Favipiravir for COVID-19 Pneumonia: Effectiveness, Safety, and Clinical Outcomes: A Retrospective Single-Center Experience
by
, , , ,
Saad Alqahtani
1
,
Mushary Alqahtani
2,*,
Khaled Amer
3,
Fasih Ur Rahman
4,
Razan AlMasoudi
5,
Sahar Al-Otaibi
6,
Batool Alahmary
7,
Osama Asiri
8,
Abdulaziz Alshamrani
8,
Razan Alshehri
8,
Fahad Asiri
9,
Mohammed Alqahtani
2,
Abdulqader Alshahrani
2 and
Yahya Elsharif
2 1
Consultant of Infectious Disease & Internal Medicine, Armed Forces Hospital Southern Region, Khamis Mushait 61961, Saudi Arabia
2
Internal Medicine Resident, Armed Forces Hospital Southern Region, Khamis Mushait 61961, Saudi Arabia
3
Internal Medicine Resident, Asir Central Hospital (ACH), Abha 62523, Saudi Arabia
4
Department of Internal Medicine, Armed Forces Hospital Southern Region, Khamis Mushait 61961, Saudi Arabia
5
Pediatric Resident, Al Aziziyah Children Hospital, Jeddah 23342, Saudi Arabia
6
Department of Otorhinolaryngology, Head and Neck Surgery, Armed Forces Hospital Southern Region, Khamis Mushait 61961, Saudi Arabia
7
Medical Intern, King Faisal University, Al-Ahsa 31982, Saudi Arabia
8
Medical Intern, King Khalid University, Abha 62521, Saudi Arabia
9
General Practitioner, Ministry of Health (MOH), Riyadh 62521, Saudi Arabia
*
Author to whom correspondence should be addressed.
COVID 2024, 4(12), 1971-1984; https://doi.org/10.3390/covid4120139
Submission received: 13 October 2024
/
Revised: 7 December 2024
/
Accepted: 9 December 2024
/
Published: 11 December 2024
(This article belongs to the Topic Multifaceted Efforts from Basic Research to Clinical Practice in Controlling COVID-19 Disease)
Abstract
:Background: Coronaviruses, including SARS-CoV-2, cause a range of respiratory and gastrointestinal illnesses, with COVID-19 becoming a global pandemic in 2020. Favipiravir, an antiviral drug, has shown promising results in reducing disease progression and improving recovery in COVID-19 patients. Methodology: This retrospective cohort study evaluated the efficacy, safety, and clinical outcomes of favipiravir in COVID-19 pneumonia patients admitted to the AFHSR. The analysis included patient characteristics, treatment responses, and laboratory parameters. Data were cleaned using Excel and analyzed with IBM SPSS version 29.0.0. Results: Our study included 297 COVID-19 pneumonia patients treated with favipiravir, with 129 (43.4%) females and 165 (55.6%) males with a mean age of 61.47 years. Comorbidities were present in 223 patients (75.1%), most commonly diabetes (N = 78, 33.6%) and hypertension (N = 72, 31.0%). Common symptoms were shortness of breath (N = 92, 31.0%), a cough (N = 86, 29.0%), and fever (N = 69, 23.3%). Complications occurred in 53 patients (17.8%), with acute kidney injury in 15 patients (5.1%). The overall mortality was 62 (20.9%), higher in those with comorbidities (75.7%, p = 0.017). Kaplan–Meier analysis showed worse survival for patients with comorbidities (p = 0.049) and smokers (p = 0.042). Elevated WBCs, LDH, AST, and CRP were linked to better survival (p < 0.05). Non-survivors had more severe respiratory impairment (FiO2, p = 0.035). Conclusions: Our study suggests favipiravir may help reduce ICU admissions and mortality in COVID-19 pneumonia patients, but outcomes are significantly influenced by age, comorbidities, and complications. This highlights the need for individualized treatment strategies. Further randomized controlled trials are essential to define favipiravir’s role in COVID-19 management.
1. Introduction
Coronaviruses are a family of viruses responsible for a range of illnesses, from moderate to severe, including Middle East Respiratory Syndrome (MERS) and severe acute respiratory syndrome (SARS). They commonly cause infections in the respiratory and gastrointestinal tracts. These positive-strand RNA viruses are classified into four major genera: Alphacoronavirus, Betacoronavirus, Gammacoronavirus, and Deltacoronavirus [1,2]. In March 2020, Saudi Arabia confirmed its first COVID-19 case in an adult Saudi national. In response, the Ministry of Health swiftly implemented measures to control the outbreak, designating over 25 hospitals with 8800 total beds, including 8000 ICU beds and 2200 isolation beds, to treat and manage suspected and confirmed cases during the pandemic [3,4]. Most COVID-19 patients experience mild symptoms, but the disease can worsen, particularly in the elderly or those with underlying conditions like chronic lung or cardiovascular disease. Common symptoms include fever, a cough, muscle pain, and gastrointestinal issues. While most cases remain mild, about 25% progress to more severe illness, with some developing acute respiratory distress syndrome (ARDS) and approximately 5% reaching a critical condition. Various treatments are under investigation, including chloroquine, hydroxychloroquine, favipiravir, monoclonal antibodies, antisense RNA, corticosteroids, convalescent plasma, and vaccines [5,6].
Favipiravir (Avigan) is an antiviral drug that inhibits viral RNA-dependent RNA polymerase, a key enzyme in viral replication. Initial in vitro studies demonstrated its inhibitory effects against SARS-CoV-2. Clinical studies show favipiravir is more effective than Lopinavir/Ritonavir in reducing disease progression and the viral load in COVID-19 patients. In a trial comparing favipiravir to arbidol, the favipiravir group had a significantly higher clinical recovery rate by day 7 and a faster reduction in fever and coughing in moderate cases, including those with hypertension and diabetes. An Indian phase 3 trial confirmed faster recovery and high tolerability with favipiravir in mild-to-moderate COVID-19 patients, and a meta-analysis showed improved viral clearance and reduced hospitalization. Common side effects include diarrhea, nausea, vomiting, chest pain, and elevated liver enzymes [7,8,9]. Few studies have explored the use of favipiravir for COVID-19 management in Saudi Arabia. Therefore, we conducted this retrospective cohort study to evaluate the effectiveness, safety, and clinical outcomes of favipiravir in COVID-19 pneumonia patients admitted to the Armed Forces Hospitals Southern Region (AFHSR).
2. Materials and Methods
Our study examined COVID-19 patients admitted to the Armed Forces Hospitals Southern Region (AFHSR), Saudi Arabia, between January 2020 and January 2023, all of whom were over 18 years of age. We employed a retrospective, non-interventional approach to gather data, using a standardized data extraction form to collect key demographic, clinical, and laboratory information. This included details on patient age, gender, and pre-existing comorbidities such as diabetes and cardiovascular disease. Additionally, we closely examined the medications administered and the laboratory profiles, including inflammatory markers and organ function tests. Our primary focus was to assess the effectiveness and safety of favipiravir, and to evaluate clinical outcomes such as the length of the hospital stay, readmission rates, and the overall mortality. All data were meticulously organized and analyzed to provide a comprehensive understanding of patient outcomes. The study received full approval from the Institutional Review Board at the AFHSR, ensuring compliance with ethical research standards.
A comprehensive statistical analysis was conducted on the dataset, encompassing both descriptive and inferential methodologies. A descriptive analysis was conducted to summarize the demographic characteristics of the participants, which included the age, gender, and other features. Moreover, the Chi-Square Test and Fisher’s Exact Test were used to determine the association between categorical variables. The Independent Sample T Test was used to determine the association and difference between continuous variables. Subsequently, Kaplan–Meier Survival Analysis was used to find the survival rate in favipiravir users based on different parameters. All statistical analyses were executed using IBM’s SPSS software, version 29.0.0.
3. Results
Our study included 297 COVID-19 pneumonia patients treated with favipiravir, of which 129 (43.4%) were female. The mean age was 61.47 years (SD = 16.8), with an age range of 23 to 106 years, and the mean BMI was 31.15 kg/m2 (SD = 7.4), ranging from 20.7 to 56.0. The majority of patients, 277 (93.3%), had no history of smoking. Comorbidities were present in 223 patients (75.1%), while 73 (24.6%) had none. Regarding non-COVID-19 medications, 137 patients (46.1%) were on antidiabetics, and 77 (25.9%) were on anticoagulants. The mean duration of favipiravir use was 8.3 days (SD = 21.6). Common antibiotics included macrolides, used in 129 patients (43.4%), and cephalosporins in 104 patients (35.0%). Corticosteroids were frequently administered, with long-acting variants given to 224 patients (75.4%) and short-acting variants to 11 patients (3.7%) (Table 1). The most common comorbidities were diabetes mellitus (33.6%) and hypertension (31.0%), followed by ischemic heart disease or acute coronary syndrome (8.3%) and chronic kidney disease (3.5%), with less frequent comorbidities shown in Figure 1. The most commonly reported symptom was shortness of breath (31.0%), followed by a cough (29.0%) and fever (23.3%). Less frequent symptoms included fatigue (3.8%), vomiting or diarrhea (3.0%), chest pain (2.1%), and abdominal pain (1.6%), with 6.2% of patients experiencing other unspecified symptoms (Figure 2).
Table 2 presents the laboratory parameters for 297 COVID-19 pneumonia patients treated with favipiravir. The mean hemoglobin (Hb) level was 14.29 g/dL, ranging from 7.5 to 112.0 g/dL. The mean white blood cell (WBC) count was 6.51 × 109/L, and the platelet count averaged 219.96 × 109/L. The erythrocyte sedimentation rate (ESR) was elevated at 70.31 mm/h. Liver function tests indicated a mean ALT of 32.58 U/L and AST of 42.89 U/L. Renal function tests showed a mean creatinine level of 100.16 µmol/L and urea at 7.32 mmol/L. The average sodium and potassium levels were 133.57 mmol/L and 4.21 mmol/L, respectively. Inflammatory markers such as D-Dimer (3.18 mg/L), ferritin (439.41 ng/mL), and CRP (72.11 mg/L) were elevated. Other notable values included LDH at 302.63 U/L and FiO2 at 80.25%.
Table 3 shows the effectiveness, safety, and clinical outcomes for 297 COVID-19 pneumonia patients treated with favipiravir. Blood cultures were negative in 200 patients (67.3%) and positive in 26 (8.8%), with Staphylococcus being the most common pathogen (4.4%). Urine cultures were negative in 168 (56.6%) and positive in 15 (5.1%). Sputum and tracheal cultures were positive in eight (2.7%) and nine (3.0%) patients, respectively. Most patients (78.1%) did not have a CT scan, and the most common abnormal finding was consolidation (9.1%). The mean hospital stay was 6.17 days, and the mean ICU stay was 22 days. Intubation was required in 65 patients (21.9%), while 40 patients (13.5%) developed ARDS. Complications were present in 53 patients (17.8%), with acute kidney injury (AKI) in 5.1% and pulmonary embolism in 3.0%. Overall, 62 patients (20.9%) died, and 96 (32.3%) were readmitted within 15 days.
The association between the overall survival and mortality and various sociodemographic and clinical parameters showed that gender was not significantly associated with survival (p = 0.374), but age was a strong predictor, with those who died being younger on average (58.87 years vs. 70.82 years, p < 0.001). Comorbidities were linked to higher mortality (p = 0.017), with 75.7% of those with comorbidities dying. Complications were highly significant (p < 0.001), as 41.5% of patients with complications died. Positive sputum (p = 0.006) and tracheal cultures (p < 0.001) were associated with higher survival. Early readmission was significantly linked to mortality, particularly within 15 days (p = 0.028). Interestingly, survivors had higher white blood cell (WBC) counts (7.91 vs. 6.15, p < 0.001) and higher lactic acid dehydrogenase (LDH) levels (346.30 vs. 291.10, p = 0.007). Additionally, survivors had elevated aspartate aminotransferase (AST) levels (50.49 vs. 40.91, p = 0.010), creatinine (114.28 vs. 96.45, p = 0.052), and urea levels (8.85 vs. 6.93, p = 0.009). Markers like C-reactive protein (CRP) were higher in survivors (88.50 vs. 67.77, p = 0.011), and GGT (72.58 vs. 45.85, p = 0.002) also showed significant differences. Non-survivors required higher FiO2 (83.35 vs. 73.80, p = 0.035), indicating more severe respiratory impairment. Other parameters like hemoglobin, the platelet count, and bilirubin levels did not show significant differences (Table 4).
The Kaplan–Meier analysis compared the survival of COVID-19 pneumonia patients treated with favipiravir based on gender, comorbidities, and smoking history (Figure 3, Figure 4 and Figure 5). Gender analysis showed no significant difference in survival (p = 0.393), although males had a longer mean survival time (158 days) compared to females (28 days). Comorbidity analysis revealed a significant impact on survival (p = 0.049); patients without comorbidities had a much higher mean survival time (313 days) than those with comorbidities (24 days). Smoking history also plays a significant role (p = 0.042); non-smokers had a mean survival time of 178 days, while smokers had just 11 days. These findings suggest that comorbidities and smoking significantly worsen survival outcomes, while gender differences in survival are not statistically significant.
4. Discussion
Coronaviruses, including those causing MERS, SARS, and COVID-19, have led to a global health crisis. Favipiravir, an antiviral drug, has shown effectiveness in inhibiting viral replication and speeding up recovery in COVID-19 patients. Studies, including that by Hung et al., highlight its benefits when added to standard care, improving viral clearance and clinical outcomes [10,11]. Despite its use in Saudi Arabia, research remains limited, prompting this study to assess favipiravir’s effectiveness and safety in COVID-19 pneumonia patients at the AFHSR.
The patient population had a mean age of 61.47 years, with 55.6% being male, indicating that COVID-19 pneumonia is more severe and common in older adults. Liu et al. reported that 27% of severe cases occur in patients over 60. The average BMI was 31.15 kg/m2, reflecting common obesity, which is linked to worse outcomes, as noted by Russo et al. Comorbidities, present in 75.1% of patients (notably diabetes and hypertension), were also key risk factors. Abid et al. found a 2.85-fold increased mortality risk for diabetes and a 3.05-fold increased mortality risk for hypertension, particularly in ICU patients. These findings highlight the need for targeted management in high-risk groups [12,13,14]. COVID-19 pneumonia commonly presents with shortness of breath, a cough, and fever, consistent with typical symptoms. Tavakolifard et al. cited the British Medical Journal, reporting fever (83–98%), a dry cough (57–82%), and dyspnea (18–55%) as common symptoms, with a loss of smell occurring early in mild to moderate cases [15]. Our study observed high corticosteroid use (75.4%) and the frequent administration of macrolides (43.4%) and cephalosporins (35.0%), which were associated with reduced mortality in severe cases. Fernandes et al. noted that the RECOVERY trial found that dexamethasone lowered the 28-day mortality in severe COVID-19 cases, but it is discouraged in mild cases due to risks of accelerating viral replication [16].
Our patients exhibited elevated inflammatory markers, such as CRP, D-Dimer, and ferritin, which are associated with severe COVID-19 and a poor prognosis. Trofin et al. reported that the levels of IL-6, CRP, ferritin, LDH, and D-Dimer rise with disease severity, with D-Dimer predicting severe cases and LDH indicating viral variants [17]. In our study, elevated CRP levels were more frequent among survivors, potentially reflecting a protective immune response. Luan et al. noted that CRP is typically low in viral infections, suggesting that macrophage activation may drive its elevation in COVID-19 [18]. High D-Dimer levels have been linked to coagulopathy and thrombotic events. However, Rajendran et al. found only a 1.1% incidence of clinical thrombosis in hospitalized COVID-19 patients, questioning the predictive value of D-Dimer for thrombosis despite its association with mortality [19]. Interestingly, survivors in our study had higher WBC counts and LDH levels, possibly indicating an adaptive immune response contributing to better outcomes. In contrast, Shahri et al. found higher WBC counts in non-survivors [20]. Additionally, Li et al. identified the lactic dehydrogenase–lymphocyte ratio (LLR) as a strong predictor of poor prognosis, with LLR > 345 being an independent risk factor for severe outcomes [21,22].
In terms of effectiveness, we found that 21.9% of patients required intubation, and the overall mortality rate was 20.9%. These rates are slightly higher than those reported in other studies of severe COVID-19 patients, suggesting that favipiravir may provide some benefit in managing COVID-19 pneumonia. Choi et al. noted sex-related differences in COVID-19 mortality, with rates of 8.18% in men and 4.54% in women, though women with comorbidities had a higher mortality rate of 9.27%. Hassanipour et al. found that the mortality rate in the favipiravir group was approximately 30% lower than the control group, although the difference was not statistically significant. Our study also observed a 32.3% readmission rate within 15 days, highlighting the need for close monitoring post-discharge, especially for high-risk patients. Overall, our findings align with previous research, supporting favipiravir’s effectiveness in treating COVID-19, though the higher mortality rate (20.9%) in our cohort may reflect differences in patient populations, comorbidities, or the timing of treatment [22,23,24].
5. Conclusions
Our study suggests that favipiravir may benefit COVID-19 management, especially in moderate to severe cases, but several limitations must be considered. The absence of a randomized control group and the variation in the timing of favipiravir administration affect the robustness of our findings. Additionally, the study focused primarily on mortality and did not assess other important outcomes, such as viral load reduction or the symptom duration. Despite these limitations, our results align with previous research, showing that comorbidities like diabetes and hypertension significantly impacted survival. Patients without comorbidities or complications, as well as non-smokers, had better outcomes, while positive sputum or tracheal cultures increased the mortality risk.
Author Contributions
Conceptualization, S.A., M.A. (Mushary Alqahtani), K.A., F.U.R., R.A. (Razan AlMasoudi), S.A.-O., B.A., O.A., A.A. (Abdulaziz Alshamrani), R.A. (Razan Alshehri), F.A., M.A. (Mohammed Alqahtani), A.A. (Abdulqader Alshahrani) and Y.E.; data curation, M.A. (Mushary Alqahtani), K.A., F.U.R., R.A. (Razan AlMasoudi), S.A.-O., B.A. and O.A.; formal analysis, M.A. (Mushary Alqahtani), K.A., F.U.R., M.A. (Mohammed Alqahtani), A.A. (Abdulqader Alshahrani) and Y.E.; methodology, R.A. (Razan AlMasoudi), S.A.-O., B.A., O.A., A.A. (Abdulaziz Alshamrani), R.A. (Razan Alshehri), F.A., M.A. (Mohammed Alqahtani), A.A. (Abdulqader Alshahrani) and Y.E.; project administration, S.A. and M.A. (Mushary Alqahtani); resources, S.A., M.A. (Mushary Alqahtani), B.A., O.A., A.A. (Abdulaziz Alshamrani), R.A. (Razan Alshehri) and F.A.; software, R.A. (Razan AlMasoudi), S.A.-O., B.A., O.A. and A.A. (Abdulaziz Alshamrani); supervision, S.A., M.A. (Mushary Alqahtani), K.A., F.U.R. and R.A. (Razan AlMasoudi); validation, S.A., M.A. (Mushary Alqahtani), K.A., F.U.R., R.A. (Razan AlMasoudi), M.A. (Mohammed Alqahtani), A.A. (Abdulqader Alshahrani) and Y.E.; visualization, O.A., A.A. (Abdulaziz Alshamrani), R.A. (Razan Alshehri) and F.A.; writing—original draft, R.A. (Razan AlMasoudi), S.A.-O., B.A., O.A., A.A. (Abdulaziz Alshamrani), R.A. (Razan Alshehri), F.A., M.A. (Mohammed Alqahtani), A.A. (Abdulqader Alshahrani) and Y.E.; writing—review and editing, S.A., M.A. (Mushary Alqahtani), K.A. and F.U.R. All authors have read and agreed to the published version of the manuscript.
Funding
This research received no external funding.
Institutional Review Board Statement
This study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of the Armed Forces Southern Region Hospital on 2 April 2023 (AFHSRMREC/2023/INFECTIOUS DISEASE-MEDICINE/667).
Informed Consent Statement
Informed consent was obtained from all subjects involved in the study.
Data Availability Statement
The data are available upon request if needed.
Conflicts of Interest
The authors declare no conflicts of interest.
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Figure 1.
Different comorbidities among participants (n = 233).
Figure 2.
Presenting symptoms among COVID-19 pneumonia patients (n = 297).
Figure 3.
Survival of COVID-19 pneumonia patients with favipiravir usage based on gender difference.
Figure 3.
Survival of COVID-19 pneumonia patients with favipiravir usage based on gender difference.
Figure 4.
Survival of COVID-19 pneumonia patients with favipiravir usage based on comorbidities.
Figure 5.
Survival of COVID-19 pneumonia patients with favipiravir usage based on smoking.
Table 1.
Sociodemographic and other parameters of COVID-19 pneumonia patients who used favipiravir (n = 297).
Table 1.
Sociodemographic and other parameters of COVID-19 pneumonia patients who used favipiravir (n = 297).
| Frequency, N (%) | ||
|---|---|---|
| Gender | Female | 129 (43.4%) |
| Male | 165 (55.6%) | |
| Age | Mean (SD) | 61.47 (16.8) |
| Range | 23–106 | |
| BMI (Kg/m2) | Mean (SD) | 31.15 (7.4) |
| Range | 20.7–56.0 | |
| Smoking History | No | 277 (93.3%) |
| Yes | 6 (2.0%) | |
| Comorbidities | No | 73 (24.6%) |
| Yes | 223 (75.1%) | |
| Non-COVID-19-related | ACEI/ARB | 23 (7.7%) |
| Anticoagulants | 77 (25.9%) | |
| Antidiabetics | 137 (46.1%) | |
| Antiplatelets | 2 (0.7%) | |
| Betablockers | 11 (3.7%) | |
| CCB | 7 (2.4%) | |
| Diuretics | 4 (1.3%) | |
| Statins | 14 (4.7%) | |
| Thyroxin Drugs | 2 (0.7%) | |
| Days of Favipiravir Use | Mean (SD) | 8.3 (21.6) |
| Antibiotics | Carbapenems | 16 (5.4%) |
| Cephalosporin | 104 (35.0%) | |
| Fluoroquinolones | 22 (7.4%) | |
| Macrolides | 129 (43.4%) | |
| Penicillins | 3 (1.0%) | |
| Tetracyclines | 13 (4.4%) | |
| Corticosteroids | Long-acting | 224 (75.4%) |
| Short-acting | 11 (3.7%) | |
Table 2.
Different lab-related parameters of COVID-19 pneumonia patients who used favipiravir (n = 297).
Table 2.
Different lab-related parameters of COVID-19 pneumonia patients who used favipiravir (n = 297).
| Mean (SD) | Range (Min–Max) | |
|---|---|---|
| CBC | ||
| Hemoglobin (Hb) (g/dL) | 14.29 (6.17) | 7.50–112.00 |
| White blood cell (WBC) count (109/L) | 6.51 (3.37) | 1.90–22.78 |
| Platelet count (109/L) | 219.96 (82.67) | 52.00–656.00 |
| Erythrocyte sedimentation rate (ESR) (mm/h) | 70.31 (29.86) | 6.00–120.00 |
| LFTs | ||
| Alanine aminotransferase (ALT) (U/L) | 32.58 (22.82) | 6.00–160.00 |
| Aspartate aminotransferase (AST) (U/L) | 42.89 (25.49) | 13.00–204.00 |
| Alkaline phosphatase(ALP) (U/L) | 70.42 (35.08) | 28.0–263.0 |
| Gamma-glutamyl transferase (GGT) (U/L) | 51.29 (59.36) | 8.0–516.0 |
| Total bilirubin (µmol/L) | 14.46 (18.20) | 0.4–292.3 |
| Direct bilirubin (µmol/L) | 4.44 (10.41) | 0.1–170.1 |
| RFTs | ||
| Creatinine (µmol/L) | 100.16 (63.26) | 37–581 |
| Urea (mmol/L) | 7.32 (5.06) | 2–36 |
| Serum Profile | ||
| Sodium (mmol/L) | 133.57 (4.67) | 116.00–161.00 |
| Potassium (mmol/L) | 4.21 (0.58) | 3–7 |
| Corrected calcium (mmol/L) | 3.11 (13.96) | 1.89–232 |
| Phosphorus (mmol/L) | 1.22 (3.20) | 0.49–53 |
| Magnesium (mmol/L) | 0.78 (0.10) | 0.52–1.26 |
| Other | ||
| D-Dimer (mg/L) | 3.18 (27.42) | 0.19–455.00 |
| Ferritin (ng/mL) | 439.41 (598.67) | 6.90–4454.00 |
| C-reactive protein (CRP)(mg/L) | 72.11 (55.62) | 5.0–345.2 |
| Lactic acid dehydrogenase (LDH)(U/L) | 302.63 (137.85) | 98.00–1411.00 |
| FiO2 | 80.25 (18.66) | 0–100 |
| Hematocrit (%) | 42.82 (6.17) | 23.2–59.5 |
| Temperature (°C) | 38.75 (21.05) | 23.9–373.0 |
| Heart rate | 96.46 (17.35) | 54.0–196.0 |
| Respiratory rate | 20.51 (1.45) | 17.0–28.0 |
| Mean arterial pressure (MAP) | 88.50 (11.05) | 64.0–118.0 |
Table 3.
Effectiveness, safety, and clinical outcome for COVID-19 pneumonia patients who used favipiravir (n = 297).
Table 3.
Effectiveness, safety, and clinical outcome for COVID-19 pneumonia patients who used favipiravir (n = 297).
| Frequency N (%) | ||
|---|---|---|
| Microbiology and Imaging | ||
| Blood Culture | Negative | 200 (67.3%) |
| Positive | 26 (8.8%) | |
| Common Pathogen Class (Staphylococcus) | 13 (4.4%) | |
| Urine Culture | Negative | 168 (56.6%) |
| Positive | 15 (5.1%) | |
| Commonly Mixed Growth | 5 (1.5%) | |
| Sputum Culture | Negative | 112 (37.7%) |
| Positive (WBCs and Mixed Bacteria) | 8 (2.7%) | |
| Tracheal Culture | Negative | 84 (28.3%) |
| Positive (WBCs and Mixed Bacteria) | 9 (3.0%) | |
| CT Findings | No CT Performed | 232 (78.1%) |
| Normal | 10 (3.4%) | |
| Consolidation | 27 (9.1%) | |
| Ground Glass | 15 (5.1%) | |
| Pleural Effusion | 6 (2.0%) | |
| Other | 4 (1.3%) | |
| Length of Stay | ||
| Length of Hospital Stay (Days) | Mean (SD) | 6.17 (4.89) |
| Range | 1–20 | |
| Length of ICU Stay (Days) | Mean (SD) | 22.00 (37.52) |
| Range | 3–89 | |
| Outcome and Complications | ||
| Needed Intubation | No | 220 (74.1%) |
| Yes | 65 (21.9%) | |
| Acute respiratory distress syndrome (ARDS) | No | 241 (81.1%) |
| Yes | 40 (13.5%) | |
| Complication | No Complications | 244 (82.2%) |
| ACS | 3 (1.0%) | |
| AKI | 15 (5.1%) | |
| ARDS | 4 (1.3%) | |
| Cardiac Arrest | 8 (2.7%) | |
| CVA | 9 (3.0%) | |
| Liver Failure/Heart Failure | 5 (1.7%) | |
| Pulmonary Embolism (PE) | 9 (3.0%) | |
| Survival | Dead | 62 (20.9%) |
| Alive | 232 (78.1%) | |
| Readmission | Within 15 Days | 96 (32.3%) |
| Within 30 Days | 9 (3.0%) | |
| Within 60 Days | 14 (4.7%) | |
| Within 90 Days | 4 (1.3%) | |
Table 4.
Association between overall survival/mortality and different sociodemographic and other parameters of participants.
Table 4.
Association between overall survival/mortality and different sociodemographic and other parameters of participants.
| Overall Outcome/Survival | Sig. Value | |||
|---|---|---|---|---|
| Dead, N (%) | Alive, N (%) | |||
| Gender | Female | 24 (18.8%) | 104 (81.3%) | 0.374 a |
| Male | 38 (23.0%) | 127 (77.0%) | ||
| Age (Year) | Mean (SD) | 70.82 (16.62) | 58.87 (16.02) | <0.001 c |
| BMI (Kg/m2) | Mean (SD) | 29.38 (9.08) | 31.60 (7.15) | 0.273 c |
| Smoking | No | 56 (20.3%) | 220 (79.7%) | 0.108 b |
| Yes | 3 (50.0%) | 3 (50.0%) | ||
| Comorbidities | No | 8 (11.1%) | 64 (88.9%) | 0.017 a |
| Yes | 54 (24.3%) | 168 (75.7%) | ||
| Complications | No | 31 (12.9%) | 210 (87.1%) | <0.001 a |
| Yes | 31 (58.5%) | 22 (41.5%) | ||
| Blood Culture | Negative | 45 (22.5%) | 155 (77.5%) | 0.173 a |
| Positive | 9 (34.6%) | 17 (65.4%) | ||
| Urine Culture | Negative | 41 (24.4%) | 127 (75.6%) | 0.534 a |
| Positive | 5 (33.3%) | 10 (66.7%) | ||
| Sputum Culture | Negative | 18 (16.1%) | 94 (83.9%) | 0.006 b |
| Positive | 5 (62.5%) | 3 (37.5%) | ||
| Tracheal Culture | Negative | 16 (19.0%) | 68 (81.0%) | <0.001 b |
| Positive | 8 (88.9%) | 1 (11.1%) | ||
| Readmission | Within 15 Days | 2 (2.1%) | 94 (97.9%) | 0.028 b |
| Within 30 Days | 1 (11.1%) | 8 (88.9%) | ||
| Within 60 Days | 2 (14.3%) | 12 (85.7%) | ||
| Within 90 Days | 1 (25.0%) | 3 (75.0%) | ||
| Alive, Mean (SD) | Dead, Mean (SD) | |||
| Length of Hospital Stay (Days) | 9.33 (9.7) | 5.0 (3.3) | 0.182 | |
| Length of ICU Stay (Days) | 3.0 (-) | 5.50 (3.5) | 0.333 | |
| Laboratory Parameters | ||||
| Hemoglobin (Hb) (g/dl) | 13.40 (2.18) | 14.53 (6.83) | 0.207 | |
| White Blood Cells (WBCs) (109/L) | 7.91 (4.10) | 6.15 (3.05) | <0.001 | |
| Platelets (109/L) | 226.23 (77.03) | 218.29 (84.19) | 0.506 | |
| Erythrocyte Sedimentation Rate (ESR) (mmh/h) | 76.19 (31.68) | 68.91 (29.36) | 0.217 | |
| D-Dimer (mg/L) | 3.18 (7.53) | 3.18 (30.45) | 0.999 | |
| Lactic Acid Dehydrogenase (LDH) (U/L) | 346.30 (203.06) | 291.10 (112.51) | 0.007 | |
| Aspartate Aminotransferase (AST) (U/L) | 50.49 (36.16) | 40.91 (21.55) | 0.010 | |
| Creatinine (µmol/L) | 114.28 (72.36) | 96.45 (60.27) | 0.052 | |
| Urea (mmol/L) | 8.85 (5.46) | 6.93 (4.88) | 0.009 | |
| C-Reactive Protein (CRP) (mg/l) | 88.50 (60.19) | 67.77 (53.66) | 0.011 | |
| Alkaline Phosphatase (ALP) (U/L) | 86.93 (48.87) | 66.13 (29.15) | <0.001 | |
| Gamma-Glutamyl Transferase (GGT) (U/L) | 72.58 (102.13) | 45.85 (40.64) | 0.002 | |
| Total Bilirubin (µmol/L) | 13.44 (7.43) | 14.73 (20.10) | 0.628 | |
| FiO2 | 73.80 (20.50) | 83.35 (17.06) | 0.035 | |
| Vital Parameters | ||||
| Temperature, “°C” | 37.29 (0.78) | 39.04 (23.06) | 0.620 | |
| Heart Rate | 98.49 (17.22) | 96.04 (17.38) | 0.400 | |
| Respiratory Rate | 20.39 (1.64) | 20.53 (1.42) | 0.572 | |
| Mean Arterial Pressure (MAP) | 85.67 (10.36) | 88.90 (11.14) | 0.346 | |
a Chi-Square Test, b Fisher’s Exact Test, c Independent T Test.
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Alqahtani, S.; Alqahtani, M.; Amer, K.; Ur Rahman, F.; AlMasoudi, R.; Al-Otaibi, S.; Alahmary, B.; Asiri, O.; Alshamrani, A.; Alshehri, R.; et al. Favipiravir for COVID-19 Pneumonia: Effectiveness, Safety, and Clinical Outcomes: A Retrospective Single-Center Experience. COVID 2024, 4, 1971-1984. https://doi.org/10.3390/covid4120139
AMA Style
Alqahtani S, Alqahtani M, Amer K, Ur Rahman F, AlMasoudi R, Al-Otaibi S, Alahmary B, Asiri O, Alshamrani A, Alshehri R, et al. Favipiravir for COVID-19 Pneumonia: Effectiveness, Safety, and Clinical Outcomes: A Retrospective Single-Center Experience. COVID. 2024; 4(12):1971-1984. https://doi.org/10.3390/covid4120139
Chicago/Turabian StyleAlqahtani, Saad, Mushary Alqahtani, Khaled Amer, Fasih Ur Rahman, Razan AlMasoudi, Sahar Al-Otaibi, Batool Alahmary, Osama Asiri, Abdulaziz Alshamrani, Razan Alshehri, and et al. 2024. "Favipiravir for COVID-19 Pneumonia: Effectiveness, Safety, and Clinical Outcomes: A Retrospective Single-Center Experience" COVID 4, no. 12: 1971-1984. https://doi.org/10.3390/covid4120139
APA StyleAlqahtani, S., Alqahtani, M., Amer, K., Ur Rahman, F., AlMasoudi, R., Al-Otaibi, S., Alahmary, B., Asiri, O., Alshamrani, A., Alshehri, R., Asiri, F., Alqahtani, M., Alshahrani, A., & Elsharif, Y. (2024). Favipiravir for COVID-19 Pneumonia: Effectiveness, Safety, and Clinical Outcomes: A Retrospective Single-Center Experience. COVID, 4(12), 1971-1984. https://doi.org/10.3390/covid4120139
