4. Discussion
Reddy P.K.
DISEASE, VIRUS
The results of our triple-blinded randomized controlled trial show no benefit of Favipiravir in preventing the hospitalization of mild to moderate COVID-19 patients in 28 days of follow-up. The results of our study were in line with the results of most previous studies on the lack of benefits of Favipiravir on COVID-19 patients’ outcomes. Several trials focused on the effect of Favipiravir on the treatment of COVID-19 patients, mostly hospitalized and a few in outpatient settings.Hassaniazad et al. [On the other hand, a multicentric, randomized clinical trial by Ivashchenko A.A. et al. found promising effects of Favipiravir in hospitalized COVID-19 patients. In that study, the viral clearance rate on day five was higher in those who received Favipiravir (1600 mg on day one/600 mg on days 2–14 or 1800 mg on day one/800 mg on days 2–14) than in those who received standard care. However, the rate of viral clearance on day ten and the rate of improvement of chest CT scan on day 15 were the same in both groups [To the best of our knowledge, one study has considered hospitalization as an outcome of the effect of Favipiravir [This discrepancy in results is also apparent in systematic reviews. The results of a systematic review by Deng W. et al. showed that Favipiravir reduces the virus clearance time and hospitalization period in mild to moderate COVID-19 patients but not in severe cases [The contradictory results of Favipiravir studies could be due to different factors, including the lack of one definition for the severity of the disease, the study design, the dosage and duration of therapy, the situation of the outbreak in the society, and various characteristics of the study sample.Based on a study by Reddy P.K. et al. on 1083 mild-moderate COVID-19 patients, AEs were reported in 12% of patients, of which 11% were mild [Our study has some limitations. This study would benefit from more objective outcomes, such as improvement in oxygen saturation or viral clearance. Considering the outpatient setting of this study, patients were not supposed to return to the clinics, so we were limited in choosing objective outcomes. Another limitation was the sample size of our study along with noncompliance of patients mainly due to the high number of tablets they were supposed to consume. Hence, we suggest future studies should be conducted with a larger sample size. Moreover, the lack of consensus on the doses and duration of Favipiravir indicates an urgent need for more studies.