Experimental Treatment with Favipiravir for COVID-19: An Open-Label Control Study

Qingxian Cai(Southern University of Science and Technology), Minghui Yang(Southern University of Science and Technology), Dongjing Liu(Southern University of Science and Technology), Jun Chen(Southern University of Science and Technology), Dan Shu(Southern University of Science and Technology), Junxia Xia(Southern University of Science and Technology), Xuejiao Liao(Southern University of Science and Technology), Yuanbo Gu(Southern University of Science and Technology), Qiue Cai(Southern University of Science and Technology), Yang Yang(Southern University of Science and Technology), Chenguang Shen(Southern University of Science and Technology), Xiaohe Li(Southern University of Science and Technology), Ling Peng(Southern University of Science and Technology), Deliang Huang(Southern University of Science and Technology), Jing Zhang(Southern University of Science and Technology), Shurong Zhang(Southern University of Science and Technology), Fuxiang Wang(Southern University of Science and Technology), Jiaye Liu(Southern University of Science and Technology), Li Chen(Southern University of Science and Technology), Shuyan Chen(Southern University of Science and Technology), Zhaoqin Wang(Southern University of Science and Technology), Zheng Zhang(Southern University of Science and Technology), Ruiyuan Cao, Wu Zhong, Yingxia Liu(Southern University of Science and Technology), Lei Liu(Southern University of Science and Technology)
Engineering
March 18, 2020
10.1016/j.eng.2020.03.007
Cited by 1,405Open Access
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Abstract

There is currently an outbreak of respiratory disease caused by a novel coronavirus. The virus has been named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the disease it causes has been named coronavirus disease 2019 (COVID-19). More than 16% of patients developed acute respiratory distress syndrome, and the fatality ratio was 1%–2%. No specific treatment has been reported. Herein, we examined the effects of favipiravir (FPV) versus lopinavir (LPV)/ritonavir (RTV) for the treatment of COVID-19. Patients with laboratory-confirmed COVID-19 who received oral FPV (Day 1: 1600 mg twice daily; Days 2–14: 600 mg twice daily) plus interferon (IFN)-α by aerosol inhalation (5 million international unit (IU) twice daily) were included in the FPV arm of this study, whereas patients who were treated with LPV/RTV (Days 1–14: 400 mg/100 mg twice daily) plus IFN-α by aerosol inhalation (5 million IU twice daily) were included in the control arm. Changes in chest computed tomography (CT), viral clearance, and drug safety were compared between the two groups. For the 35 patients enrolled in the FPV arm and the 45 patients in the control arm, all baseline characteristics were comparable between the two arms. A shorter viral clearance median time was found for the FPV arm versus the control arm (4 d (interquartile range (IQR): 2.5–9) versus 11 d (IQR: 8–13), P < 0.001). The FPV arm also showed significant improvement in chest CT compared with the control arm, with an improvement rate of 91.43% versus 62.22% (P = 0.004). After adjustment for potential confounders, the FPV arm also showed a significantly higher improvement rate in chest CT. Multivariable Cox regression showed that FPV was independently associated with faster viral clearance. In addition, fewer adverse events were found in the FPV arm than in the control arm. In this open-label before-after controlled study, FPV showed better therapeutic responses on COVID-19 in terms of disease progression and viral clearance. These preliminary clinical results provide useful information of treatments for SARS-CoV-2 infection.

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