Evaluasi Efektivitas Penggunaan Antivirus Pada Pasien Covid-19 di Ruang Rawat Inap RSUD Dr. Moewardi
Keywords:
COVID-19; Remdesivir; Favipiravir; Efektivitas antivirus; Parameter klinis.Abstract
This study aims to evaluate the effectiveness of using the antiviral drugs Remdesivir and Favipiravir in COVID-19 patients undergoing treatment at Dr. Moewardi General Hospital in Surakarta. The study utilizes a descrptive design with a retrospective data analysis approach involving 17 confirmed COVID-19 patients. The data analyzed includes patient profile, the severity of the disease, the typy of antiviral administered, and changes in clinical parameters such as creatinin levels, oxygen saturation (SpO2) and respiratory rate (RR). The results indicate that the majority of patients treated were male (88,33%) and over 50 years old (88,3%) with the most patients having a moderate severity level of the disease (58,9%0. Remdesivir was the most commonly used antiviral (76,4%). The use of Remdesivir was associated with an average increase in SpO2 of 4,15% and an increase in RR of 0,52 breaths/minute. On the other hand, the use of Favipiravir did not show a significant change in SpO2 but resulted in an increase in RR by 2,67 breath/minute. The use of combination antivirals showed the highest increase in RR of 7 breaths/minute. The study concludes that Remdesivir is more effective than Favipiravir in improving patient oxygenation without causing a significant increase in RR. However the use of antivirals, especially ini combination, requires close monitoring to prevent potential side effects. The results of this study are expected to provide guidance in selecting the most appropriate antiviral therapy for COVID-19 patients and emphasize the importance of intensive clinical monitoring during treatment.
Downloads
References
Beigel, J. H., Tomashek, K. M., Dodd, L. E., Mehta, A. K., Zingman, B. S., Kalil, A. C., ... & Lane, H. C. 2020. Remdesivir for the treatment of Covid-19—preliminary report. The New England Journal of Medicine.
Bhimraj, A., Morgan, R. L., Shumaker, A. H., Lavergne, V., Baden, L., Cheng, V. C., Edwards, K. M., Gandhi, R., Muller, W. J., O'Horo, J. C., Shoham, S., Murad, M. H., Mustafa, R. A., Sultan, S., Falck-Ytter, Y., & Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19. 2020. Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America, ciaa478.
Cai, H. 2020. Sex difference and smoking predisposition in patients with COVID-19. The Lancet Respiratory Medicine, 8(4), e20.
Cai, Q., Yang, M., Liu, D., Chen, J., Shu, D., Xia, J., ... & Liu, L. (2020). Experimental treatment with favipiravir for COVID-19: An open-label control study. Engineering, 6(10), 1192-1198.
Carr, A. C., & Maggini, S. 2017. Vitamin C and immune function. Nutrients, 9(11), 1211.
Cheng, Y., Luo, R., Wang, K., Zhang, M., Wang, Z., Dong, L., Li, J., Yao, Y., Ge, S., & Xu, G. 2020. Kidney disease is associated with in-hospital death of patients with COVID-19. Kidney International, 97(5), 829-838.
Grein, J., Ohmagari, N., Shin, D., Diaz, G., Asperges, E., Castagna, A., ... & Flanigan, T. 2020. Compassionate Use of Remdesivir for Patients with Severe Covid-19. The New England Journal of Medicine.
Guan, W. J., Ni, Z. Y., Hu, Y., Liang, W. H., Ou, C. Q., He, J. X., ... & China Medical Treatment Expert Group for Covid-19. 2020. Clinical characteristics of coronavirus disease 2019 in China. The New England Journal of Medicine, 382(18), 1708-1720.
Horby, P., Lim, W. S., Emberson, J. R., Mafham, M., Bell, J. L., Linsell, L., ... & Landray, M. J. 2020. Dexamethasone in hospitalized patients with Covid-19—preliminary report. The New England Journal of Medicine.
Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., Zhang, L., Fan, G., Xu, J., Gu, X., Cheng, Z., Yu, T., Xia, J., Wei, Y., Wu, W., Xie, X., Yin, W., Li, H., Liu, M., ... & Cao, B. 2020. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet, 395(10223), 497-506.
Ivashchenko, A. A., Dmitriev, K. A., Vostokova, N. V., Azarova, V. N., Blinow, A. A., Egorova, A. N., ... & Karapetian, R. N. 2021. AVIFAVIR for Treatment of Patients with Moderate COVID-19: Interim Results of a Phase II/III Multicenter Randomized Clinical Trial. Clinical Infectious Diseases, 73(3), 531-534.
Liu, Y., Li, Y., Xiang, F., & Zhu, L. 2020. Clinical features and outcomes of 2019 novel coronavirus-infected patients: a systematic review and meta-analysis. Journal of Infection, 80(4), 656-665.
Luo, H., Tang, Q. L., Shang, Y. X., Liang, S. B., Yang, M., Robinson, N., & Liu, J. P. 2020. Can Chinese medicine be used for prevention of coronavirus disease 2019 (COVID-19)? A review of historical classics, research evidence and current prevention programs. Chinese Journal of Integrative Medicine, 26(4), 243-250.
Mahase, E. 2020. Covid-19: What treatments are being investigated? BMJ, 368, m1252.
Makmun, A., et.al. 2021. Literature review on COVID-19 treatment strategies : A comparative analysis. Journal of Infectious Diseases and Clinical Research, 10(3), 112-125.
Matsuyama, R., Nishiura, H., Kutsuna, S., Hayakawa, K., Ohmagari, N., & Sugawara, T. 2020. The effectiveness of favipiravir, an antiviral agent on SARS-CoV-2 infection; a study of Japanese cases. Journal of Infection, 81(4), e8-e10.
Moore, J. B., & June, C. H. 2020. Cytokine release syndrome in severe COVID-19. Science, 368(6490), 473-474.
Peckham, H., de Gruijter, N. M., Raine, C., Radziszewska, A., Ciurtin, C., Wedderburn, L. R., Rosser, E. C., Webb, K., & Deakin, C. T. 2020. Male sex identified by global COVID-19 meta-analysis as a risk factor for death and ITU admission. Nature Communications, 11(1), 6317.
Qomara, W.F., et.al. 2021. A review on antiviral therapy for COVID-19 : Clinical outcomes and safety. Journal of Medical and Health Sciences, 12(4), 134-146.
Rawson, T. M., Moore, L. S. P., Zhu, N., Ranganathan, N., Skolimowska, K., Gilchrist, M., ... & Holmes, A. H. 2020. Bacterial and fungal co-infection in individuals with coronavirus: a rapid review to support COVID-19 antimicrobial prescribing. Clinical Infectious Diseases.
Shinkai, N., Sugiyama, A., Hoshina, Y., Noda, N., Tarumoto, N., Imai, K., & Maesaki, S. 2021. Efficacy and safety of favipiravir for the treatment of COVID-19: A systematic review and meta-analysis. Journal of Infection and Chemotherapy, 27(10), 1375-1387.
Spinner, C. D., Gottlieb, R. L., Criner, G. J., Arribas, J. R., Cattelan, A. M., Soriano, V., ... & Marty, F. M. 2020. Effect of Remdesivir vs Standard Care on Clinical Status at 11 Days in Patients With Moderate COVID-19: A Randomized Clinical Trial. JAMA, 324(11), 1048-1057.
Sri Lestari, Y., Sari, D.P., & Pratama, R. 2020. A literature review on the therapeutic management of COVID-19. Journal of Pharmaceutical Research and Clinical Practice, 5(2), 45-52.
Tang, N., Bai, H., Chen, X., Gong, J., Li, D., & Sun, Z. 2020. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. Journal of Thrombosis and Haemostasis, 18(5), 1094-1099.
Unhale, S.S., Bilal, Q., Sanap, S., Thakhre, S., & Bairagi, R. 2020. A review on coronavirus (COVID-19). World Journal of Pharmaceutical and Life Sciences, 6(4), 109-115.
Wang, Y., Zhang, D., Du, G., Du, R., Zhao, J., Jin, Y., ... & Wang, C. 2020. Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial. The Lancet, 395(10236), 1569-1578.
World Health Organization (WHO). 2020. Clinical management of COVID-19: interim guidance.
Wu, Z., & McGoogan, J. M. 2020. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: Summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA, 323(13), 1239-1242.
Xie, J., Covassin, N., Fan, Z., Singh, P., Gao, W., Li, G., Kara, T., Somers, V. K. 2020. Association Between Hypoxemia and Mortality in Patients With COVID-19. Mayo Clinic Proceedings, 95(6), 1138-1147.
Yang, J., Zheng, Y., Gou, X., Pu, K., Chen, Z., Guo, Q., ... & Zhou, Y. 2020. Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: A systematic review and meta-analysis. International Journal of Infectious Diseases, 94, 91-95.
Zhang, X., Qin, J., Chen, Y., Du, W., Shu, F., Tan, J., & Ye, H. 2020. A rapid advice guideline for the management of critically ill patients with COVID-19. Chinese Journal of Evidence-Based Medicine, 20(5), 1-10.
