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Comment
. 2020 Nov 17;64(12):e02017-20.
doi: 10.1128/AAC.02017-20. Print 2020 Nov 17.

Favipiravir and the Need for Early Ambulatory Treatment of SARS-CoV-2 Infection (COVID-19)

Peter A McCullough  1   2   3
Affiliations
Comment

Favipiravir and the Need for Early Ambulatory Treatment of SARS-CoV-2 Infection (COVID-19)

Peter A McCullough. Antimicrob Agents Chemother. .

Abstract

It is becoming increasingly clear that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), like most human viral infections, will require multiple drugs in combination to treat COVID-19 illness. In this issue of the Journal, Doi and colleagues describe successful treatment of patients with early COVID-19 with favipiravir, an oral polymerase inhibitor, to rapidly and substantially clear SARS-CoV-2 from nasal secretions irrespective if it was started relatively early or later within the first week of infection. These data support the concept that favipiravir could be paired with at least one more off-target antiviral agent (doxycycline, azithromycin, or ivermectin) followed by corticosteroids and antithrombotics to prevent COVID-19 hospitalization and death in those over age 50 and/or those with one or more comorbidities. Clinical trials and advanced practice should immediately pivot to combination/sequential drug therapy for ambulatory COVID-19 illness.

Keywords: COVID-19; SARS-CoV-2; ambulatory treatment; antiviral agents; favipiravir.

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Figures

FIG 1
FIG 1
Treatment algorithm for COVID-19-like and confirmed COVID-19 illness in ambulatory patients at home in self-quarantine. Yr, year; BMI, body mass index; Dz, disease; DM, diabetes mellitus; CVD, cardiovascular disease; CKD, chronic kidney disease; HCQ, hydroxychloroquine; Mgt, management; Ox, oximetry. Reproduced from reference .
See this image and copyright information in PMC

Comment in

Comment on

  • A Prospective, Randomized, Open-Label Trial of Early versus Late Favipiravir Therapy in Hospitalized Patients with COVID-19.
    Doi Y, Hibino M, Hase R, Yamamoto M, Kasamatsu Y, Hirose M, Mutoh Y, Homma Y, Terada M, Ogawa T, Kashizaki F, Yokoyama T, Koba H, Kasahara H, Yokota K, Kato H, Yoshida J, Kita T, Kato Y, Kamio T, Kodama N, Uchida Y, Ikeda N, Shinoda M, Nakagawa A, Nakatsumi H, Horiguchi T, Iwata M, Matsuyama A, Banno S, Koseki T, Teramachi M, Miyata M, Tajima S, Maeki T, Nakayama E, Taniguchi S, Lim CK, Saijo M, Imai T, Yoshida H, Kabata D, Shintani A, Yuzawa Y, Kondo M. Doi Y, et al. Antimicrob Agents Chemother. 2020 Nov 17;64(12):e01897-20. doi: 10.1128/AAC.01897-20. Print 2020 Nov 17. Antimicrob Agents Chemother. 2020. PMID: 32958718 Free PMC article. Clinical Trial.

References

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