The Evaluation of Patients with Severe COVID-19 Pneumonia Who are Recieving Favipiravir Treatment

Abstract

Introduction: There is no known specific treatment for Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2). Our retrospective study evaluates the effectiveness of steroid treatment and the factors affecting treatment in patients with severe Coronavirus disease-2019 (COVID-19) pneumonia that received favipiravir treatment. Materials and Methods: This study included patients older than 18 years with severe COVID-19 pneumonia who received favipiravir treatment in a training and research hospital between March 1 and May 31, 2020. It retrospectively evaluated respiratory rate >30/min and/or severe respiratory distress and oxygen saturation <90 and typical thoracic computerized tomography findings: Bilateral lobular, peripheral lesions, and the presence of ground-glass opacities were determined as the criteria for severe pneumonia. For 82 cases of SARS-CoV-2 polymerise chain reaction positive, age, gender, symptoms, comorbidities, steroid use, and mortality rates were examined. Results: Eighty-two patients with confirmed COVID-19 diagnosed with severe pneumonia were included in the study. Of these cases, 63% were males. The median patient age was 64 +/- 16.98 (21-97, minimum-maximum) years. The mortality in women was 23%, and the mortality in men was 30%. The correlation between gender and mortality was statistically significant (p=0.04). Advanced age, chronic renal failure, and confusion on hospital admission were associated with mortality (p=0.04, p=0.02, p=0.02, respectively). Methylprednisolone was given to 12 patients as an additional treatment. The mortality of the patients who received steroid treatment was significantly lower than those who did not (p=0.017). There was no bacterial infection in these 12 patients, who received steroid treatment and the procalcitonin level was not high. Conclusion: In confirmed COVID-19 patients without concomitant bacterial infections, steroid treatment can lower mortality and long-term morbidities. Similar to prospective randomized studies, our study showed that steroid use reduces mortality in patients with severe COVID-19 pneumonia.