ABSTRACT
Introduction. It is known that most patients with COVID-19 have a disease of mild to moderate severity and can be treated at home. A potential etiotropic drug in the treatment of such patients is favipiravir. To finally decide on the inclusion of this drug in the international recommendations for the treatment of COVID-19, further studies are needed to assess its effectiveness and safety in patients with COVID-19. The aim of the study was to study the clinical efficacy of favipiravir in the complex therapy of patients with moderate-severity COVID-19 coronavirus infection. Materials and methods. A retrospective analysis of 468 medical records of an inpatient patient with a moderate form of coronavirus infection COVID-19, who were treated at the State Clinical Hospital at the Multi-Specialty Medical Center of the Akimat of Nur-Sultan, the Semey Infectious Diseases Hospital, for the period August-October 2020, was carried out. The experimental (main) group consisted of 40 patients with COVID-19 of moderate severity, who, in addition to standard therapy in accordance with the Clinical Protocol for Diagnosis and Treatment "COVID-19 Coronavirus infection (10th edition with changes from 15.07.2020), were prescribed oral favipiravir at a dose of 1600 mg/12 h on day 1, then 600 mg/12 h on the following days, for a total of 7 days. The comparison group (control group) consisted of 40 patients with moderate CVI who did not receive favipiravir. Descriptive statistics were performed with the calculation of the mean (M) and standard deviation (SD) for quantitative variables;percentages were calculated for qualitative variables. Statistical analysis was performed using Microsoft Excel and IBM SPSS Statistics 20.0. P <0.05 was considered statistically significant. Results and discussion. The present study showed that the early initiation of antiviral therapy with Favipiravir, compared with standard therapy without an antiviral drug, in patients with a moderate form of COVID-19 is associated with a statistically significant clinical improvement and a large percentage of virus elimination from the mucous membranes of the upper respiratory tract according to molecular genetic research. In the group of patients receiving favipiravir, complete remission of the disease with normalization of the main clinical parameters and the absence of complaints for 7 days of hospitalization was significantly more often than in the comparison group. Conclusions. The results obtained showed that Favipiravir is an effective antiviral drug in the complex treatment of COVID-19 coronavirus infection of moderate severity. Early administration of the drug in patients with a moderate form of the disease can prevent the progression of the disease to a more severe condition and the development of complications that require additional medical interventions.
ABSTRACT
Introduction. Currently, one of the promising antiviral drugs for the treatment of COVID-19 is remdesivir. For a final decision on the inclusion of this drug in the international recommendations for the treatment of COVID-19, further studies are needed to evaluate its effectiveness and safety in patients with COVID-19. The aim of the study is to study the clinical efficacy of remdesivir in the comprehensive therapy of patients with moderate severity of COVID-19. Materials and methods of research. In the study data was analyzed from 80 medical records of an inpatient patient with a moderate form of COVID-19. The work was carried out in accordance with the task of the Ministry of Health of the Republic of Kazakhstan as part of a clinical study which is an open retrospective study to evaluate the effectiveness of remdesivir in the comprehensive treatment of patients with COVID-19. The experimental group (the main group) consisted of 40 patients with a moderate form of COVID-19 were prescribed remdesivir at a dose of 200 mg IV on 1st day, then 100 mg IV daily, for a total of 5-7 days in addition to standard therapy. The comparison group (control group) consisted of 40 patients who received pathogenetic and symptomatic therapy without remdesivir in accordance with the clinical protocol. Statistical processing of the obtained data was carried out by methods of descriptive statistics, using a comparative analysis by the T-test Student method, frequency analysis, Chi-square calculations with the IBM SPSS Statistics 20.0 and Jamovi programs. Results and discussion. The study showed that an early start of antiviral therapy with Remdesivir compared to standard therapy without an antiviral drug in patients with a moderate form of COVID-19 is associated with a statistically significant clinical improvement and a large percentage of virus elimination from the upper respiratory tract proved by molecular genetic study. In the group of patients receiving remdesivir, complete remission of the disease with normalization of body temperature and no complaints for 7 days of hospitalization was significantly more often than in the comparison group. Antiviral therapy with the remdesivir was prescribed to patients with concomitant pathology (diabetes mellitus, obesity, arterial hypertension), which is a risk factor for a severe, unfavorable course of the disease. There were no cases of deterioration of the patient's condition due to the progression of the infectious process during the use of remdesivir. Whereas in the control group, 10% of patients had progression of the disease with the development of complications. All these patients had risk factors for the development of severe COVID-19. Conclusion. The results obtained showed that the remdesivir is an effective antiviral drug in the comprehensive treatment of COVID-19 coronavirus infection of moderate severity. Early administration of the drug in patients with a moderate form of the disease can prevent the progression of the disease to a more severe condition and the development of complications that require additional medical interventions. This drug can be used in patients with concomitant pathologies that are risk factors for a severe, unfavorable course of coronavirus infection caused by SARS-CoV-2.