Clinical outcomes in COVID-19 patients treated with antivirals: a retrospective analysis

Drug repurposing is considered as a rapid strategy for COVID-19 drug discovery and many drugs have been tried for treatment of COVID-19. Antivirals like favipiravir and remdesivir have become part of the COVID-19 Management Protocol by Ministry of Health and Family Welfare (MOHFW) as well as Maharashtra State guidelines since beginning, after being approved by Drugs Controller General of India (DCGI). Although these drugs have shown promising results, their efficacy is still not proven completely and needs to be studied in large populations. The purpose of our study was to evaluate the clinical outcomes in hospitalised patients with COVID-19 treated with remdesivir and/or favipiravir.

Retrospective analysis of medical records of 914 adult COVID-19 patients hospitalized in a tertiary care center in Mumbai was conducted. We assessed the following outcomes: severity of disease, need for oxygen supplementation, incidence of complications, discharge from hospital or death, oxygen requirement at the time of discharge, duration of hospital stay. These outcomes were compared between patients who received remdesivir only, patients who received favipiravir only, patients who received both remdesivir and favipiravir and patients who did not receive either remdesivir or favipiravir (control group).

Of total 914 patients in our study, 55.79% patients received only remdesivir, 13.45% received only favipiravir, 7.76% received remdesivir plus favipiravir and 22.97% did not receive any antivirals. Higher number of patients in remdesivir only group (60.19%) and remdesivir plus favipiravir groups (56.33%) required supplemental oxygen [vs 32.38 % patients in control group and 24.39% in favipiravir only group]. Highest number of patients (91.05%) in favipiravir only group got discharged under Indian Council of Medical Research (ICMR) guidelines closely followed by 88.73% in remdesivir plus favipiravir group, 88.43% in remdesivir only group and 82.38 % patients in control group. 8.43% patients in remdesivir only group, 6.5% in favipiravir only group, 7.04% in remdesivir plus favipiravir group and 10.47 % patients in control group needed oxygen support after discharge.

Majority of patients in our study got discharged under ICMR guidelines with higher proportion of patients in the treatment groups as compared to the control group. Also, lesser number of patients in the treatment groups required oxygen supplementation post discharge as compared to the control group.