Safety and efficacy of favipiravir versus hydroxychloroquine in management of COVID-19: A randomised controlled trial
Dabbous et al.
, Safety and efficacy of favipiravir versus hydroxychloroquine in management of COVID-19: A randomised..
, Scientific Reports, doi:10.1038/s41598-021-85227-0 (date from earlier preprint)
Dabbous et al., 29 Sep 2020, peer-reviewed, 11 authors.
Safety and efficacy of favipiravir
in management of COVID‑19:
A randomised controlled trial
Hany M. Dabbous1*, Manal H. El‑Sayed2, Gihan El Assal3, Hesham Elghazaly2,
Fatma F. S. Ebeid2, Ahmed F. Sherief1, Maha Elgaafary4, Ehab Fawzy5, Sahar M. Hassany5,
Ahmed R. Riad5 & Mohamed A. TagelDin3
Favipiravir is considered a potential treatment for COVID-19 due its efficacy against different
viral infections. We aimed to explore the safety and efficacy of favipiravir in treatment of COVID19 mild and moderate cases. It was randomized-controlled open-label interventional phase 3
clinical trial [NCT04349241]. 100 patients were recruited from 18th April till 18th May. 50 patients
received favipiravir 3200 mg at day 1 followed by 600 mg twice (day 2–day 10). 50 patients received
hydroxychloroquine 800 mg at day 1 followed by 200 mg twice (day 2–10) and oral oseltamivir
75 mg/12 h/day for 10 days. Patients were enrolled from Ain Shams University Hospital and Assiut
University Hospital. Both arms were comparable as regards demographic characteristics and
comorbidities. The average onset of SARS-CoV-2 PCR negativity was 8.1 and 8.3 days in HCQ-arm and
favipiravir-arm respectively. 55.1% of those on HCQ-arm turned PCR negative at/or before 7th day
from diagnosis compared to 48% in favipiravir-arm (p = 0.7). 4 patients in FVP arm developed transient
transaminitis on the other hand heartburn and nausea were reported in about 20 patients in HCQarm. Only one patient in HCQ-arm died after developing acute myocarditis resulted in acute heart
failure. Favipiravir is a safe effective alternative for hydroxychloroquine in mild or moderate COVID-19
At the end of 2019, the entire world saw the first appearance of the coronavirus disease 2019 (COVID-19)1. By
March 2020, it was declared a pandemic by the World Health Organization (WHO). Globally, more than 83 million cases of COVID-19 and more than 1.5 million deaths have been reported so f ar2, 3. The first case registered
in Egypt was in February 2020, and, since then, the number has been increasing. By early July 2020, nearly 1.5
hundred thousand confirmed cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and
about 8000 deaths were reported by the Ministry of Health (MoH)4. In Egypt, the curve of new cases prompted
an investigation into the different treatment options to find the most effective and safe choice for COVID-19
patients. Favipiravir (FPV) is one of the potential options according to a Chinese study, considering its past history of efficacy against viral influenza5.
Being a novel RNA-dependent RNA polymerase (RdRp) inhibitor, FPV has also shown efficacy against the
Ebola virus6, 7. FVP, known as Avigan, is a pyrazine derivative and guanine analogue that acts as a chain termination tool and prevents RNA elongation. Favipiravir demonstrated anti-viral activities against a broad array of
RNA viruses, including arenaviruses, bunyaviruses, and fi
loviruses8. In Japan, favipiravir has been approved for
influenza A resistant to neuraminidase i nhibitors9.
Also, an expert consensus group in China suggested that chloroquine improved lung imaging and shortened
the disease c ourse10. However, a number of additional reports have since shown no positive impact with the
addition of hydroxychloroquine (HCQ)11. The aim of the current study was to explore the safety..
is less effective
Please send us corrections, updates, or comments. Vaccines and
treatments are complementary. All practical, effective, and safe means should
be used based on risk/benefit analysis. No treatment, vaccine, or intervention
is 100% available and effective for all current and future variants. We do not
provide medical advice. Before taking any medication, consult a qualified
physician who can provide personalized advice and details of risks and
benefits based on your medical history and situation. FLCCC
provide treatment protocols.