HYDROXYCHLOROQUINE, FAVIPIRAVIR OR STANDARD CARE IN MANAGEMENT OF SARS-COV-2: A RETROSPECTIVE COHORT STUDY

Dr. Nada Bassam Rabie*, Dr. Hassan Mueed Alsharif, Dr. Fayez Bukhari, Dr. Sana’a Fageeh, Dr. Samia Bukhari, Dr. Sarah Tayeb, Dr. Ghadah Rayes, Dr.Ahmad Algarni, Dr. Naif Turki Marzooki, Dr. Abdulraheem Bayameen, Dr. Nayef Abdulrahman Aljohani, Dr. Ahamd Rasheed, Dr. Ali Awais, Dr. Waleed Elsayad, Dr. Fahdah Almutairii, Dr. Raghdah Faraj, Dr. Yasir Alard, Dr. Sahal Khojah, Dr. Nader Nabil Elbanhawy, Dr. Mohamed Elamin Boshara, Dr. Hussain Abdullah Abualola

ABSTRACT

Background: Despite the tremendous efforts to offer safe and effective treatment guides for patients with SARS-CoV-2 infection, no clear answers exist. Here we are studying two relatively safe medications that were previously recommended for SARS-CoV-2 treatment and comparing them with standard of care. Methods: This is a retrospective electronic chart review study on SARS-CoV-2 infected patients between June and August 2020. Patients were eligible if they fulfilled the following criteria: (1) Age more than 14 years old, (2) Have confirmed SARS-CoV-2 infection and (3) Symptomatic, regardless of severity. Results: A total of 361 patients were included in the study. The mean age was 53 years 16.8, with 204 (56.4%) males. Patients were selected to be distributed between the hydroxychloroquine/zinc (HCQ/Z), favipiravir and standard of care group at 1:1:2 ratio. Most patients become asymptomatic at day 14 (n=139, 39%). There was no statistically significant difference between the three groups in terms of symptom resolution. Favipiravir showed earlier virologic clearance (as early as day 5) as compared to HCQ/Z and standard of care groups, even though this difference was not statistically significant (36%, 28% and 30% respectively, P-value 0.866). More patients in the favipiravir group required ICU admission (7% for favipiravir, 3% for HCQ/Z and 5% for the standard of care group (P-value 0.343). Similarly, out of 12 deaths, 4 were in the favipiravir group, 8 in the standard of care group and none in the HCQ/Z group (P-value= 0.137). No sever side effect was reported in any of the treatment groups. Conclusions: Standard of care alone was shown to be as effective as HCQ/Z and favipiravir in terms of symptom control. Similarly, no difference could be appreciated in terms of number of ICU admission and mortality. Implementation of clear therapeutic guidelines are needed to better define the components and goals of the best supportive care.

Keywords: COVID-19, SARS-CoV-2, hydroxychloroquine, favipiravir.