Safety and efficacy of Favipiravir in moderate to severe SARS-CoV-2 pneumonia

Solaymani‐Dodaran, Masoud; Ghanei, Mostafa; Bagheri, Minoo; Qazvini, Ali; Vahedi, Ensieh; Saadat, Seyed Hassan; Setarehdan, Seyed Amin; Ansarifar, Akram; Biganeh, Hossein; Mohazzab, Arash; Khalili, Davood; Ghazale, Amir Hosein; Heidari, Mohammad Reza; Taheri, Ramezan Ali; Khoramdad, Maliheh; Asadi, Maryam; Nazemieh, Masoud; Varshochi, Mojtaba; Abbasian, Samaneh; Bakhtiari, Ali Shojaee; Mosaed, Reza; Hosseini-Shokouh, Seyyed-Javad; Shahrokhi, Masoume; Yassin, Zeynab; Zohal, Mohammad Ali; Qaraati, Maryam; Rastgoo, Nafiseh; Sami, Ramin; Eslami, Mohammad; Asghari, Akram; Namazi, Mansoor; Ziaie, Shadi; Jafari-Moghaddam, Raana; Kalantari, Saeid; Memarian, Mohammad; Khodadadi, Javad; Afshari, Mohammad Hossein; Momen‐Heravi, Mansooreh; Behzadseresht, Niusha; Mobayen, Ahmad Reza; Mozafari, Abolfazl; Movasaghi, Fatemeh; Shoushtari, Maryam Haddadzadeh; Moazen, Javad

doi:10.1016/j.intimp.2021.107522

Cited by 58 publications

(63 citation statements)

References 29 publications

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“…Correspondingly, we prefer Favipiravir to meet the necessity. However, it should be noted that antiviral therapy fails to prevent pulmonary involvement, which is the histopathological inflammatory process rather than the effect of infection itself 37 .…”

Section: Resultsmentioning

confidence: 99%

What We Learned from COVID-19: From endotheliitis to treatment

Dirican

Ildir

Uzar

et al. 2021

Preprint

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Introduction: The outbreak of the novel coronavirus 2019 (COVID-19) caused a pandemic that led to death of more than 3 million people globally. COVID-19 may yield a variety of clinical pictures, differing from pneumonitis to Acute Respiratory Distress Syndrome (ARDS) along with vascular damage in the lung tissue, which is named as endotheliitis, To date, no specific treatment was approved by any authority for the prevention or treatment of COVID-19. Materials and Methods: Here, we presented our experience on COVID-19 with evaluating 11,190 COVID-19 patients by presenting the manifestations of endotheliitis in skin, lung, and brain tissues according to different phases of COVID-19. In our perspective, distinctive manifestations in each COVID-19 patient, including non-respiratory conditions in the acute phase and the emerging risk of long-lasting complications, suggest that COVID-19 has an endotheliitis-centred thrombo-inflammatory pathophysiology. Accordingly, our treatment strategy was adopted to prevent both respiratory and vascular distresses, which are categorized according to extent of endotheliitis. (Group A: no or mild pulmonary involvement, Group B: moderate pulmonary involvement with clinical risk of deterioration, Group C: severe pulmonary involvement and respiratory failure). Potential pathophysiological mechanisms contributing to endotheliitis includes cytokine storm and toxic plasma, thromboinflammation and systemic microangiopathy. Results: A total of 11.190 COVID-19 patients that were diagnosed and treated in Samsun VM Medicalpark Hospital, Turkey, between March 2020 and April 2021 were retrospectively evaluated. The mean age was 59.2 years and male to female ratio was 5507/5683. Among these patients, 1896 (16.9%) individuals were hospitalized. While 1220 (64.3%) of the inpatients were hospitalized within the first 10 days after the diagnosis, 676 (35.7%) of them were hospitalized 10 days after their diagnosis. The number of patients who did not respond to group A and B treatments and developed hypoxemic respiratory failure (Group C) was 520 (27.4%). Among hospitalized patients, 146 (7.7%) individuals needed ventilator support (non-invasive/invasive mechanical ventilation) and were followed in the intensive care unit, and 43 (2.2%) patients died. In conclusion; Endotheliitis can also explain the mechanism behind the respiratory failure in COVID-19, and the difference of COVID-19 related ARDS from ARDS seen in other critical conditions. Hence, daily evaluation of momentary changes in clinical, laboratory and radiological findings of patients and deciding appropriate pathophysiological treatment would help to reduce the mortality rate of COVID-19.

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Section: Resultsmentioning

confidence: 99%

What We Learned from COVID-19: From endotheliitis to treatment

Dirican

Ildir

Uzar

et al. 2021

Preprint

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“…Although favipiravir had positive results in previous trials [ 23 , 24 ], our trial is the largest to examine favipiravir's efficacy in the moderate-to-severe confirmed COVID-19 population, with no clinical benefit observed. In another large trial done comparing favipiravir to lopinavir/ritonavir regimen, there was no effect in reducing the number of ICU admissions, intubations, or in-hospital mortality [ 25 ]. In addition, it is undeniable that use of combination therapy was associated with a higher rate of AEs than in the control group.…”

Section: Discussionmentioning

confidence: 99%

Favipiravir and Hydroxychloroquine Combination Therapy in Patients with Moderate to Severe COVID-19 (FACCT Trial): An Open-Label, Multicenter, Randomized, Controlled Trial

et al. 2021

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“…8,9 Meanwhile, for months, no large RCTs reported the benefits of antiparasitic ivermectin and antiviral favipiravir in COVID-19, although some small studies reported conflicting results for ivermectin 10,11 and favipiravir. 12,13 For example, in an RCT involving 400 adult patients with mild COVID-19, no clinical improvement was observed in patient receiving ivermectin compared to placebo. 10 To date, only antiviral remdesivir was shown to facilitate significant clinical improvements and has been authorized for COVID-19 by major drug safety regulators.…”

Section: Introductionmentioning

confidence: 99%

Immunomodulation as a Potent COVID-19 Pharmacotherapy: Past, Present and Future

Hertanto¹,

Wiratama²,

Sutanto³

et al. 2021

JIR

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In the first year of its appearance, the 2019 coronavirus disease (COVID-19) has affected more than 150 million individuals and killed 3 million people worldwide. The pandemic has also triggered numerous global initiatives to tackle the newly emerging disease, including the development of SARS-CoV-2 vaccines and the attempt to discover potential pharmacological therapies. Nonetheless, despite the success of SARS-CoV-2 vaccine development, COVID-19 therapy remains challenging. Several repurposed drugs that were documented to be useful in small clinical trials have been shown to be ineffective in larger studies. Additionally, the pathophysiology of SARS-CoV-2 infection displayed the predominance of hyperinflammation and immune dysregulation in inducing multiorgan damage. Therefore, the potential benefits of both immune modulation and suppression in COVID-19 have been extensively discussed. Here, we reviewed the roles of immunomodulation as potential COVID-19 pharmacological modalities based on the existing data and proposed several new immunologic targets to be tested in the foreseeable future.

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Safety and efficacy of Favipiravir in moderate to severe SARS-CoV-2 pneumonia

Cited by 58 publications

References 29 publications

What We Learned from COVID-19: From endotheliitis to treatment

What We Learned from COVID-19: From endotheliitis to treatment

Favipiravir and Hydroxychloroquine Combination Therapy in Patients with Moderate to Severe COVID-19 (FACCT Trial): An Open-Label, Multicenter, Randomized, Controlled Trial

Immunomodulation as a Potent COVID-19 Pharmacotherapy: Past, Present and Future

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