Data suggests that favipiravir (FVP) could be used against SARS-CoV-2. Our aim was to investigate the role of FVP in COVID-19 treatment. A prospective sequential cohort study was performed among adults hospitalized at our center between March and August 2020 with moderate-to-severe, PCR-confirmed COVID-19. For diagnosis and severity, ECDC and WHO definitions were utilized. Patients were screened for inclusion by a priori criteria and included in the FVP cohort if standard-of-care (SOC) + FVP or the non-FVP cohort if SOC ± other antivirals without FVP were administered for > 48 h from diagnosis. Treatment allocation was done per national guidelines, based on severity and drug availability. Primary endpoint was disease progression, a composite of 14-day all-cause death, need for mechanical ventilation, or immunomodulatory therapy. The impact of FVP exposure on disease progression was analyzed by binomial logistic regression. In all, 150 patients were included, 75 in each cohort. Disease progression (17/75, 22.7% vs. 10/75, 13.3%, p = 0.13), 14-day all-cause death (9/75, 12.0% vs. 10/75, 13.3%, p = 0.8), and need for mechanical ventilation (8/75, 10.7% vs. 4/75, 5.3%, p = 0.22) were similar, while immunomodulatory therapies were required more frequently among patients receiving FVP (10/75, 13.3% vs. 1/75, 1.3%, p < 0.01). The use of favipiravir was not retained as a protective factor against disease progression in multivatiate analysis. Time to antiviral therapy from PCR positivity, disease severity, need for oxygen supportation, and ICU admittance rates did not differ statistically between cohorts. In this study, favipiravir did not seem to positively affect disease progression.

数据表明，法匹拉韦 (FVP) 可用于对抗 SARS-CoV-2。我们的目的是研究 FVP 在 COVID-19 治疗中的作用。在 2020 年 3 月至 2020 年 8 月期间在我们中心住院的中度至重度经 PCR 确认的 COVID-19 的成年人中进行了一项前瞻性顺序队列研究。对于诊断和严重程度，使用了 ECDC 和 WHO 的定义。通过先验标准筛选患者纳入，如果护理标准 (SOC) + FVP 或非 FVP 队列，如果 SOC ± 其他无 FVP 的抗病毒药物在诊断后给药 > 48 小时，则纳入 FVP 队列。根据严重程度和药物可用性，根据国家指南进行治疗分配。主要终点是疾病进展，包括 14 天全因死亡、需要机械通气或免疫调节治疗。通过二项式逻辑回归分析 FVP 暴露对疾病进展的影响。总共包括 150 名患者，每组 75 名。疾病进展 (17/75, 22.7% vs. 10/75, 13.3%,p  = 0.13)、14 天全因死亡 (9/75, 12.0% vs. 10/75, 13.3%, p  = 0.8)，以及需要机械通气 (8/75, 10.7% vs. 4/75) , 5.3%, p  = 0.22) 相似，而接受 FVP 的患者更频繁地需要免疫调节治疗 (10/75, 13.3% vs. 1/75, 1.3%, p  < 0.01)。在多变量分析中，法匹拉韦的使用并未保留为防止疾病进展的保护因素。从 PCR 阳性到抗病毒治疗的时间、疾病严重程度、对氧气支持的需要和 ICU 入院率在队列之间没有统计学差异。在这项研究中，法匹拉韦似乎对疾病进展没有积极影响。