A Favipiravir-induced Fever in a Patient with COVID-19

Abstract

We herein report the first case of a fever induced by favipiravir, a potential coronavirus disease 2019 therapeutic drug. An 82-year-old man diagnosed with bilateral pneumonia was transferred to our hospital following a positive severe acute respiratory syndrome coronavirus 2 polymerase chain reaction test. He was treated with compassionate use of favipiravir. Both his oxygen demand and fever gradually improved after admission; however, his fever relapsed, and the C-reactive protein (CRP) levels increased on day 7. We diagnosed his fever as being favipiravir-induced. The fever resolved a few days after favipiravir discontinuation, demonstrating the accuracy of the diagnosis. This case revealed that favipiravir can induce a fever.

A possible interaction between favipiravir and methotrexate: Drug-induced hepatotoxicity in a patient with osteosarcoma

“…8 Besides, a case report of favipiravir-related cholestatic liver injury was recently presented by Yamazaki et al. 5 In our case, acute liver injury (ALI) developed right after the initiation of Favipiravir treatment in a patient with normal liver function test at baseline. Discontinuation of favipiravir along with steroid therapy for toxic hepatitis resulted in rapid improvement in liver function tests.…”

The efficacy and adverse effects of favipiravir on patients with COVID-19: A systematic review and meta-analysis of published clinical trials and observational studies

“…After favipiravir administration, the clinical status improved in 74 cases, worsened in 48 cases (with 21 deaths), and was unclear in 20 cases. The reported side effects were hyperuricemia Hosoba et al, 2020;Ono et al, 2020;Takoi et al, 2020 ), fever ( Koba et al, 2020 ;Kurita et al, 2020 ;Takoi et al, 2020 ), lymphocytosis ( Dauby et al, 2021 ), eosinophilia ( Takoi et al, 2020 ), lymphocytopenia ( Atallah et al, 2020 ), hepatotoxicity ( Hosoba et al, 2020 ;Takumida et al, 2021 ;Yamazaki et al, 2021 ), nephrotoxicity ( Nasa et al, 2021 ), acute pancreatitis ( Khan et al, 2021 ), wood's lamp fluorescence on nails and hair, and nausea ( Aslan Kayiran et al, 2021 ).…”

A case of COVID-19 diagnosed with favipiravir-induced drug fever based on a positive drug-induced lymphocyte stimulation test

“…However, as in our case, drug fever after 10 days of favipiravir was described in a case report by Takoi and his colleagues ( Takoi et al, 2020 ). Also, Kurita et al reported that the favipiravir-induced drug fever occurred about a week after administration ( Kurita et al, 2020 ).…”