COVID-19 pnömonisinde erken ve geç dönemde favipiravir: retrospektif gözlemsel bir çalışma

Abstract

Amaç: COVID-19 pandemisinde RNA bağımlı bir RNA polimeraz inhibitörü olan favipiravirin erken kullanımına ilişkin olumlu sonuçlar bildirilmiştir. Çalışmamızda favipiravirin erken kullanımı ile geç kullanımı karşılaştırarak COVID-19 pnömonisi ve sepsis kontrolünde favipiravirin potansiyel rolünü anlamayı amaçladık. Gereç ve Yöntem: Türkiye’de Sağlık Bakanlığı tarafından sürekli güncellenen kılavuzlar doğrultusunda tedaviler yürütülmektedir.14 Nisan 2020 tarihinde yayınlanan rehberin ardından geç dönemde son tedavi seçeneği olarak favipiravir almış 18 hastayı ve erken dönemde almış olan 17 hastayı iki farklı grupta inceledik. Her iki gruptaki hastaların demografik özellikleri, komorbiditeleri, APACHE-II skorları, ardışık SOFA skorları ve mortalite durumları kaydedildi. Bulgular: Gruplar arası cinsiyet ve yaş farkı istatistiksel olarak anlamlı değildi. Gruplar arası APACHE-II puanı açısından fark istatistiksel olarak anlamlıydı (p=0.018). Geç dönemde kullanan grubun APACHE-II puanları daha yüksekti. Gruplar arasında mortalite oranı favipiraviri erken kullanan grupta istatistiksel olarak anlamlı olmasa da numerik olarak daha düşüktü. Sonuç: Sınırlı sayıda hasta ile yapılan çalışmalarda, favipiravirin erken dönemde kullanıldığında viral klirenste lopinavir/ritonavire göre belirgin bir avantaj sağladığı ve viral yükte önemli bir azalma sağladığı gösterilmiştir. Favipiraviri geç dönemde kullanan grup bize daha ciddi geldi ve mortalite oranı daha yüksekti. Favipiravir az hasta sayılı çalışmalarda bile anlamlı bir etki yaptığı ve bu konuda yapılacak daha büyük çalışmalara ihtiyaç olduğunu düşünüyoruz.

Keywords

• covıd-19
• favipiravir
• pnömoni

A retrospective, observational study: early versus late favipiravir in COVID-19 pneumonia

Abstract

Aim: Positive results have been reported regarding the early use of favipiravir,a RNA-dependent RNA polymerase inhibitor,in the COVID-19 pandemic. In our study, we aimed to understand the potential role of favipiravir in controlling COVID-19 pneumonia and sepsis by comparing the early use of favipiravir with the late using. Material and Method: Treatments are carried out in line with the guidelines constantly updated by the Ministry of Health in Turkey. Following the guide published on April 14,2020,we examined 18 patients who received favipiravir as the last treatment option in the late period and 17 patients who received favipiravir in the early period in two different groups.We recorded the demographic characteristics,comorbidities,APACHE-II scores,consecutive SOFA scores and mortality status of the patients in both groups. Results: The difference between groups in terms of gender and age was not statistically significant.The difference between groups in terms of APACHE-II score was statistically significant.(p=0.018)The late group also had higher APACHE-II scores.The difference between groups in terms of exitus was not statistically significant but lower in the group using favipiravir early. Conclusion: In studies with a limited number of patients, favipiravir has been shown to have a significant advantage over lopinavir/ritonavir in viral clearance as well as a significant reduction in viral load when used in the early period.Similarly,in our study,patients who used favipiravir in the late period came to us more seriously and the mortality rate was higher. We think that favipiravir had a significant effect even in studies with a small number of patients, and larger studies are needed in this area.

Keywords

• COVID-19
• favipiravir
• pneumonia

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