Does Favipiravir Reduce Mortality in Patients with COVID-19 ARDS and Severe Pneumonia?

Abstract

E-mail : drrabiayilmaz@gmail.com Phone : +90 539 840 27 19 ORCID ID : orcid.org/0000-0003-1707-4607 ABSTRACT Objective: Although there is no antiviral treatment specific to the virus, favipiravir has entered the treatment routine as an antiviral in our country in May 2020. In this study, in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) acute respiratory distress syndrome (ARDS) in the intensive care unit; The effects of favipiravir antiviral regimen on mortality and morbidity were evaluated. Materials and Methods: Patients admitted to the intensive care unit were divided into two groups as those who received favipiravir (group F; n=208) and those who did not (group N; n=101). The treatment of the cases is arranged according to current national guidelines. Metavision/QlinICU Clinical Decision Support Software, in intensive care unit; Acute Physiology and Chronic Health Evaluation-II, Sequential Organ Failure Assessment score, aspartate aminotransferase, alanine aminotransferase, urea, creatinine, lactate dehydrogenase, ferritin, C-reactive protein (CRP), procalcitonin, Pro-BNP, D-dimer, fibrinogen, white blood cell, neutrophil count (NEU), lymphocyte count (LYM), NEU/LYM, CRP, t1 acceptance (0th hour), t2 follow-up (24th hour) and t3 (discharge or ex) values of acute phase parameters, and the comorbidity is obtained by Structured Query Language queries. The primary outcome is mortality; secondary outcomes are possible drugrelated organ toxicities, sudden change of the level of the acute phase reactants, requirement of continuous renal replacement therapy (CRRT), hospitalization time, ventilator dependent days. Results: One hundred eight women (35%), 201 men (65%), a total of 309 cases were evaluated in the study. In the demographic data of the groups, no statistically significant difference was found between the frequency of comorbidity, mortality rate, CRRT need, and secondary infection. The mean increase of 107.66±628.99 units between the t1 and t3 measurement was found to be statistically significant in F group cases. In the F group, the neutrophil/lymphocyte ratio (NLR) during the follow-up period and the last NLR were found to be lower than the initial value. Conclusion: It was determined that favipiravir used in the treatment of SARS-CoV-2 ARDS has no superiority in preventing mortality.