The Effectiveness of Favipiravir Treatment in Severe COVID-19 Pneumonia: a Single Centre Experience

Objective: The aim of this study was to investigate the efficacy of favipiravir (FVP) in severe COVID-19.Methods: This is a retrospective study of 142 COVID-19 patients with severe pneumonia signs, who received inpatient treatment between March 15 and May 20, 2020. The patients were divided into two groups according to the use of FVP treatment; group 1 (n = 99) included patients who treated with FVP and group 2 (n = 43) who didn’t receive FVP.Results: Mean age was 66.47 ± 11.89 in group 1, and 68.58 ± 14.78 in group 2. Forty patients (40.4%) in group 1 and 22 (51.2%) in group 2 were treated in the intensive care unit (P > 0.05). The proportion of eosinophil, tendency of increasing thrombocyte counts and eosinophil/neutrophil ratio in FVP group was significantly higher than non-FVP group (p < 0.05). In Group 1, patients had significantly reduced erythroid series, and elevated uric acid levels as side effects of FVP. With respect to complications during hospitalization, there was no significant difference among the groups for mechanical ventilator requirement, acute kidney injury, dialysis requirement and sepsis (P > 0.05). The mortality rates in Group 1 (n = 26 [26.3%]) were lower than those in group 2 (n = 16 [37.2%]), but it was not statistically significant.Conclusions: While the treatment of COVID-19 pneumonia options were limited during the initial stages of the pandemic, the FVP may be effective in severe cases. To confirm this effect, randomized controlled studies are needed in patients of all disease severities.

Anahtar Kelime:

Şiddetli COVID-19 Pnömonisinde Favipiravir Tedavisinin Etkinliği: Tek Merkez Deneyimi

Öz:

Amaç: Çalışmamızda, şiddetli COVID-19'da favipiravirin (FVP) etkinliğiniaraştırmak amaçlandı. Gereç ve Yöntem: 15 Mart - 20 Mayıs 2020 tarihleri arasında yatarak tedavi gören,ağır pnömoni belirtileri olan 142 COVID-19 hastası retrospektif olarak analiz edildi.Hastalar FVP tedavisinin kullanımına göre iki gruba ayrıldı; grup 1 (n = 99) FVP iletedavi edilen hastaları ve grup 2 FVP tedavisi almayan hastaları içeriyordu.Bulgular: Grup 1'de ortalama yaş 66,47 ± 11,89, grup 2'de 68,58 ± 14,78 idi. Grup1'de 40 hasta (% 40,4) ve grup 2'de 22 (% 51,2) yoğun bakım ünitesinde tedavi edildi(P> 0,05) . FVP tedavi grubunda eozinofil düzeyi, trombosit sayısı ve eozinofil /nötrofil oranı FVP tedvisi almayan gruba göre anlamlı olarak yüksek bulundu (p<0.05). Grup 1'de hastalarda FVP'nin yan etkileri olarak eritroid serileri önemli ölçüdeazalmış ve ürik asit seviyeleri yükselmiştir. Hastanede yatış sırasındakikomplikasyonlar açısından mekanik ventilatör ihtiyacı, akut böbrek hasarı, diyalizgereksinimi ve sepsis açısından gruplar arasında anlamlı fark yoktu (P> 0.05). Grup1'deki mortalite oranları (n = 26 [% 26.3]), grup 2” deki hastalardan (n = 16 [% 37.2])daha düşüktü, ancak istatistiksel olarak anlamlı değildi. Sonuç: COVID-19 pnömonisinde tedavi seçenekleri pandeminin ilk aşamalarındasınırlı iken, ciddi vakalarda FVP etkili olabilir. Bu etkiyi doğrulamak için, tümhastalık şiddetlerindeki hastalarda randomize kontrollü çalışmalara ihtiyaç vardır.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020; 395 (10229): 1054– 62.
2. Shi Q, Zhang X, Jiang F, Zhang X, Hu N, Bimu C, et al. Clinical Characteristics and Risk Factors for Mortality of COVID-19 Patients With Diabetes in Wuhan, China: A Two-Center, Retrospective Study. Diabetes Care 2020; 43 (7): 1382-1391.
3. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China. The Journal of the American Medical Association 2020; 323 (11): 1061-1069.
4. Grasselli G, Zangrillo A, Zanella A, Antonelli M, Cabrini L, Castelli A, et al. Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy. The Journal of American Medical Association 2020; 323 (16): 1574-1581.
5. Yang X, Yu Y, Xu J, Shu H, Xia J ’an, Liu H, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. The Lancet Respiratory Medicine 2020; 8 (5): 475-481.
6. Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson WK, et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. The Journal of American Medical Association 2020; 323 (20): 2052-2059.
7. Wu R, Wang L, Kuo H-CD, Shannar A, Peter R, Chou PJ, et al. An Update on Current Therapeutic Drugs Treating COVID-19. Current Pharmacology Reports 2020;1–15. 7
8. Wang M, Cao R, Zhang L, Yang X, Liu J, Xu M, et al. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Cell Research 2020; 30 (3): 269–71.
9. Geleris J, Sun Y, Platt J, Zucker J, Baldwin M, Hripcsak G, et al. Observational Study of Hydroxychloroquine in Hospitalized Patients with Covid-19. New England Journal of Medicine 2020; 382 (25): 2411-2418.
10.Sissoko D, Laouenan C, Folkesson E, M’Lebing A-B, Beavogui A-H, Baize S, et al. Experimental Treatment with Favipiravir for Ebola Virus Disease (the JIKI Trial):A Historically Controlled, Single-Arm Proof-ofConcept Trial in Guinea. PLoS Medicine 2016;13 (3): e1001967.
11.Furuta Y, Komeno T, Nakamura T. Favipiravir (T-705), a broad spectrum inhibitor of viral RNA polymerase. Proceedings of the Japan Academy, Series B 2017; 93 (7): 449–63.
12. Cai Q, Yang M, Liu D, Chen J, Shu D, Xia J, et al. Experimental Treatment with Favipiravir for COVID-19: An Open-Label Control Study. Engineering (Beijing) 2020.
13.Pilkington V, Pepperrell T, Hill A. A review of the safety of favipiravir- a potential treatment in the COVID19 pandemic?. Journal of Virus Eradication 2020; 36 (2): 45–51.
14. Giuseppe P, Alessandro S, Chiara P, Federica B, Romualdo D B, Fabio C, et al. COVID-19 diagnosis and management: a comprehensive review. Journal of Internal Medicine 2020; 288 (2): 192-206.
15. Tian W, Jiang W, Yao J, Nicholson CJ, Li RH, Sigurslid HH, et al. Predictors of mortality in hospitalized COVID-19 patients: A systematic review and meta-analysis. Journal of Medical Virology 2020; 10.1002/jmv.26050.
16. Du RH, Liang LR, Yang CQ, Wang W, Cao TZ, Li M, et al. Predictors of mortality for patients with COVID-19 pneumonia caused by SARSCoV-2: a prospective cohort study. European Respiratory Journal 2020; 55 (5): 2000524.
17. Wang Y, Fan G, Salam A, Horby P, Hayden FG, Chen C, et al. Comparative Effectiveness of Combined Favipiravir and Oseltamivir Therapy Versus Oseltamivir Monotherapy in Critically Ill Patients With Influenza Virus Infection. The Journal of Infectious Diseases. 2020; 221 (10): 1688–98.
18. Morales Hernández E, Rando-Matos Y, Dopico E, Solsona Díaz L. History of a fluctuating eosinophilia. Semergen 2020; S1138-3593(20)30133-7.
19. Lavoignet C-E, Le Borgne P, Chabrier S, Bidoire J, Slimani H, Chevrolet-Lavoignet J, et al. White blood cell count and eosinopenia as valuable tools for the diagnosis of bacterial infections in the ED. European Journal of Clinical Microbiology & Infectious Diseases 2019; 38 (8): 1523-1532.
20. Zhang J-J, Dong X, Cao Y-Y, Yuan Y-D, Yang Y-B, Yan YQ, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy 2020.
21. Li Q, Ding X, Xia G, Chen H-G, Chen F, Genk Z, et al. Eosinopenia and elevated C-reactive protein facilitate triage of COVID-19 patients in fever clinic:a retrospective case-control study. EClinicalMedicine 2020; 100375.
22. Yaylaci S, Dheir H, Senocak D, Genc AB, Kocayigit H, Cekic D, et al. The effects of favipiravir on hematological parameters of covid-19 patients. Revista da Associação Médica Brasileira 2020; 66: 65-70.
23. Eikan M, Naohiko A, Mariko M, Takaaki A. Uric Acid Elevation by Favipiravir, an Antiviral Drug. The Tohoku Journal of Experimental Medicine 2020; 251 (2): 87-90.

APA	dheir h, YAYLACI S, Sipahi S, Şenocak D, toptan h, ASICI N, Demirci T, TOCOĞLU A, kocayiğit h, Aydemir Y, salihi s, Firat N, KARABAY O (2021). The Effectiveness of Favipiravir Treatment in Severe COVID-19 Pneumonia: a Single Centre Experience. , 4 - 10. 10.18521/ktd.841747
Chicago	dheir hamad,YAYLACI SELÇUK,Sipahi Savaş,Şenocak Didar,toptan hande,ASICI NESE,Demirci Taner,TOCOĞLU Aysel,kocayiğit havva,Aydemir Yusuf,salihi salih,Firat Necattin,KARABAY OĞUZ The Effectiveness of Favipiravir Treatment in Severe COVID-19 Pneumonia: a Single Centre Experience. (2021): 4 - 10. 10.18521/ktd.841747
MLA	dheir hamad,YAYLACI SELÇUK,Sipahi Savaş,Şenocak Didar,toptan hande,ASICI NESE,Demirci Taner,TOCOĞLU Aysel,kocayiğit havva,Aydemir Yusuf,salihi salih,Firat Necattin,KARABAY OĞUZ The Effectiveness of Favipiravir Treatment in Severe COVID-19 Pneumonia: a Single Centre Experience. , 2021, ss.4 - 10. 10.18521/ktd.841747
AMA	dheir h,YAYLACI S,Sipahi S,Şenocak D,toptan h,ASICI N,Demirci T,TOCOĞLU A,kocayiğit h,Aydemir Y,salihi s,Firat N,KARABAY O The Effectiveness of Favipiravir Treatment in Severe COVID-19 Pneumonia: a Single Centre Experience. . 2021; 4 - 10. 10.18521/ktd.841747
Vancouver	dheir h,YAYLACI S,Sipahi S,Şenocak D,toptan h,ASICI N,Demirci T,TOCOĞLU A,kocayiğit h,Aydemir Y,salihi s,Firat N,KARABAY O The Effectiveness of Favipiravir Treatment in Severe COVID-19 Pneumonia: a Single Centre Experience. . 2021; 4 - 10. 10.18521/ktd.841747
IEEE	dheir h,YAYLACI S,Sipahi S,Şenocak D,toptan h,ASICI N,Demirci T,TOCOĞLU A,kocayiğit h,Aydemir Y,salihi s,Firat N,KARABAY O "The Effectiveness of Favipiravir Treatment in Severe COVID-19 Pneumonia: a Single Centre Experience." , ss.4 - 10, 2021. 10.18521/ktd.841747
ISNAD	dheir, hamad vd. "The Effectiveness of Favipiravir Treatment in Severe COVID-19 Pneumonia: a Single Centre Experience". (2021), 4-10. https://doi.org/10.18521/ktd.841747

APA	dheir h, YAYLACI S, Sipahi S, Şenocak D, toptan h, ASICI N, Demirci T, TOCOĞLU A, kocayiğit h, Aydemir Y, salihi s, Firat N, KARABAY O (2021). The Effectiveness of Favipiravir Treatment in Severe COVID-19 Pneumonia: a Single Centre Experience. KONURALP TIP DERGİSİ, 13(1), 4 - 10. 10.18521/ktd.841747
Chicago	dheir hamad,YAYLACI SELÇUK,Sipahi Savaş,Şenocak Didar,toptan hande,ASICI NESE,Demirci Taner,TOCOĞLU Aysel,kocayiğit havva,Aydemir Yusuf,salihi salih,Firat Necattin,KARABAY OĞUZ The Effectiveness of Favipiravir Treatment in Severe COVID-19 Pneumonia: a Single Centre Experience. KONURALP TIP DERGİSİ 13, no.1 (2021): 4 - 10. 10.18521/ktd.841747
MLA	dheir hamad,YAYLACI SELÇUK,Sipahi Savaş,Şenocak Didar,toptan hande,ASICI NESE,Demirci Taner,TOCOĞLU Aysel,kocayiğit havva,Aydemir Yusuf,salihi salih,Firat Necattin,KARABAY OĞUZ The Effectiveness of Favipiravir Treatment in Severe COVID-19 Pneumonia: a Single Centre Experience. KONURALP TIP DERGİSİ, vol.13, no.1, 2021, ss.4 - 10. 10.18521/ktd.841747
AMA	dheir h,YAYLACI S,Sipahi S,Şenocak D,toptan h,ASICI N,Demirci T,TOCOĞLU A,kocayiğit h,Aydemir Y,salihi s,Firat N,KARABAY O The Effectiveness of Favipiravir Treatment in Severe COVID-19 Pneumonia: a Single Centre Experience. KONURALP TIP DERGİSİ. 2021; 13(1): 4 - 10. 10.18521/ktd.841747
Vancouver	dheir h,YAYLACI S,Sipahi S,Şenocak D,toptan h,ASICI N,Demirci T,TOCOĞLU A,kocayiğit h,Aydemir Y,salihi s,Firat N,KARABAY O The Effectiveness of Favipiravir Treatment in Severe COVID-19 Pneumonia: a Single Centre Experience. KONURALP TIP DERGİSİ. 2021; 13(1): 4 - 10. 10.18521/ktd.841747
IEEE	dheir h,YAYLACI S,Sipahi S,Şenocak D,toptan h,ASICI N,Demirci T,TOCOĞLU A,kocayiğit h,Aydemir Y,salihi s,Firat N,KARABAY O "The Effectiveness of Favipiravir Treatment in Severe COVID-19 Pneumonia: a Single Centre Experience." KONURALP TIP DERGİSİ, 13, ss.4 - 10, 2021. 10.18521/ktd.841747
ISNAD	dheir, hamad vd. "The Effectiveness of Favipiravir Treatment in Severe COVID-19 Pneumonia: a Single Centre Experience". KONURALP TIP DERGİSİ 13/1 (2021), 4-10. https://doi.org/10.18521/ktd.841747