Abstract
Amaç: Günümüzde, Koronavirüs hastalığı 2019’un semptomları, görüntüleme özellikleri ve laboratuvar bulguları bilinmektedir ancak hastalığın tedavisi netlik kazanmamıştır. Bu çalışmada, invaziv mekanik ventilasyona ihtiyaç duymayan hastalarda favipiravirin etkinliğini tedavi sonrası laboratuvar ve bilgisayarlı tomografi bulgularındaki değişimleri, tedavi kılavuzundan çıkarılan hidroksiklorokin ile karşılaştırarak incelemeyi amaçladık.
Gereç ve Yöntem: Çalışmamızda Koronavirüs hastalığı 2019 tanısı konulan ve hidroksiklorokin ve favipiravir ile tedavi edilen 49 hasta incelendi. Hastalar tedavi şekillerine göre 3 gruba ayrıldı. Bu 3 gruptaki hastaların tedavi öncesi ve sonrası laboratuvar bulgularındaki ve bilgisayarlı tomografi görüntülemesindeki değişiklikler incelendi.
Bulgular: Gruplarda, toraks bilgisayarlı tomografi tetkikinde izlenen lezyon paternlerinin oranları ve türleri arasında istatistiksel olarak anlamlı bir fark yoktu. Her bir grupta lezyon paterni olarak en sık hidroksiklorokin grubunda 18 hastada (%81.8), favipiravir grubunda 7 hastada (%70) ve hidroksiklorokin+favipiravir grubunda 10 hastada (%58.8) buzlu cam dansitesi+konsolidasyon varlığı izlendi. Her 3 grupta da C-reaktif protein, ferritin, fibrinojen değerlerinde ve bilgisayarlı tomografi skorlarında tedavi sonrası istatistiksel olarak anlamlı düzelme mevcuttu ve ilaçlar arasında istatistiksel olarak anlamlı bir fark yoktu.
Sonuç: Bu çalışmada, yoğun bakıma ihtiyaç duymayan Koronavirüs hastalığı 2019 hastalarında hidroksiklorokine kıyasla tedavi sonrası laboratuvar ve bilgisayarlı tomografi bulgularındaki değişiklikler açısından favipiravirin anlamlı bir üstünlüğü bulunamamıştır.
Keywords
Şiddetli Akut Solunum Sendromu Koronavirüs 2 Favipiravir Bilgisayarlı Tomografi Tomografi Skoru
Supporting Institution
Yok
Project Number
Yok
Thanks
Yok
References
- Weekly Operational Update on COVID-19 13 February 2021(cited 2021 Feb 15). Available from: https://www.who.int/publications/m/item/weekly-operational-update-on-covid-19---13-february-2021
- Kanne JP. Chest CT findings in 2019 novel coronavirus (2019-nCoV) infections from Wuhan, China: key points for the radiologist. Radiology 2020;295:16–17. DOI: https://doi.org/10.1148/radiol.2020200241
- Li LQ, Huang T, Wang YQ, Wang ZP, Liang Y, Huang T, et al. COVID-19 patients’ clinical characteristics, discharge rate, and fatality rate of meta-analysis. J Med Virol 2020;92:577–83. https://doi.org/10.1002/jmv.25757
- Fang FC, Naccache SN, Greninger AL. The laboratory diagnosis of coronavirus disease 2019—frequently asked questions. Clin Infect Dis 2020;71:2996-001. https://doi.org/10.1093/cid/ciaa742
- Ji P, Zhu J, Zhong Z, Li H, Pang J, Li B, et al. Association of elevated inflammatory markers and severe COVID-19: A meta-analysis. Medicine 2020:99(47). http://dx.doi.org/10.1097/MD.0000000000023315
- Fang Y, Zhang H, Xie J, Lin M, Ying L, Pang P, et al. Sensitivity of Chest CT for COVID-19: Comparison to RT-PCR. Radiology 2020;296:115–17. https://doi.org/10.1148/radiol.202020 0432
- Ye Z, Zhang Y, Wang Y, Huang Z, Song B. Chest CT manifestations of new coronavirus disease 2019 (COVID-19): a pictorial review. Eur Radiol 2020;30:4381–389. https://doi.org/10.1007/s00330-020-06801-0
- Jin YH, Cai L, Cheng ZS, Cheng H, Deng T, Fan YP, et al. A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version). Military Med Res 2020;7:1-23. https://doi.org/10.1186/s40779-020-0233-6
- Akçay Ş, Özlü T, Yılmaz A. Radiological approaches to COVID-19 pneumonia. Turk J Med Sci 2020;50:604-10. https://doi.org/10.3906/sag-2004-160
- Yoon SH, Lee KH, Kim JY, Lee YK, Ko H, Kim KH, et al. Chest radiographic and CT findings of the 2019 novel coronavirus disease (COVID-19): analysis of ninepatients treated in Korea. Korean J Radiol 2020;21:494-00. https://doi.org/10.3348/kjr.2020.0132
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- Barlow A, Landolf KM, Barlow B. Review of emerging pharmacotherapy for the treatment of coronavirusdDisease 2019. Pharmacotherapy 2020;40:416–37. https://doi.org/10.1002/phar.2398
- Coronavirus disease (COVID-19): Solidarity Trial and hydroxychloroquine (cited 2020 Sep 1). Available from: https://www.who.int/news-room/q-a-detail/coronavirus-disease-covid-19-hydroxychloroquine
- T.C. Sağlık Bakanlığı COVID-19 Erişkin Hasta Tedavisi (cited 2021 May 17). Avaible from: https://covid19.saglik.gov.tr/Eklenti/40719/0/covid-19rehberieriskinhastayonetimivetedavipdf.pdf
- Sanders JM, Monogue ML, Jodlowski TZ, Cutrell JB. Pharmacologic treatments for coronavirus disease 2019 (COVID-19). JAMA 2020;323:1824-836. https://doi.org/ 10.1001/jama.2020.6019
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- Francone F, Lafrate F, Masci GM, Coco S, Cilia F, Manganaro L, et al. Chest CT score in COVID-19 patients: correlation with disease severity and short-term prognosis. Eur Radiol 2020;30:6808-817. https://doi.org/10.1007/s00330-020-07033-y
- Yavuz SŞ, Ünal S. Antiviral treatment of Covid-19. . Turk J Med Sci 2020;50:611-19. https://doi.org/10.3906/sag-2004-145
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- Magagnoli J, Narendran S, Pereira F, Cummings TH, Hardin JW, Sutton SS, et al. Outcomes of hydroxychloroquine usage in United States veterans hospitalized with Covid-19. Med 2020;1: 114-27. https://doi.org/10.1016/j.medj.2020.06.001
- Keyaerts E, Li S, Vijgen L, Rysman E, Verbeeck J, Ranst MV, et al. Antiviral activity of chloroquine against human coronavirus OC43 infection in newborn mice. Antimicrob Agents Chemother 2009;53:3416-421. https://doi.org/10.1128/AAC.01509-08
- Barnard DL, Day CW, Bailey K, Heiner M, Montgomery R, Lauridsen L, et al. Evaluation of immunomodulators, interferons and known in vitro SARS-coV inhibitors for inhibition of SARS-coV replication in BALB/c mice. Antivir Chem Chemother 2006;17: 275-84.
- Vincent MJ, Bergeron E, Benjannet S, Erickson BR, Rollin PE, Ksiazek TG, et al. Chloroquine is a potent inhibitor of SARS coronavirus infection and spread. Virol J 2005;2:1-10. https://doi.org/10.1186/1743-422X-2-69
- Rosenberg ES, Dufort EM, Udo T, Wilberschied LA, Kumar J, Tesoriero J, et al. Association of treatment with Hydroxychloroquine or Azithromycin with in-hospital mortality in patients with COVID-19 in NewYork State. JAMA 2020;323:2493-502. https://doi.org/10.1001/jama.2020.8630
- Geleris J, Sun Y, Platt J, Zucker J, Baldwin M, Hripcsak G, et al. Observational study of Hydroxychloroquine in hospitalized patients with Covid-19. N Engl J Med 2020;382:2411-418. https://doi.org/10.1056/NEJMoa2012410
- Gasmi A, Peana M, Noor S, Lysiuk R, Menzel A, Benahmed AG, et al. Chloroquine and hydroxychloroquine in the treatment of COVID-19:the never-ending story. Appl Microbiol Biotechnol 2021;105:1333-343. https://doi.org/10.1007/s00253-021-11094-
- Cai Q, Yang M, Liu D, Chen J, Shu D, Xia J, et al. Experimental treatment with Favipiravir for COVID-19: an open-label control study. Engineering 2020;6:1192-198. http://dx.doi.org/10.1016/j.eng.2020.03.007
- Dabbous HM, Abd-Elsalam S, El-Sayed M, Sherief AF, Ebeid FFS, Abd-El Ghafar MS, et al. Efficacy of favipiravir in COVID-19 treatment: a multi-center randomized study. Arch Virol 2021;166:949-54. https://doi.org/10.1007/s00705-021-04956-9
- Uçan A, Çerçi P, Efe S, Akgün H, Özmen A, Yağmuroğlu A, et al. Benefits of treatment with Favipiravir in hospitalized patients for COVID-19: a retrospective observational case-control study. 2021. https://doi.org/10.21203/rs.3.rs-175340/v1
- Önol S, Karakacıoğlu D, Bayraktarlı RY. COVID-19 pnömonisinde radyolojik takip (zamansal değişim). Savaş R, editör. Radyoloji ve COVID-19. 1. Baskı. Ankara: Türkiye Klinikleri; 2020. P.57-63
- Raymondi DM, Hernandez L. Supportive treatment of COVID 19 patients with mild respiratory failure in a primary hospital. Med Clin 2020;155(5):222-24. https://doi.org/10.1101/2020.02.10.20021832
Abstract
Objective: Today, the symptoms, imaging features and laboratory findings of the disease are known, but the treatment of the Coronavirus disease 2019 has not been clarified. In this study, we aim to investigate the efficacy of favipiravir in patients who do not need invasive mechanical ventilation, by examining the post-treatment laboratory and computed tomography findings compared to the hydroxychloroquine which removed from the treatment guide.
Methods: In our study, 49 patients diagnosed with Coronavirus disease 2019 and treated with hydroxychloroquine and favipiravir were examined. The patients were divided into 3 groups according to their treatment modalities. The changes in the pre- and post-treatment laboratory findings and computed tomography imaging of the patients in these 3 groups were examined.
Results:There was no statistically significant difference between the rates and types of lesion patterns observed on thorax computed tomography in the groups. The most common lesion pattern in each group was the presence of ground glass opacity + consolidation in 18 patients (81.8%) in the hydroxychloroquine group, 7 patients (70%) in the favipiravir group and 10 patients (58.8%) in the hydroxychloroquine + favipiravir group. In all 3 groups, there was a statistically significant improvement in C-reactive protein, ferritin, fibrinogen values and computed tomography scores after treatment and there was no statistically significant difference between drugs.
Conclusion: In this study, we found no significant superiority of favipiravir in terms of changes in laboratory and computed tomography findings after treatment in Covid-19 patients who do not need intensive care compared to hydroxychloroquine.
Keywords
Severe Acute Respiratory Syndrome Coronavirus 2 Favipiravir Computed Tomography Tomography Score
Project Number
Yok
References
- Weekly Operational Update on COVID-19 13 February 2021(cited 2021 Feb 15). Available from: https://www.who.int/publications/m/item/weekly-operational-update-on-covid-19---13-february-2021
- Kanne JP. Chest CT findings in 2019 novel coronavirus (2019-nCoV) infections from Wuhan, China: key points for the radiologist. Radiology 2020;295:16–17. DOI: https://doi.org/10.1148/radiol.2020200241
- Li LQ, Huang T, Wang YQ, Wang ZP, Liang Y, Huang T, et al. COVID-19 patients’ clinical characteristics, discharge rate, and fatality rate of meta-analysis. J Med Virol 2020;92:577–83. https://doi.org/10.1002/jmv.25757
- Fang FC, Naccache SN, Greninger AL. The laboratory diagnosis of coronavirus disease 2019—frequently asked questions. Clin Infect Dis 2020;71:2996-001. https://doi.org/10.1093/cid/ciaa742
- Ji P, Zhu J, Zhong Z, Li H, Pang J, Li B, et al. Association of elevated inflammatory markers and severe COVID-19: A meta-analysis. Medicine 2020:99(47). http://dx.doi.org/10.1097/MD.0000000000023315
- Fang Y, Zhang H, Xie J, Lin M, Ying L, Pang P, et al. Sensitivity of Chest CT for COVID-19: Comparison to RT-PCR. Radiology 2020;296:115–17. https://doi.org/10.1148/radiol.202020 0432
- Ye Z, Zhang Y, Wang Y, Huang Z, Song B. Chest CT manifestations of new coronavirus disease 2019 (COVID-19): a pictorial review. Eur Radiol 2020;30:4381–389. https://doi.org/10.1007/s00330-020-06801-0
- Jin YH, Cai L, Cheng ZS, Cheng H, Deng T, Fan YP, et al. A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version). Military Med Res 2020;7:1-23. https://doi.org/10.1186/s40779-020-0233-6
- Akçay Ş, Özlü T, Yılmaz A. Radiological approaches to COVID-19 pneumonia. Turk J Med Sci 2020;50:604-10. https://doi.org/10.3906/sag-2004-160
- Yoon SH, Lee KH, Kim JY, Lee YK, Ko H, Kim KH, et al. Chest radiographic and CT findings of the 2019 novel coronavirus disease (COVID-19): analysis of ninepatients treated in Korea. Korean J Radiol 2020;21:494-00. https://doi.org/10.3348/kjr.2020.0132
- Wiersinga WJ, Rhodes A, Cheng AC, Peacock SJ, Prescott HC. Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19). JAMA 2020;324:782-93. https://doi.org/10.1001/jama.2020.12839
- Barlow A, Landolf KM, Barlow B. Review of emerging pharmacotherapy for the treatment of coronavirusdDisease 2019. Pharmacotherapy 2020;40:416–37. https://doi.org/10.1002/phar.2398
- Coronavirus disease (COVID-19): Solidarity Trial and hydroxychloroquine (cited 2020 Sep 1). Available from: https://www.who.int/news-room/q-a-detail/coronavirus-disease-covid-19-hydroxychloroquine
- T.C. Sağlık Bakanlığı COVID-19 Erişkin Hasta Tedavisi (cited 2021 May 17). Avaible from: https://covid19.saglik.gov.tr/Eklenti/40719/0/covid-19rehberieriskinhastayonetimivetedavipdf.pdf
- Sanders JM, Monogue ML, Jodlowski TZ, Cutrell JB. Pharmacologic treatments for coronavirus disease 2019 (COVID-19). JAMA 2020;323:1824-836. https://doi.org/ 10.1001/jama.2020.6019
- T.C. Sağlık Bakanlığı COVID-19 Erişkin Hasta Tedavisi (cited 2020 Apr 13). Avaible from: https://www.ekmud.org.tr/files/uploads/files/COVID-19_Rehberi-6.pdf
- Pan F, Ye T, Sun P, Gui S, Liang B, Li L, et al. Time course of lung changes at chest CT during recovery from coronavirus disease 2019 (COVID-19). Radiology 2020;295:715–21. https://doi.org/10.1148/radiol.2020200370
- Francone F, Lafrate F, Masci GM, Coco S, Cilia F, Manganaro L, et al. Chest CT score in COVID-19 patients: correlation with disease severity and short-term prognosis. Eur Radiol 2020;30:6808-817. https://doi.org/10.1007/s00330-020-07033-y
- Yavuz SŞ, Ünal S. Antiviral treatment of Covid-19. . Turk J Med Sci 2020;50:611-19. https://doi.org/10.3906/sag-2004-145
- Liu J, Cao R, Xu M, Wang X, Zhang H, Hu H, et al. Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitro. Cell Discov 2020;6:1-4. https://doi.org/10.1038/s41421-020-0156-0
- Magagnoli J, Narendran S, Pereira F, Cummings TH, Hardin JW, Sutton SS, et al. Outcomes of hydroxychloroquine usage in United States veterans hospitalized with Covid-19. Med 2020;1: 114-27. https://doi.org/10.1016/j.medj.2020.06.001
- Keyaerts E, Li S, Vijgen L, Rysman E, Verbeeck J, Ranst MV, et al. Antiviral activity of chloroquine against human coronavirus OC43 infection in newborn mice. Antimicrob Agents Chemother 2009;53:3416-421. https://doi.org/10.1128/AAC.01509-08
- Barnard DL, Day CW, Bailey K, Heiner M, Montgomery R, Lauridsen L, et al. Evaluation of immunomodulators, interferons and known in vitro SARS-coV inhibitors for inhibition of SARS-coV replication in BALB/c mice. Antivir Chem Chemother 2006;17: 275-84.
- Vincent MJ, Bergeron E, Benjannet S, Erickson BR, Rollin PE, Ksiazek TG, et al. Chloroquine is a potent inhibitor of SARS coronavirus infection and spread. Virol J 2005;2:1-10. https://doi.org/10.1186/1743-422X-2-69
- Rosenberg ES, Dufort EM, Udo T, Wilberschied LA, Kumar J, Tesoriero J, et al. Association of treatment with Hydroxychloroquine or Azithromycin with in-hospital mortality in patients with COVID-19 in NewYork State. JAMA 2020;323:2493-502. https://doi.org/10.1001/jama.2020.8630
- Geleris J, Sun Y, Platt J, Zucker J, Baldwin M, Hripcsak G, et al. Observational study of Hydroxychloroquine in hospitalized patients with Covid-19. N Engl J Med 2020;382:2411-418. https://doi.org/10.1056/NEJMoa2012410
- Gasmi A, Peana M, Noor S, Lysiuk R, Menzel A, Benahmed AG, et al. Chloroquine and hydroxychloroquine in the treatment of COVID-19:the never-ending story. Appl Microbiol Biotechnol 2021;105:1333-343. https://doi.org/10.1007/s00253-021-11094-
- Cai Q, Yang M, Liu D, Chen J, Shu D, Xia J, et al. Experimental treatment with Favipiravir for COVID-19: an open-label control study. Engineering 2020;6:1192-198. http://dx.doi.org/10.1016/j.eng.2020.03.007
- Dabbous HM, Abd-Elsalam S, El-Sayed M, Sherief AF, Ebeid FFS, Abd-El Ghafar MS, et al. Efficacy of favipiravir in COVID-19 treatment: a multi-center randomized study. Arch Virol 2021;166:949-54. https://doi.org/10.1007/s00705-021-04956-9
- Uçan A, Çerçi P, Efe S, Akgün H, Özmen A, Yağmuroğlu A, et al. Benefits of treatment with Favipiravir in hospitalized patients for COVID-19: a retrospective observational case-control study. 2021. https://doi.org/10.21203/rs.3.rs-175340/v1
- Önol S, Karakacıoğlu D, Bayraktarlı RY. COVID-19 pnömonisinde radyolojik takip (zamansal değişim). Savaş R, editör. Radyoloji ve COVID-19. 1. Baskı. Ankara: Türkiye Klinikleri; 2020. P.57-63
- Raymondi DM, Hernandez L. Supportive treatment of COVID 19 patients with mild respiratory failure in a primary hospital. Med Clin 2020;155(5):222-24. https://doi.org/10.1101/2020.02.10.20021832
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Original Articles |
| Authors | |
| Project Number | Yok |
| Publication Date | December 24, 2021 |
| Submission Date | May 21, 2021 |
| Acceptance Date | October 12, 2021 |
| Published in Issue | Year 2021 Volume: 12 Issue: 44 |
