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      Fluorescence of ocular surface in a Covid -19 patient after Favipiravir treatment: a case report

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          Abstract

          Background

          Favipiravir is used in treatment of Covid-19 patients. We aimed to share of ocular surface fluorescence in a patient after Favipiravir treatment in this case report.

          Case presentation

          A 20-year-old male patient declared no known systemic disease prior to Covid-19. He applied to us with blurry vision and blue light reflection after Covid-19 treatment with Favipiravir. We observed bilateral fluorescence on his eyes and fluorescence of his nails. Biomicroscopic examination was insignificant.

          Conclusion

          We investigated the fluorescence of favipiravir tablets under ultraviolet light. Drug demonstrated fluorescence. We recorded the favipiravir fluorescence in-vitro. This appears to be a strong evidence in terms of the linkage between the fluorescence of the ocular surface and favipiravir.

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          Experimental Treatment with Favipiravir for COVID-19: An Open-Label Control Study

          Qingxian Cai, Minghui Yang, Dongjing Liu … (2020)
          An outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and its caused coronavirus disease 2019 (COVID-19) has been reported in China since December 2019. More than 16% of patients developed acute respiratory distress syndrome, and the fatality ratio was about 1%–2%. No specific treatment has been reported. Herein, we examine the effects of Favipiravir (FPV) versus Lopinavir (LPV)/ritonavir (RTV) for the treatment of COVID-19. Patients with laboratory-confirmed COVID-19 who received oral FPV (Day 1: 1600 mg twice daily; Days 2–14: 600 mg twice daily) plus interferon (IFN)-α by aerosol inhalation (5 million U twice daily) were included in the FPV arm of this study, whereas patients who were treated with LPV/RTV (Days 1–14: 400 mg/100 mg twice daily) plus IFN-α by aerosol inhalation (5 million U twice daily) were included in the control arm. Changes in chest computed tomography (CT), viral clearance, and drug safety were compared between the two groups. For the 35 patients enrolled in the FPV arm and the 45 patients in the control arm, all baseline characteristics were comparable between the two arms. A shorter viral clearance time was found for the FPV arm versus the control arm (median (interquartile range, IQR), 4 (2.5–9) d versus 11 (8–13) d, P < 0.001). The FPV arm also showed significant improvement in chest imaging compared with the control arm, with an improvement rate of 91.43% versus 62.22% (P = 0.004). After adjustment for potential confounders, the FPV arm also showed a significantly higher improvement rate in chest imaging. Multivariable Cox regression showed that FPV was independently associated with faster viral clearance. In addition, fewer adverse reactions were found in the FPV arm than in the control arm. In this open-label nonrandomized control study, FPV showed significantly better treatment effects on COVID-19 in terms of disease progression and viral clearance; if causal, these results should be important information for establishing standard treatment guidelines to combat the SARS-CoV-2 infection.
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            Favipiravir versus other antiviral or standard of care for COVID-19 treatment: a rapid systematic review and meta-analysis

            Dhan Bahadur Shrestha, Pravash Budhathoki, Sitaram Khadka … (2020)
            Background The COVID-19 causing coronavirus is an enveloped RNA virus that utilizes an enzyme RNA dependent RNA polymerase for its replication. Favipiravir (FVP) triphosphate, a purine nucleoside analog, inhibits that enzyme. We have conducted this systematic review and meta-analysis on efficacy and safety of the drug FVP as a treatment for COVID-19. Methods Databases like Pubmed, Pubmed Central, Scopus, Embase, Google Scholar, preprint sites, and clinicaltirals.gov were searched. The studies with the standard of care (SOC) and FVP as a treatment drug were considered as the treatment group and the SOC with other antivirals and supportive care as the control group. Quantitative synthesis was done using RevMan 5.4. Clinical improvement, negative conversion of reverse transcription-polymerase chain reaction (RT-PCR), adverse effects, and oxygen requirements were studied. Results We identified a total of 1798 studies after searching the electronic databases. Nine in the qualitative studies and four studies in the quantitative synthesis met the criteria. There was a significant clinical improvement in the FVP group on the 14th day compared to the control group (RR 1.29, 1.08–1.54). Clinical deterioration rates were less likely in the FVP group though statistically not significant (OR 0.59, 95% CI 0.30–1.14) at the endpoint of study (7–15 days). The meta-analysis showed no significant differences between the two groups on viral clearance (day 14: RR 1.06, 95% CI 0.84–1.33), non-invasive ventilation or oxygen requirement (OR 0.76, 95% CI 0.42–1.39), and adverse effects (OR 0.69, 0.13–3.57). There are 31 randomized controlled trials (RCTs) registered in different parts of the world focusing FVP for COVID-19 treatment. Conclusion There is a significant clinical and radiological improvement following treatment with FVP in comparison to the standard of care with no significant differences on viral clearance, oxygen support requirement and side effect profiles.
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              Author and article information

              Contributors
              Mehmet Ali Doran:
              ORCID: http://orcid.org/0000-0003-1195-4830
              malidoran75@gmail.com
              Journal
              Journal ID (nlm-ta): Virol J
              Journal ID (iso-abbrev): Virol J
              Title: Virology Journal
              Publisher: BioMed Central (London )
              ISSN (Electronic): 1743-422X
              Publication date (Electronic): 13 July 2021
              Publication date PMC-release: 13 July 2021
              Publication date Collection: 2021
              Volume: 18
              Electronic Location Identifier: 146
              Affiliations
              GRID grid.414882.3, ISNI 0000 0004 0643 0132, Department of Ophthalmology, , Tepecik Training and Research Hospital, ; Izmir, Turkey
              Author information
              http://orcid.org/0000-0003-1195-4830
              Article
              Publisher ID: 1610
              DOI: 10.1186/s12985-021-01610-3
              PMC ID: 8276213
              PubMed ID: 34256791
              SO-VID: 0d279222-e2bb-4689-a043-c17096673888
              Copyright © © The Author(s) 2021
              License:

              Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

              History
              Date received : 3 April 2021
              Date accepted : 29 June 2021
              Categories
              Subject: Case Report
              Custom metadata
              issue-copyright-statement © The Author(s) 2021

              ScienceOpen disciplines: Microbiology & Virology
              Keywords: fluorescence,covid-19,favipiravir,ocular surface,ultraviolet light
              Data availability:
              ScienceOpen disciplines: Microbiology & Virology
              Keywords: fluorescence, covid-19, favipiravir, ocular surface, ultraviolet light

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