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1.
International Journal of Infectious Diseases ; 2022.
Article in English | ScienceDirect | ID: covidwho-1799910

ABSTRACT

Objectives This study aimed to evaluate the efficacy and adverse events of favipiravir in COVID-19 patients. Methods Our protocol was registered on PROSPERO (CRD42020206305). Fourteen databases were searched until February 8th, 2021. An update search for new RCTs was done on March 2nd, 2022. Meta-analysis was done for randomized controlled trials (RCTs) and non-RCTs. Results Overall, 157 studies (24 RCTs, one non-RCT, 21 observational studies, two case series, and 106 case reports) were included. On hospitalized patients, in comparison to standard of care, favipiravir showed a higher rate of viral clearance at day 5 (RR=1•60, p=0•02), defervescence at day 3-4 (RR=1•99, p<0•01), chest radiological improvement (RR=1•33, p<0•01), hospital discharge at day 10-11 (RR=1•19, p<0•01), and shorter clinical improvement time (MD=-1.18, p=0.05). Regarding adverse events, favipiravir groups had higher rates of hyperuricemia (RR=9•42, p<0•01), increased alanine aminotransferase (RR=1•35, p<0.01), but lower rates of nausea (RR=0•42, p<0•01) and vomiting (RR=0•19, p=0•02). There were no differences regarding mortality (RR=1•19, p=0.32), and increased aspartate aminotransferase (RR=1•11, p=0•25). On non-hospitalized patients, no significant differences were reported. Conclusion Adding favipiravir to the standard of care provides better outcomes for hospitalized COVID-19 patients. Pregnant, lactating women, and patients with a history of hyperuricemia should avoid using favipiravir.

2.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-312799

ABSTRACT

Background: The burden of COVID-19 on healthcare systems worldwide requires an efficient treatment option. Favipiravir, a nucleoside analog, is a potential COVID-19 treatment. Therefore, this study aimed to evaluate the efficacy and adverse events of favipiravir in COVID-19 patients.Method: In our systematic review and meta-analysis, we performed searches of PubMed, Scopus, Embase, Web of Science, the Cochrane Library, Google Scholar, European PMC, Virtual Health Library, mRCT, ClinicalTrials.gov, SIGLE, the WHO COVID-19 research article database, Covid-evidence.org, and the iSearch COVID-19 Portfolio with the latest update on February 8 th , 2021. All types of studies in which favipiravir was used on COVID-19 patients were included and extracted by two independent authors. All studies underwent systematic review, data from controlled trials underwent meta-analysis. Our protocol was registered on PROSPERO as CRD42020206305.Findings: 145 studies (15 randomized controlled trials (RCTs), one non-RCT, 21 observational studies, two case series, and 106 case reports) were included. In comparison to standard of care (SOC), favipiravir showed a higher rate of viral clearance at day 5 (RR=1·49, p=0·03), defervescence at day 3 (RR=1·91, p<0·01), chest computed tomography (CT) improvement at day 14-15 (RR=1·40, p<0·01), and hospital discharge at day 10-11 (RR=1·31, p<0·01). Regarding adverse events, the favipiravir groups had higher rates of hyperuricemia (RR=9·42, p<0·01), but lower rates of nausea (RR=0·41, p<0·01) and vomiting (RR=0·09, p=0·02).Interpretation: Adding favipiravir to the standard of care provides better outcomes for COVID-19 patients. Pregnant and lactating women as well as a history of hyperuricemia or gouty arthritis should be noticed when using favipiravir. Using favipiravir could reduce the rate of nausea and vomiting for some patients.Registration Details: Registered on PROSPERO as CRD42020206305.Funding Information: Grant Asian clinical trial network construction project (Number JP20LK0201001J0001) by Japan Agency for Medical Research and Development (AMED).Declaration of Interests: We declare no competing interests.

3.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-309765

ABSTRACT

Background: The SARS-CoV-2 pandemic has cost millions of deaths and lifelong consequences since December 2019. We attempted to evaluate the incidence, distribution, and risk factors associated with death after applying the social distance strategy to the second wave of SARS-CoV-2 in the Danang outbreak (July 2020), Vietnam. Methods: : We retrospectively reviewed the online Danang Hospital reports, gathering the epidemiological history of confirmed SARS-CoV-2 patients. We then conducted a descriptive analysis of Fisher's Phi Coefficient and Cramer's, along with multiple logistic regression models to test the effects of symptomatology and control measures performed by the Vietnamese government on transmission dynamics. The last report we examined was on August 29, 2020. Results: : 389 SARS-CoV-2 confirmed cases related to the Danang outbreak are included in our analysis with a mean age of 47.1 (SD = 18.4), involving 154 men and 235 women, 34 cases of death, and 355 were alive. The study showed significant results related to age, quarantine measures, previous negative SARS-CoV-2 test, and a range of symptoms, including shortness of breath and myalgia (p-value < 0.05). Our multiple-variable analysis suggested the significant risk of death was related to age, severe symptomology, undetected SARS-CoV-2 test results, and prior quarantined SARS-CoV-2 history. Conclusions: : Vietnamese authorities had implemented successful quarantine practices to control the SARS-CoV-2 outbreaks. However, this virus has shown dynamic spread beyond the ability of the country to control its transmission. Adequate screening, social distancing, and adequate care of the elderly and healthcare workers can lower the risk of future outbreaks.

4.
Rev Med Virol ; 31(6): e2288, 2021 11.
Article in English | MEDLINE | ID: covidwho-1384306

ABSTRACT

SARS Coronavirus-2 is one of the most widespread viruses globally during the 21st century, whose severity and ability to cause severe pneumonia and death vary. We performed a comprehensive systematic review of all studies that met our standardised criteria and then extracted data on the age, symptoms, and different treatments of Covid-19 patients and the prognosis of this disease during follow-up. Cases in this study were divided according to severity and death status and meta-analysed separately using raw mean and single proportion methods. We included 171 complete studies including 62,909 confirmed cases of Covid-19, of which 148 studies were meta-analysed. Symptoms clearly emerged in an escalating manner from mild-moderate symptoms, pneumonia, severe-critical to the group of non-survivors. Hypertension (Pooled proportion (PP): 0.48 [95% Confident interval (CI): 0.35-0.61]), diabetes (PP: 0.23 [95% CI: 0.16-0.33]) and smoking (PP: 0.12 [95% CI: 0.03-0.38]) were highest regarding pre-infection comorbidities in the non-survivor group. While acute respiratory distress syndrome (PP: 0.49 [95% CI: 0.29-0.78]), (PP: 0.63 [95% CI: 0.34-0.97]) remained one of the most common complications in the severe and death group respectively. Bilateral ground-glass opacification (PP: 0.68 [95% CI: 0.59-0.75]) was the most visible radiological image. The mortality rates estimated (PP: 0.11 [95% CI: 0.06-0.19]), (PP: 0.03 [95% CI: 0.01-0.05]), and (PP: 0.01 [95% CI: 0-0.3]) in severe-critical, pneumonia and mild-moderate groups respectively. This study can serve as a high evidence guideline for different clinical presentations of Covid-19, graded from mild to severe, and for special forms like pneumonia and death groups.


Subject(s)
COVID-19/pathology , Cough/pathology , Dyspnea/pathology , Fatigue/pathology , Fever/pathology , SARS-CoV-2/pathogenicity , Antiviral Agents/therapeutic use , COVID-19/drug therapy , COVID-19/mortality , COVID-19/virology , Comorbidity , Cough/drug therapy , Cough/mortality , Cough/virology , Diabetes Mellitus/diagnosis , Diabetes Mellitus/physiopathology , Dyspnea/drug therapy , Dyspnea/mortality , Dyspnea/virology , Fatigue/drug therapy , Fatigue/mortality , Fatigue/virology , Fever/drug therapy , Fever/mortality , Fever/virology , Humans , Hypertension/diagnosis , Hypertension/physiopathology , Immunologic Factors/therapeutic use , Prognosis , Respiratory Distress Syndrome/diagnosis , Respiratory Distress Syndrome/physiopathology , Severity of Illness Index , Smoking/physiopathology , Survival Analysis
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