contacts whose index cases received standard care. Favipiravir led to a 58 % secondary attack rate, substantially lower than the 71.8 % observed with standard treatment, representing a 54 % reduction in transmission likelihood, with an odds ratio of 0.46 (95 % confidence interval [CI] [0.23-0.89]). Index cases treated with favipiravir also demonstrated a relative risk reduction of 0.19 in transmission (95 % CI [0.11-0.27]). Remarkably, favipiravir effectiveness was most notable in unvaccinated index cases, those with symptomatic infections, individuals living in shared spaces like dormitories, flats, or apartments, and those not adhering to mask-wearing within their households.
Favipiravir has demonstrated in this study an indirect role in reducing household SARS-CoV-2 transmission, showing notable efficacy in symptomatic and unvaccinated index cases. This breakthrough highlights its potential in broader public health strategies. Exploring the roles and challenges of other anti-SARS-CoV-2 agents remains a vital goal in ongoing research.
虽然某些研究表明，对流感指数病例进行抗病毒治疗可减少家庭内传播，但抗SARS-CoV-2药物在减少家庭传播方面的疗效仍有待最终确定。
2021年4月至2022年5月在泰国多个中心进行的一项回顾性研究，将892例接受法匹拉韦治疗的个体与84例接受标准治疗的轻度至中度COVID-19指数病例进行了比较。该研究通过检查二代发病率，重点关注法匹拉韦治疗对减少家庭SARS-CoV-2传播的影响。
与170例接受标准治疗的指数病例的家庭接触者相比，法匹拉韦显著降低了家庭SARS-CoV-2传播，1836例与接受法匹拉韦治疗的指数病例的家庭接触者。法匹拉韦导致二代发病率为58%，大大低于标准治疗观察到的71.8%，传播可能性降低了54%，优势比为0.46（95%置信区间[CI][0.23-0.89]）。接受法匹拉韦治疗的指数病例在传播方面也显示相对风险降低了0.19（95%CI[0.11-0.27]）。值得注意的是，法匹拉韦的有效性在未接种疫苗的指数病例、有症状感染的个体、居住在宿舍、公寓或公寓等共享空间的人以及家庭中不戴口罩的人中最为显著。
法匹拉韦在本研究中已证明在减少家庭SARS-CoV-2传播方面具有间接作用，在有症状和未接种疫苗的指数病例中显示出显著疗效。这一突破凸显了其在更广泛的公共卫生策略中的潜力。探索其他抗SARS-CoV-2药物的作用和挑战仍然是正在进行的研究中的一个重要目标。
