Observational study of the effects of Favipiravir vs Lopinavir/Ritonavir on clinical outcomes in critically Ill patients with COVID-19

J Clin Pharm Ther. 2021 Apr;46(2):454-459. doi: 10.1111/jcpt.13305. Epub 2020 Oct 31.

Abstract

What is known and objectives: In November 2019, several patients were diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Wuhan, China. So far, there are no specific treatments with proven high efficacy in patients with SARS-CoV-2. Presently, several drugs, such as hydroxychloroquine, ribavirin, favipiravir (FVP), lopinavir/ritonavir (LPV/r), remdesivir and oseltamivir, have been suggested as effective treatments for SARS-CoV-2. The aim of this study was to describe the clinical experience with FPV and LPV/r in critically ill patients with COVID-19 at Sakarya University Education and Research Hospital.

Methods: The study included 107 consecutive patients who had a laboratory confirmation of COVID-19 and were admitted to the intensive care unit (ICU) between 19 March and 19 May 2020. Follow-up continued through 30 May 2020 when the last observed patients were discharged.

Results and discussion: Of the 107 patients, 65 received FPV (Group FPV) and 42 received LPV/r (Group LPV/r). The two groups were similar in terms of demographic data and clinical findings. 43 (66.2%) of the 65 patients in the FPV group and 23 (54.8%) of the 42 patients in the LPV/r group died (p = 0.237). The median ICU stay was 6.6 (IQR, 3-10) days in the FPV group and 9 (IQR, 6-16) days in the LPV/r group, which was a statistically significant difference (p = 0.010).

What is new and conclusion: The length of hospital stay was significantly lower in the FVP group compared to the LPV/r group among patients who were discharged from the ICU. Although the analysis was done with a limited number of patients and the observed difference in mortality rate is of some concern, FVP treatment may be more beneficial than LPV/r in terms of effective use in the ICU.

Keywords: COVİD-19; favipiravir; lopinavir.

Publication types

  • Observational Study

MeSH terms

  • Amides* / administration & dosage
  • Amides* / adverse effects
  • Antiviral Agents / administration & dosage
  • Antiviral Agents / adverse effects
  • COVID-19 Drug Treatment*
  • COVID-19* / diagnosis
  • COVID-19* / mortality
  • COVID-19* / physiopathology
  • Critical Illness* / mortality
  • Critical Illness* / therapy
  • Drug Combinations
  • Female
  • Humans
  • Intensive Care Units / statistics & numerical data
  • Length of Stay / statistics & numerical data
  • Lopinavir* / administration & dosage
  • Lopinavir* / adverse effects
  • Male
  • Middle Aged
  • Mortality
  • Pyrazines* / administration & dosage
  • Pyrazines* / adverse effects
  • Ritonavir* / administration & dosage
  • Ritonavir* / adverse effects
  • SARS-CoV-2 / isolation & purification
  • Treatment Outcome
  • Turkey / epidemiology

Substances

  • Amides
  • Antiviral Agents
  • Drug Combinations
  • Pyrazines
  • lopinavir-ritonavir drug combination
  • Lopinavir
  • favipiravir
  • Ritonavir