PhD Scientific Days 2021

Budapest, 7-8 July 2021

CL_III_L: Clinical Medicine III. Lectures

Does favipiravir avoid disease progression among adult patients hospitalized with moderate to severe COVID-19? A prospective, sequential cohort study from Hungary

Balint Gergely SZABO1,2, Katalin Szidonia LENART1, Borisz PETRIK3, Zsofia GASPAR3, Noemi KISS-DALA1,2, Janos SZLAVIK1, Botond LAKATOS1, Saint Ladislaus COVID-19 Collaborative
1 South Pest Central Hospital, National Institute of Hematology and Infectious Diseases, Saint Ladislaus Campus (H-1097 Albert Florian ut 5‑7., Budapest, Hungary)
2 Semmelweis University, Doctoral School of Clinical Medicine (H-1085 Ulloi ut 26., Budapest, Hungary)
3 Semmelweis University, Faculty of Medicine (H-1085 Ulloi ut 26., Budapest, Hungary)

Text of the abstract

Introduction
Data suggests that favipiravir (FVP) could be used against SARS-CoV-2.

Aims
Our aim was to investigate the role of FVP in COVID-19 treatment.

Methods
A prospective sequential cohort study was performed among adults hospitalized at our centre between March–August, 2020 with moderate to severe, PCR confirmed COVID-19. For diagnosis and severity, ECDC and WHO definitions were utilized. Patients were screened for inclusion by a priori criteria, and included in the FVP cohort if standard-of-care (SOC)+FVP or the non-FVP cohort if SOC±other antivirals without FVP were administered for >48 hours since diagnosis. Treatment allocation was done per national guidelines, based on severity and drug availability. Primary endpoint was disease progression, a composite of 14-day all-cause death, need for mechanical ventilation or immunomodulatory therapy. The impact of FVP exposure on disease progression was analysed by binomial logistic regression.

Results
In all, 150 patients were included, 75 in each cohort. Time to antiviral therapy from PCR positivity, disease severity, need for oxygen supportation and ICU admittance rates did not differ statistically between cohorts. Disease progression (17/75, 22.7% vs. 10/75, 13.3%, p=0.13), 14-day all-cause death (9/75, 12.0% vs. 10/75, 13.3%, p=0.8) and need for mechanical ventilation (8/75, 10.7% vs. 4/75, 5.3%, p=0.22) were similar, while immunomodulatory therapies were required more frequently among patients receiving FVP (10/75, 13.3% vs. 1/75, 1.3%, p<0.01). The use of favipiravir was not retained as a protective factor against disease progression in multivatiate analysis.

Conclusions
In this study, favipiravir did not seem to positively affect disease progression.

Funding
The article itself did not receive any external funding. BGSz received the EFOP-3.6.3-VEKOP-16-2017-00009 Doctorate Grant, and was supported by the ÚNKP-19-3-I-SE-74 New National Excellence Program of the Ministry of Innovation and Technology of Hungary. The funding sources had no involvement in the preparation, writing, interpretation, or submission of this article.

University and Doctoral School

Semmelweis University, Károly Rácz Doctoral School of Clinical Medicine