Penelitian mengenai efektivitas favipiravir pada COVID-19 di beberapa negara memberikan hasil yang beragam. Studi populasi Indonesia masih terbatas pada derajat sedang dan berat. Evaluasi efektivitas dan keamanan favipiravir pada tingkat keparahan ringan dan sedang diperlukan dalam melengkapi pedoman terapi dengan bukti yang sesuai. Penelitian dilakukan secara kohor retrospektif menggunakan rekam medis pasien COVID-19 derajat ringan dan sedang yang dirawat di RS Grha Permata Ibu Depok pada Juli 2020 hingga 2021. Efektivitas dinilai berdasarkan perbaikan klinis saat keluar rumah sakit, hasil PCR akhir, status oksigenasi, dan durasi rawat. 192 rekam medis pasien rawat inap COVID-19 dibagi dalam kelompok favipiravir (n=96) dan non-favipiravir (n=96). Favipiravir memberikan perbaikan klinis yang lebih baik dengan effect size yang kecil (p=0,038; RR=1,19; 95% CI=1,02-1,39). Namun setelah dikontrol variabel usia, jumlah komorbid, dan oksigenasi awal, pemberian favipiravir meningkat menjadi 2,55 kali lebih efektif daripada non-favipiravir. Favipiravir juga memberikan pengaruh signifikan pada hasil PCR akhir serta durasi rawat inap (p=0,009 ; 0,002) namun tidak memberikan perbedaan dalam status oksigenasi (p=0,097). Tidak terdapat perbedaan yang signifikan pada proporsi kejadian yang tidak diinginkan (KTD) selama pemberian favipiravir (30%) dan non-favipiravir (23%) (p=0,33). Pemberian favipiravir secara signifikan terkait dengan peningkatan perbaikan klinis pasien COVID-19. KTD yang muncul selama terapi relatif aman.
Research on the effectiveness of favipiravir against COVID-19 has yielded mixed results in several countries. Study in Indonesian population was still limited in moderate to severe COVID-19. Assess the efficacy and safety of favipiravir at mild to moderate severity is necessary to complement therapy guidelines with appropriate evidence. The study was conducted in a retrospective cohort using medical records of COVID-19 hospitalized patients at Grha Permata Ibu Hospital Depok from July 2020 to 2021. Efficacy was assessed using clinical improvement at discharge, final PCR results, oxygenation status, and lenght of stay. Medical records of 192 COVID-19 hospitalized patients were divided into favipiravir (n=96) and non-favipiravir (n=96) groups. Favipiravir provided better clinical improvement with small effect size (p=0.038; RR=1.19; 95% CI=1.02-1.39). However, after controlling age, number of comorbidities, and initial oxygenation variables, favipiravir 2.55 times more potent than non-favipiravir. Favipiravir also had a significant effect on final PCR results and length of stay (p=0.009;0.002), but has no difference in oxygenation status (p=0.097). There was no difference in the adverse drug reactions during treatment with antiviruses (p=0.33). Favipiravir administration was significantly associated with enhanced clinical improvement in COVID-19 patients. Side effects that occur during treatment are relatively safe. |
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