Effectiveness of favipiravir in COVID-19 patients with risk factors for mortality: A real world experience from India

Background: Age (>50 yrs.) & comorbidity association are proven risk factors for rapid progression & mortality in COVID-19. Aims & Objective: To analyse effectiveness of favipiravir in COVID-19 patients with high risk mortality factors (age >50 yrs. & ≥1 comorbidity). Methods: Retrospective cohort study was conducted in consecutively favipiravir treated COVID-19 patients from 4 Indian centers after independent ethics committee approval. Medical records from Oct – Dec 2020 were analyzed to capture details including demography, medical history, symptoms, treatment details, clinical outcome & adverse events. Results: Of 293 favipiravir treated patients, 135 had age >50 years & ≥ 1 comorbidity. Majority (71.1%) had multiple (≥2) co-morbidities. Hypertension (78.5%) & diabetes (68.1%) were common co-morbidities. 57.04% were male with mean age of 65.5±9.2 yrs. Mean SpO2 at baseline was 94.6±3.2. CRP (51.4±48.5) & d-Dimer (594±640.7) were raised at baseline. Fever (85.2%), cough (63%), fatigue (40%), myalgia (37.9%) & dyspnoea (25.2%) were common presenting symptoms. Median duration of favipiravir treatment was 14 d. 25.9% patients received systemic steroid. Fever resolved by day 7 in 98.5%. Myalgia, dyspnea & fatigue improved in 99.3%, 99.3% & 95.6% by day 7 respectively. Requirement of Oxygen support reduced from 31.9% at baseline to 4.4% by day 7. 8.9% patients had disease progression with mortality in 2 patients. TEAEs were observed in 6.7% patients. Conclusion: We observed a trend of faster clinical resolution & limited disease progression in high risk mild to moderate COVID-19 patients treated with favipiravir.