ABSTRACT
BACKGROUND: Favipiravir is an oral antiviral, that might treat COVID-19 by enhancing viral eradication, particularly in patients with mild-to-moderate disease. Yet, the findings on the use of favipiravir in critically ill patients with COVID-19 are inconsistent. Therefore, this study aimed to assess the effectiveness and safety of favipiravir in critically ill patients with COVID-19. METHOD: A multicenter retrospective cohort study includes critically ill adult patients with COVID-19 admitted to the intensive care units (ICUs) was conducted from March 2020 to July 2021. Patients were categorized based on favipiravir use (control vs. favipiravir). The primary outcome was in-hospital mortality. Secondary outcomes included mechanical ventilation (MV) duration, 30-day mortality, ICU length of stay (LOS), hospital LOS, and complications during the stay. RESULTS: After propensity score (PS) matching (1:1 ratio), 146 patients were included in the final analysis. A higher in-hospital and 30-day mortality were observed in patients receiving favipiravir compared to the control group at crude analysis (65.3% vs. 43.8%; P-value=0.009 and 56.3% vs. 40.3; P-value=0.06, respectively); however, no differences were observed using multivariable Cox proportional hazards regression analysis (HR 1.17; 95% CI 0.73, 1.87; P-value =0.51 and HR 0.86; 95% CI 0.53, 1.39; P-value=0.53, respectively). Conversely, the MV duration and ICU LOS were longer in patients who received favipiravir than the control group (ß coefficient 0.51; CI 0.09, 0.92; P-value = 0.02, ß coefficient 0.41; CI 0.17, 0.64; P-value = 0.0006, respectively). Complications during the stay were comparable between the two groups. CONCLUSION: The use of favipiravir in critically ill patients with COVID-19 did not demonstrate a reduction in mortality; instead, it was linked with longer MV duration and ICU stay. This finding suggests limiting favipiravir use to infections where it is more effective, other than COVID-19. Further randomized clinical trials are needed to confirm these findings.
Subject(s)
COVID-19 , Adult , Humans , Antiviral Agents/therapeutic use , Retrospective Studies , Critical Illness/therapy , Intensive Care UnitsABSTRACT
Nanofiltration membranes were successfully created using multi-walled carbon nanotubes (MWCNTs) and MWCNTs modified with amine (MWCNT-NH2) and carboxylic groups (MWCNT-COOH). Chitosan (CHIT) and chitosan−glutaraldehyde (CHIT-G) were utilized as dispersants. Sonication, SEM, and contact angle were used to characterize the as-prepared membranes. The results revealed that the type of multi-walled carbon nanotubes (MWCNT, MWCNT-COOH and MWCNT-NH2) used as the top layer had a significant impact on membrane characteristics. The lowest contact angle was 38.6 ± 8.5 for the chitosan-G/MWCNT-COOH membrane. The surface morphology of membranes changed when carbon with carboxylic or amine groups was introduced. In addition, water permeability was greater for CHIT-G/MWCNT-COOH and CHIT-G/MWCNT-NH2 membranes. The CHIT-G/MWCNT-COOH membrane had the highest water permeability (5.64 ± 0.27 L m−2 h−1 bar−1). The findings also revealed that for all membranes, the rejection of inorganic salts was in the order R(NaCl) > R(MgSO4).
