Clinical study to compare the efficacy and safety of casirivimab & imdevimab, remdesivir, and favipravir in hospitalized COVID-19 patients.

Background: Corona Virus disease - 2019 (COVID-19) disease induces scientific research to find a control to this pandemic from 2020 year up to now. Recently, various advances in pharmacotherapy against COVID-19 have emerged. Objectives: To compare the efficacy and safety of antibodies cocktail (casirivimab and imdevimab), Remdesivir, and Favipravir in the COVID-19 patients. Study design: This study is a single-blind non-Randomized Controlled Trial (non-RCT). The drugs of the study are prescribed by lectures on chest diseases, faculty of medicine-Mansoura University. The duration of the study is about six months after ethical approval.265 hospitalized COVID-19 patients were used to represent the COVID-19 population and were assigned into three groups in a ratio of (1:2:2) respectively, Group (A) received REGN3048-3051(Antibodies cocktail (casirivimab and imdevimab)), group (B) received remdesivir, and group (C) received favipravir. Results: Casirivimab and imdevimab achieve less 28-day mortality rate, and less mortality at hospital discharge than Remdesivir, and Favipravir. Conclusion: From all of these results, it is concluded that Group A (Casirivimab & imdevimab) achieves more favorable outcomes than B (Remdesivir) & C (Favipravir) intervention groups. Clinical trial registration: NCT05502081, 16/08/2022, Clinicaltrials.gov.

A favipiravir-induced angioedema and urticaria in a COVID-19 patient.

Although favipiravir is a promising drug for coronavirus disease 2019, some adverse effects, including skin lesions, have been reported. A 56-year-old female who was prescribed favipiravir by a filiation team following a positive severe acute respiratory syndrome coronavirus 2 polymerase chain reaction test presented to our hospital. After examination, favipiravir and paracetamol were prescribed. She represented to the hospital with facial swelling and itchy rashes on her forearm. Angioedema and urticaria were diagnosed. Favipiravir was discontinued. Steroid and antihistaminic therapy were administered for angioedema. To our knowledge, this is the first reported case of favipiravir-induced angioedema and urticaria in Turkey.

Nail and hair findings developing in patients treated for COVID-19 infection fluorescence of keratinized tissues on Wood's lamp in COVID-19 disease.

BACKGROUND: The new severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) is the causative agent of coronavirus 2019 (COVID-2019) disease. A wide variety of symptoms of the disease has been frequently reported in the literature in recent years. However, information on the findings in keratinized tissues is still limited. Data on changes in keratinized tissues such as nails, teeth and hair, and oral mucousa due to drugs used in the treatment of this disease are also extremely insufficient. AIM: With this study, it was aimed to evaluate the changes in the keratinized tissues of our patients with COVID-19, who are frequently encountered in the Ear Nose and Throat outpatient clinic. MATERIALS AND METHOD: The study was carried out on patients who applied to Baskent University Ear Nose and Throat clinic. There were 3 groups. The first group consisted of patients diagnosed with COVID-19 and received relevant medical treatments, the second group included individuals who have never experienced COVID-19 infection but have been vaccinated against COVID-19, and the third group is the control group with normal healthy individuals who have never been diagnosed with COVID-19 infection and have not been vaccinated so far. With the Wood's lamp, fluorescent changes in nails, hair, tooth, and the oral mucousa were recorded. RESULTS: A total of 124(75 females, 49 males) patients were included in the study. Positive Wood's finding was significantly higher in COVID-19 group(Group 1) who received Favipravir when compared with individuals who did not receive Favipravir (p < 0.001). Wood's positivity was not detected in any of the individuals who did not use favipravir. The rate of determining Wood's positivity in favipravir users decreases after 58 days. DISCUSSION: Accordingly, Favipravir accumulation in the kretainized tissues manifest positive Wood's sign in our study. CONCLUSION: The adverse effects of the accumulation of the drugs-mainly Favipravir-used in the treatment of COVID-19 disease, have not yet been clearly demonstrated so far. Revealing the findings in these tissues with this study will pave the way for investigating changes or drug sequestrations in other organs in the long term.

The comparison of favipiravir and lopinavir/ritonavir combination in COVID-19 treatment

Background/aim: SARS-CoV-2, a ribonucleic acid coronavirus, rapidly spread worldwide within a short timeframe. Although different antiviral, antiinflammatory, and immunomodulatory drugs are used, current evidence is insufficient as to which drug is more efficient. Our study compared favipiravir and lopinavir/ritonavir (LPV/RTV) therapies in inpatient care for coronavirus disease 2019 (COVID-19) pneumonia. Materials and methods: Demographic data, test results, treatments, and latest status of patients receiving inpatient COVID-19 pneumonia therapy were recorded. The initial favipiravir and LPV/RTV receiving groups were compared regarding the need for intensive care units (ICU) and mortality. Logistic regression analysis was performed by including variables showing significant differences as a result of paired comparisons into the model. Results: Of the 204 patients with COVID-19 pneumonia, 59 (28.9%), 131 (64.2%), and 14 were administered LPV/RTV, favipiravir, and favipiravir with LPV/RTV, respectively. No difference was found in age, sex, presence of comorbidity, and tocilizumab, systemic corticosteroid, and plasma therapy use between patients administered with these three different treatment regimens. The mean mortality age of the patients was 71 ± 14.3 years, which was substantially greater than that of the survivors (54.2 ± 15.5 years). Compared with patients administered with LPV/RTV, ICU admission and mortality rates were lower in patients administered with favipiravir. CK-MB, AST, CRP, LDH, and creatinine levels were higher, whereas lymphocyte counts were lower in patients who died. Age, AST, CRP, LDH, and neutrophil counts were higher in patients needing ICU, and eosinophil and lymphocyte counts were significantly lower. Logistic regression analysis showed that favipiravir use independently decreased mortality (p = 0.006). Conclusion: The use of favipiravir was more effective than LPV/RTV in reducing mortality in hospitalized patients with COVID-19.