Safety and efficacy of favipiravir in COVID-19 patients with pneumonia. A randomized, double-blind, placebo-controlled study (FAVID).

PURPOSE: To design a randomized clinical trial to assess the efficacy and safety of favipiravir in patients with COVID-19 disease with pneumonia. METHODS: A randomized, double blind, placebo-controlled clinical trial of favipiravir in patients with COVID-19 pneumonia was conducted in three Spanish sites. Randomization 1:1 to favipiravir or placebo (in both groups added to the Standard of Care) was performed to treat the patients with COVID-19 pneumonia. The primary endpoint was "time to clinical improvement," measured as an improvement for ≥ two categories on a 7-point WHO ordinal scale in an up to 28 days' time frame. RESULTS: Forty-four patients were randomized (23 in the favipiravir group and 21 in the placebo group). The median time to clinical improvement was not different between the favipiravir and the placebo arms (10 days for both groups) and none of the secondary endpoints showed significant differences between arms. The proportion of adverse events (both serious and non-serious) was statistically different between the favipiravir group (68.29%) and the placebo group (31.7%) (p = 0.019), but there was insufficient statistical evidence to correlate the degree of severity of the events with the treatment group. CONCLUSIONS: Favipiravir administered for ten days to patients with COVID-19 and pneumonia did not improve outcomes compared with placebo. Although this is an underpowered negative study, efficacy results align with other randomized trials. However, in the present study, the non-serious adverse events were more frequent in the favipiravir group.

Signo de Frank y dolor torácico / Franks sign and chest pain

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Prevalencia y valor pronóstico al año de la anemia en pacientes ingresados en una unidad geriátrica de agudos / Anemia in elderly patients admitted to an acute geriatric ward

Objetivo: Analizar la prevalencia y características de pacientes con anemia ingresados en una unidad geriátrica de agudos, y su valor pronóstico de mortalidad al año. Material y métodos: Estudio descriptivo prospectivo en el que se incluyó a los pacientes ingresados en la unidad de geriatría. Se diagnosticó la anemia según los criterios de la Organización Mundial de la Salud. A todos los enfermos se les realizó una valoración geriátrica integral. Un año más tarde se realizó seguimiento vía telefónica y se valoró mortalidad y situación funcional. Resultados: Se incluyó a 145 pacientes, edad media de 81 años, de los cuales 93 (64,13%) presentaban anemia. Los tipos más frecuentes de anemia fueron la de procesos crónicos y la ferropénica. El índice de Barthel fue menor en los pacientes con anemia (p < 0,05). La mortalidad al año fue del 47,9%, sin diferencias significativas entre pacientes con y sin anemia (OR 2,07; [0,98-4,4]). Los valores del IB, el índice de Charlson, el Mini Nutritional Assessment method y el Mini Examen Cognoscitivo de Lobo basales fueron significativamente peores en los pacientes que fallecieron. Conclusión: La anemia es un enfermedad muy prevalente en pacientes de edad avanzada que ingresan por un proceso agudo y se asocia con una peor situación funcional (AU)

Objective: To describe the characteristics, prevalence and prognostic of anemia in older patients admitted to an acute geriatric unit. Material and methods: A prospective descriptive study was conducted on patients admitted to a geriatric unit. Anemia was defined using the World Health Organization criteria. A comprehensive geriatric assessment was performed on all patients. When possible, a telephone follow-up re-evaluation (mortality, functional status) was performed one year after discharge. Results: A total of 145 patients were studied. The mean age was 81 years, and 93 (64.13%) were anemic. Chronic diseases and iron deficiency anemia were the most frequent. Anemic patients had lower scores in the Barthel Index (P<.05). The mortality one year after discharge was 47.9%, with no differences between anemic or non-anemic patients (OR 2.07, [0.98-4.4]). All the geriatric indexes (Barthel index; Charlson comorbidity index, Mini-mental state examination and Mini Nutritional Assessment) showed worse scores in patients who died one year after discharge. Conclusions: The prevalence of anemia in the elderly admitted to a geriatric unit is elevated, and associated with a poorer functional status (AU)

[Anemia in elderly patients admitted to an acute geriatric ward]. / Prevalencia y valor pronóstico al año de la anemia en pacientes ingresados en una unidad geriátrica de agudos.

OBJECTIVE: To describe the characteristics, prevalence and prognostic of anemia in older patients admitted to an acute geriatric unit. MATERIAL AND METHODS: A prospective descriptive study was conducted on patients admitted to a geriatric unit. Anemia was defined using the World Health Organization criteria. A comprehensive geriatric assessment was performed on all patients. When possible, a telephone follow-up re-evaluation (mortality, functional status) was performed one year after discharge. RESULTS: A total of 145 patients were studied. The mean age was 81 years, and 93 (64.13%) were anemic. Chronic diseases and iron deficiency anemia were the most frequent. Anemic patients had lower scores in the Barthel Index (P<.05). The mortality one year after discharge was 47.9%, with no differences between anemic or non-anemic patients (OR 2.07, [0.98-4.4]). All the geriatric indexes (Barthel index; Charlson comorbidity index, Mini-mental state examination and Mini Nutritional Assessment) showed worse scores in patients who died one year after discharge. CONCLUSIONS: The prevalence of anemia in the elderly admitted to a geriatric unit is elevated, and associated with a poorer functional status.