FAVIPIRAVIR AND DEXAMETHASONE IN MANAGEMENT OF SARS-COV2 INFECTION

Muzamil Latief, O. Shafi, Z. Hassan, F. Abbas
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Abstract

Background. The clinical presentation of Coronavirus disease 19 (COVID-19) varies from mild symptoms to severe illness including multiorgan dysfunction. Favipiravir is an antiviral agent which has been previously used for treatment of influenza and was recently approved for treatment of mild to moderate COVID-19 in India. Objective. The Objective of this study was to assess the role of Favipiravir and Dexamethasone in patients with COVID-19. Methods. A total of 17 patients were included in this observational study. The included patients were RT-PCR for SARS-Cov-2 positive with increased inflammatory markers. All patients received Antiviral therapy, Anticoagulation (Enoxaparin 0.4mg subcutaneous twice daily), Steroids (Dexamethasone 8mg daily for 5days and 4mg daily for 5 days). Viral clearance (time to RT-PCR negative), time to defervescence after antiviral therapy, time to become independent of Oxygen support was studied. Results. Fever, myalgias, dry cough and dyspnea were the commonest presentation of COVID-19. All of our patients had lymphopenia. In our study 11 (64.7%) patients had bilateral ground glass opacities on CT chest while 6 had consolidation in addition to ground glass opacities. In two patients, who required non-invasive ventilation, Favipiravir was stopped and these patients received Remdesivir for a total of 5 days. In patients who received Favipiravir only, the Median time to RT-PCR negative, defervescence and oxygen independence was 8,3 and 6 days respectively. Conclusion. Our observational study demonstrated improvement in the majority of patients with COVID-19 with use of Favipiravir. Additional studies are needed to compare the efficiency of Favipiravir with Remdesivir.
法匹拉韦和地塞米松治疗严重急性呼吸系统综合征冠状病毒2型感染
背景冠状病毒疾病19(新冠肺炎)的临床表现从轻微症状到严重疾病不等,包括多器官功能障碍。Favipiravir是一种抗病毒药物,以前用于治疗流感,最近在印度被批准用于治疗轻度至中度新冠肺炎。客观的本研究的目的是评估法维匹拉韦和地塞米松在COVID-19患者中的作用。方法。共有17名患者参与了这项观察性研究。纳入患者的严重急性呼吸系统综合征冠状病毒2型RT-PCR阳性,炎症标志物增加。所有患者均接受抗病毒治疗、抗凝(依诺肝素0.4mg,皮下注射,每日两次)、类固醇(地塞米松8mg,每日5天,4mg,每日五天)。研究了病毒清除率(RT-PCR阴性的时间)、抗病毒治疗后退热的时间、独立于氧气支持的时间。后果发烧、肌痛、干咳和呼吸困难是新冠肺炎最常见的表现。我们所有的病人都有淋巴细胞减少症。在我们的研究中,11名(64.7%)患者的CT胸部出现双侧磨玻璃影,6名患者除磨玻璃影外还有实变。在两名需要无创通气的患者中,法维匹拉韦被停用,这些患者总共接受了5天的瑞德西韦治疗。在仅接受法维匹拉韦治疗的患者中,RT-PCR阴性的中位时间、泡腾时间和氧独立时间分别为8,3天和6天。结论我们的观察性研究表明,大多数新冠肺炎患者使用法维匹拉韦后病情有所改善。需要进行更多的研究来比较法维匹拉韦和瑞德西韦的疗效。
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