COVID-19 HASTALARINDA FAVİPİRAVİR TEDAVİSİNİN MORTALİTEYE ETKİSİNİN ARAŞTIRILMASI: ERKEN PANDEMİ DENEYİMİ
Abstract
Giriş: COVID-19 tedavisinde kullanılan ajanlardan biri olan favipiravirin diğer tedavilere üstünlüğü konusu halen tartışmalıdır. Bu çalışmayla,
hastanemizde yatarak takip edilen favipiravir alan hastalarda, ilacın tedaviye başlangıçta ya da sonradan eklenmesinin tedavi başarısı ve
28 günlük mortalite üzerinde bir fark olup olmadığını göstermeyi ve literatüre bu konuda katkıda bulunmayı amaçladık.
Yöntemler: Çalışmaya 1 Haziran-1 Temmuz 2020 tarihleri arasında, COVID-19 tanısıyla hastanemize yatarak takip edilen SARS-CoV-2
PCR pozitif hastalar dahil edildi. Hastalara ait veriler geriye dönük olarak incelendi. Hastalar tedaviye favipiravirle başlananlar, ilk seçenek tedaviye yanıt alınmadığı için tedavi rejimine favipiravir eklenenler ve favipiravir almayanlar olarak üç gruba ayrıldı.
Bulgular: Çalışmaya yaş ortalaması 58,38±18,86 yıl, %59,4’ü erkek olan 662 hasta dahil edildi. 74 hastada mortalite gelişmiş olup, mortalite oranı %11,17 idi. Hastaneye yatırılan SARS-CoV-2 PCR pozitif hastaların %69’unda toraks BT’sinde %50’den fazla tutulum saptandı. Tedaviye favipiravir eklenenlerin yaş ortalaması 66,95±15,88 yıl olup, eklenmeyen gruba göre istatistiksel olarak anlamlı yüksekti. Başlangıçtan itibaren favipiravir alanların viral klirens oranları daha yüksekti. Çalışmamızda da başlangıçtan itibaren favipiravir alanların %17,9’sinde, sonradan eklenenlerin ise %34’ünde 28. günde mortalite geliştiği saptandı ve gruplar arasında istatistiksel anlamlı fark vardı.
Sonuç: Başlangıçtan itibaren favipiravir alanların viral klirens oranları daha yüksek ve mortaliteleri daha düşüktü. Favipiravir tedavisini geç başlamanın mortaliteyi arttırdığı sonucuna varılabilir.
Keywords
References
- 1. Şimşek Yavuz S, Ünal S. Antiviral treatment of COVID-19. Turk J Med Sci. 2020;50(SI-1):611‐619. doi:10.3906/sag-2004-145
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- 12. Çinarka H, Günlüoğlu G, Çörtük M, Yurt S, Kiyik M, Koşar AF, et al. The Comparison of Lopinavir/Ritonavir Combination and Favipiravir In COVID-19 Treatment. Turk J Med Sci. 2021 Mar 17. doi: 10.3906/sag-2012-189.
- 13. Eroğlu E, Tarakçı A, Çölkesen F, Şengöz M, Kacar F, Özdemir Ş. COVID-19 Hastalarında Lopinavir/Ritonavir ve Favipravir Deneyimi. J Contemp Med. 2020; 10(4): 642-646.
- 14. Dheir H, Yaylacı S, Sipahi S, Şenocak D, Toptan H, Aşıcı N, et al. The effectiveness of favipiravir treatment in severe COVID-19 pneumonia: A single center experience. Konuralp Medical Journal. 2021; 13(1): 4-10.
- 15. Ayten O, Şaylan B. Comparison of non-severe COVID-19 pneumonia patients treated with lopinavir/ritonavir and favipiravir. Journal of Surgery and Medicine. 2020; 4(11): 970-973.
- 16. Alkan S, Önder T, Şener A, Doğan E, Gönlügür U, Şimşek T, et al. Comparisons of treatment protocols for SARS-COV-2 in early pandemic: Single center experience ın Turkey. J Contemp Med. 2022; 12(2): 1-1.
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INVESTIGATION OF THE EFFECT OF FAVIPIRAVIR TREATMENT ON MORTALITY IN COVID-19 PATIENTS: EARLY PANDEMIC EXPERIENCE
Abstract
Introduction: The superiority of favipiravir which is one of the agents used in the treatment of COVID-19, over other treatments is still controversial. With this study, we aimed to show whether there is a difference between the initial or subsequent addition of the drug to
the treatment on the treatment success and 28-day mortality in hospitalized patients receiving favipiravir, and to contribute to the literature on this subject.
Material and method: PCR-positive patients who were hospitalized in our hospital with the diagnosis of COVID-19 between June 1 and
July 1, 2020 were included in the study. The data of the patients were analyzed retrospectively. The patients were divided into 3 groups: those who started treatment with favipiravir, those who added favipiravir to the treatment regimen because there was no response to the first-line treatment, and those who did not receive favipiravir.
Results: A total of 662 patients, mean age of 58.38±18.86 years and 59.4% male were included in the study. Mortality developed in 74 people, and the mortality rate was 11.17%. More than 50% involvement was detected in thorax CT in 69% of hospitalized COVID-19 PCR positive patients. The mean age of those who added favipiravir to the treatment was 66.95±15.88 years, which was statistically significantly higher than the group that was not added. Those who received favipiravir from baseline had higher viral clearance rates. In our study, it was found that 17.9% of those who received it from the beginning and 34.0% of those who were added later developed mortality on the 28th day, and there was a statistically significant difference between these groups.
Conclusion: Those who received favipiravir from baseline had higher viral clearance rates and lower mortality. It can be concluded that late
initiation of favipiravir treatment increases mortality.
Keywords
References
- 1. Şimşek Yavuz S, Ünal S. Antiviral treatment of COVID-19. Turk J Med Sci. 2020;50(SI-1):611‐619. doi:10.3906/sag-2004-145
- 2. Jordan PC, Stevens SK, Deval J. Nucleosides for the treatment of respiratory RNA virus infections. Antivir Chem Chemother. 2018;26:2040206618764483. doi:10.1177/2040206618764483
- 3. 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 2020. doi: 10.1016/j.eng.2020.03.007
- 4. https://covid19bilgi.saglik.gov.tr/depo/rehberler/COVID-19_Rehberi.pdf
- 5. Şener A. COVİD-19 (SARS Cov-2) Tedavisi. J Biotechinol & Strategic Health Res. 2020; 4: 97-104.
- 6. Shrestha DB, Budhathoki P, Khadka S, Shah PB, Pokharel N, Rashmi P. Favipiravir versus other antiviral or standard of care for COVID-19 treatment: a rapid systematic review and meta-analysis. Virol J. 2020 Sep 24;17(1):141. doi: 10.1186/s12985-020-01412-z.
- 7. Alıravcı I, Alkan Çeviker S. COVID-19 Karaciğer Tutulumu ve Altta Yatan Karaciğer Hastalığı Olanlarda Hastalık Seyrinin İrdelenmesi: Derleme. Journal of Biotechnology and Strategic Health Research. 2020; 4(3): 206-211.
- 8. 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. Clin Infect Dis. 2020. https://doi.org/10.1093/cid/ciaa1176.
- 9. İzci-Çetinkaya F, Karagöz H, Yıldız O. [Comparison of liver safety of favipiravir and hydroxychloroquine in COVID-19 treatment].Klimik Derg. 2020; 33(3): 235-40. Turkish.
- 10. Chen C, Zhang Y, Huang J, Yin P, Chen Z, Wu J, et al. Favipiravir versus arbidol for COVID-19: a randomized clinical trial [preprint]. medRxiv 2020 Apr. 15. doi: 10.1101/2020.03.17.20037432.
- 11. Liu W, Zhou P, Chen K, Ye Z, Liu F, Li X, et al. Efficacy and safety of antiviral treatment for COVID-19 from evidence in studies of SARS-CoV-2 and other acute viral infections: a systematic review and meta-analysis. CMAJ. 2020 Jul 6;192(27):E734-E744. doi: 10.1503/cmaj.200647.
- 12. Çinarka H, Günlüoğlu G, Çörtük M, Yurt S, Kiyik M, Koşar AF, et al. The Comparison of Lopinavir/Ritonavir Combination and Favipiravir In COVID-19 Treatment. Turk J Med Sci. 2021 Mar 17. doi: 10.3906/sag-2012-189.
- 13. Eroğlu E, Tarakçı A, Çölkesen F, Şengöz M, Kacar F, Özdemir Ş. COVID-19 Hastalarında Lopinavir/Ritonavir ve Favipravir Deneyimi. J Contemp Med. 2020; 10(4): 642-646.
- 14. Dheir H, Yaylacı S, Sipahi S, Şenocak D, Toptan H, Aşıcı N, et al. The effectiveness of favipiravir treatment in severe COVID-19 pneumonia: A single center experience. Konuralp Medical Journal. 2021; 13(1): 4-10.
- 15. Ayten O, Şaylan B. Comparison of non-severe COVID-19 pneumonia patients treated with lopinavir/ritonavir and favipiravir. Journal of Surgery and Medicine. 2020; 4(11): 970-973.
- 16. Alkan S, Önder T, Şener A, Doğan E, Gönlügür U, Şimşek T, et al. Comparisons of treatment protocols for SARS-COV-2 in early pandemic: Single center experience ın Turkey. J Contemp Med. 2022; 12(2): 1-1.
- 17. Ghasemnejad-Berenji M, Pashapour S. Favipiravir and COVID-19: A Simplified Summary. Drug Res (Stuttg). 2021 Mar;71(3):166-170. doi: 10.1055/a-1296-7935.
- 18. Özlüşen B, Kozan Ş, Akcan RE, Kalender M, Yaprak D, Peltek İB, et al. Effectiveness of favipiravir in COVID-19: a live systematic review. Eur J Clin Microbiol Infect Dis. 2021 Dec;40(12):2575-2583.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | March 29, 2023 |
| Published in Issue | Year 2023 Volume: 4 Issue: 1 |
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