Učinci liječenja hidroksiklorokinomplus favipiravirom na klinički tok i biomarkeri u hospitaliziranih pacijenata s COVID-19 i upalom pluća

Background: The novel coronavirus disease 2019 (COVID-19) has a broad spectrum of clinical manifestations, the most common serious clinical manifestation of the coronavirus infection being pneumonia. Unfortunately, the optimal treatment approach is still uncertain. However, many studies have been conducted on the effectiveness of several medications in the treatment of COVID-19 infection. The aim of this study was to evaluate the effectiveness of the hydroxychloroquine (HCQ) + favipiravir (FAV) treatment regimen and HCQ alone by comparing the patient’s clinical response and laboratory results on the fifth day of treatment in patients hospitalized due to COVID-19 infection. Patients and methods: This retrospective cohort study was conducted in Malatya Training and Research Hospital between March 2020 and July 2020. The study included 69 patients with confirmed COVID-19 with pneumonia. The patients were divided into 2 groups, those receiving HCQ alone and those receiving the HCQ + FAV combination. Results: A total of 69 patients were included in the study, and the mean age was 60.09±15.56 years. A statistically significant decrease was observed in C-reactive protein (CRP) levels, at the end of the fifth day, in patients who received HCQ + FAV treatment (p=0.002), whereas there was no decrease in CRP levels in patients who received HCQ treatment alone. In addition, an increase in lymphocyte count and a better fever response was observed at the end of the fifth day in patients who received HCQ + FAV (p=0.008). However, there was no statistical difference between both treatment regimens in terms of hospital stay and treatment results (p=0.008, p=0.744, p=0.517). Conclusion: Although the combination of HCQ + FAV treatment was observed to be effective on CRP levels and fever response in patients with COVID-19 pneumonia, there was no difference in terms of hospital stay and discharge.Pozadina: Bolest uzrokovana novim koronavirusom 2019 (COVID-19) ima širok spektar kliničkih manifestacija, pri čemu je upala pluća najčešća ozbiljna klinička manifestacija infekcije koronavirusom. Nažalost, optimalni pristup liječenju još uvijek nije jasno utvrđen. Ipak, provedeno je mnogo studija koje su istraživale učinkovitost raznih lijekova u liječenju infekcije COVID-19 virusom. Cilj ove studije bio je utvrditi učinkovitost liječenja kombinacijom hidroksiklorokina (HCQ) i favipiravira (FAV) te liječenja isključivo HCQ-om, uspoređivanjem kliničkog odgovora pacijenata na liječenje i njihovih laboratorijskih rezultata nakon pet dana liječenja u pacijenata hospitaliziranih zbog infekcije virusom COVID-19. Pacijenti i metode: Ova retrospektivna kohortna studija provedena je u Malatya Training and Research Hospital između ožujka 2020. i srpnja 2020. Uključivala je 69 pacijenata s potvrđenom infekcijom virusa COVID-19 sa upalom pluća. Pacijenti su podijeljeni u dvije skupine, od kojih je jedna primala samo HCQ, a druga kombinaciju HCQ + FAV. Rezultati: U studiju je uključeno ukupno 69 pacijenata s prosječnom dobi od 60,09±15,56 godina. Zamijećena je statistički značajno smanjenje u razini C-reaktivnog proteina (CRP) na kraju petog dana liječenja u pacijenata koji su primali HCQ + FAV (p=0,002), a nije bilo smanjenja u razini CRP-a u pacijenata koji su primali samo HCQ. Uz to, u pacijenata koji su primali HCQ + FAV zamijećeno je i povećanje u broju limfocita te bolji odgovor na vrućicu na kraju petog dana liječenja (p=0,008). Ipak, nije bilo statističke razlike između ta dva režima liječenja u odnosu na trajanje hospitalizacije i rezultata liječenja (p=0,008, p=0,744, p=0,517). Zaključak: Iako je kombinacija HCQ + FAV bila učinkovita glede razine CRP-a i odgovora na vrućicu u pacijenata sa upalom pluća uzrokovanom COVID-19 virusom, nije bilo razlike u trajanju hospitalizacije i otpusta iz bolnice