Treatment Outcome of Remdesivir Compared to Favipiravir on Moderate Symptoms COVID-19

Arief Riadi Arifin, Faisal Yunus, Satria Patrama, Muhammad Ryan Adi Putra, Olivia Geraldine Roxanne

Abstract


Remdesivir and Favipiravir have been widely used as antiviral agents in treating COVID-19. However, studies providing head on comparison of treatment outcomes between the two antiviruses are rare. The aim of this study is to compare the treatment outcome of Remdesivir and Favipiravir in moderate symptoms COVID-19. Subjects were divided into two groups based on received antivirus during COVID-19 treatment in the hospital, Remdesivir group and Favipiravir group. Post-treatment outcome was measured with three indicators: symptom improvement, negative conversion of RT-PCR, and radiological improvement. Outcomes of both groups were compared with chi square test with Remdesivir serves as a risk factor and Favipiravir as control. Out of a total of 130 subjects, 65 received Remdesivir, and 65 received Favipiravir. Post-treatment RT-PCR and radiologic examination were performed on a median of Day-10 hospitalization. RT-PCR conversion to negative was significantly more likely in Remdesivir group (RR: 1,917, 95% Cl 1,044 – 3,518, p = 0.047, chi square test). There was no significant difference between Remdesivir group and Favipiravir group in symptom improvement on Day-5 (RR 0.941, 95% Cl 0.776 – 1,141), nor Day-7 (RR 1.020, 95% Cl 0.855 – 1.216). There was also no significant difference in radiological improvement (RR 0.855, 95% Cl 0.712 – 1.026). Administering remdesivir to COVID-19 patients significantly increased the occurrence of negative RT-PCR conversion after therapy compared to standard favipiravir therapy.


Keywords


Remdesivir, Favipiravir, COVID-19

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References


World Health Organization (2021) COVID-19 Weekly Epidemiological Update Edition 48. WHO.

Daou F, Abou-Sleymane G, Badro DA, Khanafer N, Tobaiqy M, Al Faraj A. The History, Efficacy, and Safety of Potential Therapeutics: A Narrative Overview of the Complex Life of COVID-19. Int J Environ Res Public Health 2021;18:955.

Galiuto L, Patrono C. Conflicting results on the efficacy of remdesivir in hospitalized Covid-19 patients: comment on the Adaptive Covid-19 Treatment Trial. Eur Heart J 2020;41:4387–4388.

Beigel JH, Tomashek KM, Dodd LE, Mehta AK, Zingman BS, Kalil AC, et al. Remdesivir for the Treatment of Covid-19 — Final Report. N Engl J Med 2020;383:1813–1826.

Wang Y, Zhang D, Du G, Du R, Zhao J, Jin Y, et al. Remdesivir in adults with severe COVID-19: a randomized, double-blind, placebo-controlled, multicentre trial. The Lancet 2020;395:1569–1578.

Hassanipour S, Arab-Zozani M, Amani B, Heidarzad F, Fathalipour M, Martinez-de-Hoyo R. The efficacy and safety of Favipiravir in treatment of COVID-19: a systematic review and meta-analysis of clinical trials. Sci Rep 2021;11:11022 .

Burhan E, Susanto AD, Nasution SA, Ginanjar E, Pitoyo W, Susilo A, Firdaus I, et al. COVID-19 Management Guideline. PDPI, PERKI, PAPDI, PERDATIN, IDAI 2020.

Instiaty, Darmayani IGAAPS, Marzuki JE, Angelia F, William, Siane A, et al. Antiviral treatment of COVID-19: a clinical pharmacology narrative review. Med J Indones 2020;29:332–45.

Jomah S, Asdaq SMB, Al-Yamani MJ. Clinical efficacy of antivirals against novel coronavirus (COVID-19): A review. J Infect Public Health 2020;13:1187–1195.

Kokic G, Hillen HS, Tegunov D, Dienemann C, Seitz F, Schmitzova J, et al. Mechanism of SARS-CoV-2 polymerase stalling by remdesivir. Nat Commun 2021;12:279.

Pruijssers AJ, George AS, Schäfer A, Leist SR, Gralinksi LE, Dinnon KH, et al. Remdesivir Inhibits SARS-CoV-2 in Human Lung Cells and Chimeric SARS-CoV Expressing the SARS-CoV-2 RNA Polymerase in Mice. Cell Rep 2020;32:107940.

Manabe T, Kambayashi D, Akatsu H, Kudo K. Favipiravir for the treatment of patients with COVID-19: a systematic review and meta-analysis. BMC Infect Dis 2021;21:489.

Marks M, Millat-Martinez P, Ouchi D, Roberts C h, Alemany A, Corbacho-Monné M, et al. Transmission of COVID-19 in 282 clusters in Catalonia, Spain: a cohort study. Lancet Infect Dis 2021;21:629–636.

Fajnzylber J, Regan J, Coxen K, Corry H, Wong C, Rosenthal A, et al. SARS-CoV-2 viral load is associated with increased disease severity and mortality. Nat Commun 2020;11:5493.

Spinner CD, Gottlieb RL, Criner GJ, Arribas López JR, Cattelan AM, Soriano Viladomiu A, et al. Effect of Remdesivir vs Standard Care on Clinical Status at 11 Days in Patients With Moderate COVID-19: A Randomized Clinical Trial. JAMA 2020;324:1048.

Pizzorno A, Padey B, Julien T, Trouillet-Assant S. Characterization and treatment of SARS-CoV-2 in nasal and bronchial human airway epithelia. 2020;24.

Shlomai A, Ben-Zvi H, Glusman Bendersky A, Shafran N, Goldberg E, Sklan EH. Nasopharyngeal viral load predicts hypoxemia and disease outcome in admitted COVID-19 patients. Crit Care 2020;24:539.

Maltezou HC, Raftopoulos V, Vorou R, Papadima K, Mellou K, Spanakis N, et al. Association Between Upper Respiratory Tract Viral Load, Comorbidities, Disease Severity, and Outcome of Patients With SARS-CoV-2 Infection. J Infect Dis 2021;223:1132–1138.

Trunfio M, Venuti F, Alladio F, Longo BM, Burdino E, Cerutti F, et al. Diagnostic SARS-CoV-2 Cycle Threshold Value Predicts Disease Severity, Survival, and Six-Month Sequelae in COVID-19 Symptomatic Patients. Viruses 2021;13:281.

Brest P, Refae S, Mograbi B, Hofman P, Milano G. Host Polymorphisms May Impact SARS-CoV-2 Infectivity. Trends Genet 2020;36:813–815.

Ong SWX, Hui TCH, Lee YS, Haja Mohideen SM, Young BE, Tan CH, et al. High-risk chest radiographic features associated with COVID-19 disease severity. PLOS ONE 2021; 16:e0245518.

Al-Smadi AS, Bhatnagar A, Ali R, Lewis N, Johnson S. Correlation of chest radiography findings with the severity and progression of COVID-19 pneumonia. Clin Imaging 2021;71:17–23.

Rabaan AA, Tirupathi R, Sule AA, Aldali J, Mutair AA, Alhumaid S, et al. Viral Dynamics and Real-Time RT-PCR Ct Values Correlation with Disease Severity in COVID-19. Diagnostics 2021;11:1091.

Shi F, Wu T, Zhu X, Ge Y, Zeng X, Chi Y, et al. Association of viral load with serum biomakers among COVID-19 cases. Virology 2020;546:122–126.

Mowrer CT, Creager H, Cawcutt K, Birge J, Lyden E, Van Schooneveld TC, et al. Evaluation of cycle threshold values at deisolation. Infect Control Hosp Epidemiol 2021;1–3.




DOI: https://doi.org/10.15408/avicenna.v4i1.31132 Abstract - 0 PDF - 0

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