Efficacy of Favipiravir in the Treatment of Mild to Moderate COVID-19 Patients in Erbil: A Controlled Clinical Trial

  • Hiwa Khalid Qadir Internist, Respiratory Medicine, Kurdistan Higher Council of Medical Specialties, Erbil, Kurdistan Region of Iraq ,44001.
  • Hama Nejm Jaff MBChB., D.T.M., M.R.C.P., F.C.C.P., F.R.C.P., Consultant Internist, Rizgary Teaching Hospital, Erbil, Kurdistan Region of Iraq, 44001, Professor at Department of Medicine, Hawler Medical University, College of Medicine. Erbil Kurdistan Region, Iraq,44001.
  • Hemin Khalid Saber M.B.Ch.B. F.I.C.M.S(med ,F.K.M.S(resp), Hawler Medical University, Erbil, Kurdistan Region of Iraq ,44001.
Keywords: COVID-19, Favipiravir, Oral antiviral agent, SARS-CoV-2, Treatment efficacy

Abstract

Background and objectives: Favipiravir (FAV) is considered to have potential efficacy against the SARS-CoV-2 virus. We aimed to explore the efficacy of favipiravir in the treatment of mild and moderate cases of COVID-19 pneumonia.  Methods: 250 patients of mild and moderate COVID-19 patients confirmed by reverse transcription-polymerase chain reaction (RT-PCR) were included from 22nd of June 2020 till 25th of October 2021, aged 18 to 90 years, 125 patients received FAV 3200 mg on day 1 followed by 600 mg twice daily (from day 2 –day 10). In another group, 125 patients did not receive favipiravir (SOC, standard of care group). They received paracetamol, vitamins D, and C plus Zinc, and azithromycin within the first 10 days of symptoms’ onset.  In both groups, the patients were monitored for clinical recovery on the 5th,10th, 15th days and after one month of receiving the therapeutic trials. Patients were enrolled from Rizgari Teaching Hospital, and from an outpatient respiratory private clinic. Both arms were comparable as regards demographic characteristics, severity, and comorbidities. It was a non-randomized –controlled trial. Results: On day five, the rate of clinical improvement in the FAV group (74.4%) was significantly (p < 0.001) higher than the rate in the SOC group (12.8%). On day 10, the mentioned rate was 88.8% in the FAV group compared with 47.2% in the SOC group (p < 0.001). The median time of clinical recovery was 6.5 days in the FAV group vs. 10.5 days in the SOC group. The rate of hospitalization in the FAV group was 11.2% compared with 28% in the SOC group. (P < 0.001). None of the patients of the FAV group died within 30 days, compared with 13.6% of patients in the SOC group. Conclusions: Favipiravir was superior to the SOC in shortening the time to clinical improvement in patients with mild to moderate COVID-19. As well as in decreasing the hospitalization rate, and mortality rate within the first month post-infection.

References

. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The lancet 2020;395 (10223):497-506.

. https://www.worldometers.info/coronavirus.

. Abdulah DM, Aziz Qazli SS, Suleman SK. Response of the Public to Preventive Measures of COVID-19 in Iraqi Kurdistan. Disaster Med Public Health Prep. 2021;15(5):e17-e25. doi:10.1017/dmp.2020.233

. Dabbous HM, El-Sayed MH, El Assal G, Elghazaly H, Ebeid FF, Sherief AF, et al. Safety and efficacy of favipiravir versus hydroxychloroquine in management of COVID-19: A randomised controlled trial. Scientific reports 2021; 11(1):1-7.

. Cai Q, Yang M, Liu D, Chen J, Shu D, Xia J, Liao X, Gu Y, Cai Q, Yang Y, Shen C. Experimental treatment with favipiravir for COVID-19: an open-label control study. Engineering. 2020; 6(10):1192-8.

. Bhagat S, Vora A, Daxini A, Dadhich P, Patil S, Barkate H. Clinical usefulness of favipiravir in moderate COVID-19 patients: Indian real-world experience. Indian Journal of Critical Care Medicine. 2021:S12-3.

. Madelain V, Oestereich L, Graw F, Nguyen TH, De Lamballerie X, Mentré F, et al. Ebola virus dynamics in mice treated with favipiravir. Antiviral research 2015; 123:70-7.

. 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 Aug 2;93(7):449-63.

. Hayden FG, Shindo N. Influenza virus polymerase inhibitors in clinical development. Current opinion in infectious diseases. 2019; 32(2):176.

. Zhonghua J, He H, Hu X, Za Z. Expert consensus on chloroquine phosphate for the treatment of novel coronavirus pneumonia. Bibl. Nac. Med. 2020 Mar 12; 43:185-8.

. Geneva, Switzerland: World Health Organization.

. Ruzhentsova TA, Oseshnyuk RA, Soluyanova TN, Dmitrikova EP, Mustafaev DM, Pokrovskiy KA, et al. Phase 3 trial of coronavir (favipiravir) in patients with mild to moderate COVID-19. American Journal of Translational Research 2021; 13(11):12575.

. Liu WD, Chang SY, Wang JT, Tsai MJ, Hung CC, Hsu CL, Chang SC. Prolonged virus shedding even after seroconversion in a patient with COVID-19. J Infect 2020; 81:318–356.

. The portal of the Russian Ministry of Health. Available from: (https://grls.rosminzdrav.ru/CIPermissionMini.aspx?CIStatementGUID=1bf6ea37-2035-45cf-aeb0-08d087c57cdf&CIPermGUID=89427E53-84C2-483E-8B04-1E9496E2D8B3; date of reference: May 21. 2020).

. FDA Guidance for Industry. COVID-19: developing drugs and biological products for treatment or prevention guidance for industry. 2020. (https://www.fda.gov/regulatory-infor-mation/search-fda-guidance-documents/covid-19-developing-drugs-and-biological-products-treatment-or-prevention; date of reference: August 30. 2020)

. Udwadia ZF, Singh P, Barkate H, Patil S, Rangwala S, Pendse A, et. Al. Efficacy and safety of favipiravir, an oral RNA-dependent RNA polymerase inhibitor, in mild-to-moderate COVID-19: A randomized, comparative, open-label, multicenter, phase 3 clinical trial. International Journal of Infectious Diseases 2021;103:62-71.

. Ivashchenko AA, Dmitriev KA, Vostokova NV, Azarova VN, Blinow AA, Egorova AN, et al. AVIFAVIR for treatment of patients with moderate COVID-19: interim results of a phase II/III multicenter randomized clinical trial. medRxiv. 2020 Jan 1.

Published
2022-05-23
How to Cite
Hiwa Khalid Qadir, Hama Nejm Jaff, & Hemin Khalid Saber. (2022). Efficacy of Favipiravir in the Treatment of Mild to Moderate COVID-19 Patients in Erbil: A Controlled Clinical Trial. International Journal of Applied Sciences: Current and Future Research Trends , 13(1), 228-235. Retrieved from https://ijascfrtjournal.isrra.org/index.php/Applied_Sciences_Journal/article/view/1235
Section
Articles