Adverse effects associated with favipiravir in patients with COVID-19 pneumonia: a retrospective study

ABSTRACT BACKGROUND: Favipiravir is generally used in treating coronavirus disease 2019 (COVID-19) pneumonia in Turkey. OBJECTIVE: To determine the side effects of favipiravir and whether it is a good treatment option. DESIGN AND SETTING: Retrospective study conducted in Atatürk Chest Diseases and Chest Surgery Training and Research Hospital, Ankara, Turkey. METHODS: 357 patients who completed favipiravir treatment at the recommended dose were included. 37 patients with drug side effects and 320 patients without drug side effects were examined in two groups. RESULTS: Side effects were observed in 37 (10.36%) out of 357 patients using favipiravir. The most common side effect was liver dysfunction, in 26 (7.28%) of the patients. The following other side effects were also observed: diarrhea (1.4%), nausea (0.84%), abdominal pain (0.28%) and thrombocytopenia (0.28%). One patient (0.28%) presented both increased transaminases and nausea. CONCLUSION: In this study, it was determined that favipiravir may constitute an alternative for treating COVID-19 pneumonia given that its side effects are generally well tolerated and not serious.

Adverse effects associated with favipiravir in patients with COVID-19 pneumonia: a retrospective study.

BACKGROUND: Favipiravir is generally used in treating coronavirus disease 2019 (COVID-19) pneumonia in Turkey. OBJECTIVE: To determine the side effects of favipiravir and whether it is a good treatment option. DESIGN AND SETTING: Retrospective study conducted in Atatürk Chest Diseases and Chest Surgery Training and Research Hospital, Ankara, Turkey. METHODS: 357 patients who completed favipiravir treatment at the recommended dose were included. 37 patients with drug side effects and 320 patients without drug side effects were examined in two groups. RESULTS: Side effects were observed in 37 (10.36%) out of 357 patients using favipiravir. The most common side effect was liver dysfunction, in 26 (7.28%) of the patients. The following other side effects were also observed: diarrhea (1.4%), nausea (0.84%), abdominal pain (0.28%) and thrombocytopenia (0.28%). One patient (0.28%) presented both increased transaminases and nausea. CONCLUSION: In this study, it was determined that favipiravir may constitute an alternative for treating COVID-19 pneumonia given that its side effects are generally well tolerated and not serious.

Effect of high-dose intravenous vitamin C on prognosis in patients with SARS-CoV-2 pneumonia / Efecto de la vitamina C intravenosa en dosis altas sobre el pronóstico en pacientes con neumonía por SARS-CoV-2

Background:Until now, the coronavirus disease 2019 (COVID-19) pandemic has affected more than 2.5 million individuals worldwide, with approximately 170,000 deaths. Currently, no treatments with robust evidence of clinical benefit exist, and utilization of experimental agents have been recommended by national and international guidelines as a part of clinical studies.Method:In this retrospective study, a total of 323 patients severe acute respiratory syndrome due to PCR-documented COVID-19 infection admitted in our unit were included. Patients were categorized into two groups as those who did or did not receive high dose intravenous vitamin C. we examined the effect of high dose intravenous vitamin C administered in addition to other commonly used agents on prognosis in patients with COVID-19 pneumonia.Results:As compared to patients who did not receive vitamin C, those in the VC group were not significantly different in terms of the length of hospital stay (p=0.05), re-admission rate (p=0.943), admission to intensive care, need for advanced oxygen support (p=0.488), need for advanced medical treatment (p<0.001), and mortality (p=0.52).Conclusion:The limited evidence based on small samples precludes definitive conclusions regarding the potential efficacy of high dose vitamin C in these patients, indicating the need for further assessment within the context of clinical research. (AU)

Antecedentes:Hasta ahora, la pandemia de la enfermedad por coronavirus 2019 (COVID-19) ha afectado a más de 2,5 millones de individuos en todo el mundo, con aproximadamente 170.000 muertes. En la actualidad, no existen tratamientos con evidencias sólidas de beneficio clínico, y la utilización de agentes experimentales ha sido recomendada por las guías nacionales e internacionales como parte de los estudios clínicos.Método:En este estudio retrospectivo se incluyeron un total de 323 pacientes con síndrome respiratorio agudo severo por infección por COVID-19 documentada por PCR, ingresados en nuestra unidad. Los pacientes se clasificaron en 2 grupos, según recibieran o no dosis elevadas de vitamina C intravenosa. Se examinó el efecto de la administración de dosis elevadas de vitamina C intravenosa, además de otros agentes utilizados habitualmente, sobre el pronóstico de los pacientes con neumonía por COVID-19.Resultados:En comparación con los pacientes que no recibieron vitamina C, los del grupo que recibieron vitamina C no fueron significativamente diferentes en cuanto a la duración de la estancia hospitalaria (p=0,05), la tasa de reingreso (p=0,943), el ingreso en cuidados intensivos, la necesidad de soporte avanzado de oxígeno (p=0,488), la necesidad de tratamiento médico avanzado (p<0,001) y la mortalidad (p=0,52).Conclusiones:Las limitadas evidencias basadas en muestras pequeñas impiden sacar conclusiones definitivas sobre la potencial eficacia de la vitamina C en dosis altas en estos pacientes, lo que indica la necesidad de una mayor evaluación en el contexto de la investigación clínica. (AU)

Preoperative pulmonary evaluation of liver transplant candidates: results from 341 adult patients.

BACKGROUND: Pulmonary disorders are among the commonly encountered and prognostically important problems in patients with chronic liver disease. To define the prevalence and types of respiratory disorders in patients with advanced liver disease evaluated for liver transplant (LT) candidacy, and to determine factors affecting postoperative outcome. MATERIAL/METHODS: The records of 341 adult patients evaluated for LT candidacy were retrospectively examined. Demographic, clinical and laboratory data including chest X-ray, spirometry and echocardiography results were collected. Postoperative pulmonary complications and mortality rates were determined. RESULTS: With a mean age of 45.1 years, 73 (21.4%) patients presented with respiratory symptoms or signs. The most common radiographic abnormality on chest X-ray was right diaphragm elevation (53.2%). Hypoxemia was detected in 38.1% of the patients. Pulmonary hypertension was detected in 100 of 327 (30.6%) patients on Doppler echocardiography. There were 141 patients who underwent surgery. Postoperative pulmonary complications developed in 60 patients, with pneumonia being the most prevalent complication (n=28). Smoking, emphysema, abnormal spirometry, pulmonary hypertension, hypoxia and orthodeoxia were found to be factors associated with increased postoperative pulmonary complications (P<0.05 for all). Mortality rate was 24.1% (n=34) and found to be significantly higher in patients who developed a postoperative complication than in those who did not (38.7% vs. 13.8%, respectively; p=0.001). CONCLUSIONS: The authors' findings indicate that pulmonary disorders impact prognosis and are common in patients evaluated for LT candidacy. Postoperative pulmonary complication is one of the major factors affecting mortality. Therefore, in order to increase the success of the transplant operation, a thorough preoperative pulmonary evaluation is of paramount importance.