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Related Concept Videos

Pneumonia IV: Management01:28

Pneumonia IV: Management

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The treatment of pneumonia varies based on its severity and the causative pathogen. Here is a structured approach to managing pneumonia, integrating pharmaceutical and supportive care strategies.
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
329
Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure01:16

Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure

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Oxygen therapy has emerged as a significant tool in enhancing the quality of life for patients suffering from pulmonary arterial hypertension (PAH). While this therapy has principally been studied on patients with significant hypoxemia, this therapeutic approach helps prevent potential organ damage and can be administered in the comfort of one's home.
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue,...
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Acute Respiratory Failure-IV01:23

Acute Respiratory Failure-IV

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Respiratory failure can manifest suddenly or gradually, characterized by a rapid decline in PaO2 and a rapid rise in PaCO2. This situation indicates a severe respiratory problem that may quickly become a life-threatening emergency. One of the early signs of hypoxemic Acute Respiratory Failure (ARF) is a change in mental status due to the brain's sensitivity to oxygen levels and changes in acid-base balance. Symptoms such as restlessness, confusion, and agitation suggest inadequate oxygen...
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Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists01:23

Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists

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Prostacyclin receptor agonists are a class of therapeutic agents integral to managing pulmonary arterial hypertension (PAH). These drugs operate by mimicking the action of prostaglandin I2, or PGI2, a naturally occurring compound in the body.
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
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Retrovirus Life Cycles01:10

Retrovirus Life Cycles

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Retroviruses have a single-stranded RNA genome that undergoes a special form of replication. Once the retrovirus has entered the host cell, an enzyme called reverse transcriptase synthesizes double-stranded DNA from the retroviral RNA genome. This DNA copy of the genome is then integrated into the host’s genome inside the nucleus via an enzyme called integrase. Consequently, the retroviral genome is transcribed into RNA whenever the host’s genome is transcribed, allowing the...
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Treatment for Pulmonary Arterial Hypertension: Phosphodiesterase Inhibitors01:28

Treatment for Pulmonary Arterial Hypertension: Phosphodiesterase Inhibitors

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Phosphodiesterase 5 (PDE5) inhibitors are potent enzymes that function to hydrolyze cyclic nucleotides to their corresponding 5' monophosphates. Their unique biochemical properties have been applied in treating Pulmonary Arterial Hypertension (PAH).
Among the PDE5 inhibitors, sildenafil (Revatio) stands out as a competitive and selective inhibitor. It operates by elevating cellular levels of cGMP and augmenting signaling through the cGMP-PKG pathway, promoting vasodilation. Upon oral...
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Early Viral Entry Assays for the Identification and Evaluation of Antiviral Compounds
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Favipiravir for treating COVID-19.

Pritish Korula1, Hanna Alexander2, Jisha Sara John2

  • 1Division of Critical Care Medicine, Christian Medical College, Vellore, India.

The Cochrane Database of Systematic Reviews
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The efficacy of favipiravir for treating coronavirus disease 2019 (COVID-19) remains uncertain due to low-certainty evidence. While it may increase adverse events, serious side effects were not significantly different compared to control groups.

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Area of Science:

  • Infectious Diseases
  • Virology
  • Clinical Trials

Background:

  • The COVID-19 pandemic, caused by SARS-CoV-2, presents ongoing global health challenges.
  • Favipiravir has been proposed as a potential treatment for COVID-19, but its definitive role is still under investigation.
  • Randomized controlled trials (RCTs) have evaluated favipiravir, yet conclusive evidence on its efficacy and safety is lacking.

Purpose of the Study:

  • To assess the effects of favipiravir compared to no treatment, supportive care, or other antiviral treatments in patients with acute COVID-19.
  • To synthesize evidence from RCTs regarding favipiravir's efficacy and safety in COVID-19 treatment.
  • To evaluate the impact of favipiravir on mortality, disease progression, and adverse events.

Main Methods:

  • A systematic search of multiple databases including the Cochrane COVID-19 Study Register, MEDLINE, and Embase was conducted up to July 18, 2023.
  • Included were 25 RCTs involving 5750 adult participants with COVID-19, predominantly with mild to moderate disease.
  • Data were collected and analyzed using standard Cochrane methodologies, with the GRADE approach employed to assess the certainty of evidence.

Main Results:

  • Evidence regarding favipiravir's effect on all-cause mortality and progression to invasive mechanical ventilation is of very low certainty.
  • Favipiravir showed little to no difference in hospital admission rates or time to clinical improvement.
  • An overall increase in adverse events was observed with favipiravir use (low-certainty evidence), but serious adverse events were not significantly different.

Conclusions:

  • The current low- to very low-certainty evidence indicates uncertainty regarding favipiravir's efficacy in treating COVID-19, regardless of disease severity.
  • Favipiravir treatment may be associated with an increased incidence of overall adverse events.
  • There is insufficient evidence to establish a definitive role for favipiravir in COVID-19 management.