Filhi Rihmayuwainilla, Irmi Syafa'ah, mohammad Fathul Qorib

Perbandingan Efektivitas Remdesivir dan Favipiravir sebagai Terapi Antivirus pada Pasien COVID-19 Derajat Sedang hingga Kritis

Introduction

Perbandingan efektivitas remdesivir dan favipiravir sebagai terapi antivirus pada pasien covid-19 derajat sedang hingga kritis. Telusuri perbandingan efektivitas remdesivir & favipiravir sebagai terapi antivirus COVID-19 derajat sedang-kritis. Temukan perbedaan signifikan pada perbaikan gejala & lama perawatan.

Abstract

COVID-19 merupakan wabah penyakit pernapasan yang menjadi pandemi pada akhir tahun 2019. Wabah tersebut menyebabkan pasien yang terinfeksi mengalami penyakit pernapasan baik yang ringan, sedang, berat, hingga kritis yang dapat menyebabkan kematian. Namun, hingga saat ini belum ada terapi spesifik untuk mengatasinya. Terapi yang paling banyak digunakan saat ini adalah antivirus, seperti remdesivir dan favipiravir. Penelitian ini bertujuan untuk menganalisis efektivitas antivirus remdesivir dan favipiravir dalam memperbaiki gejala dan durasi perawatan pasien COVID-19 derajat sedang hingga kritis di Rumah Sakit Universitas Airlangga pada bulan Mei-Juni 2021. Metode penelitian ini menggunakan studi analitik observasional dengan metode kohort retrospektif. Ini diperoleh dari rekam medis pasien COVID-19 derajat sedang hingga kritis yang menggunakan antivirus remdesivir dan favipiravir di RS Universitas Airlangga. Data dikumpulkan menggunakan teknik total sampling dan diuji dengan Mann-Whitney. Parameter yang digunakan dalam penelitian ini adalah usia, jenis kelamin, komorbiditas, tingkat keparahan, obat antivirus, dan lama pengobatan. Dari 130 subjek penelitian, 27 pasien menggunakan remdesivir dan 103 pasien menggunakan favipiravir. Hasil uji menunjukkan bahwa uji antara antivirus dan waktu perbaikan gejala menunjukkan p = 0,015 (p < 0,05) yang berarti signifikan, sedangkan uji antara antivirus dan lama pengobatan menunjukkan p = 0,018 (p < 0,05) yang berarti signifikan. Jadi, kesimpulannya adalah terdapat perbedaan efektivitas yang signifikan antara penggunaan remdesivir dan favipiravir terhadap waktu perbaikan gejala dan lama pengobatan pasien COVID-19 derajat sedang hingga kritis.

Review

This study addresses a clinically relevant and timely question regarding the comparative effectiveness of remdesivir and favipiravir as antiviral therapies for moderate to critical COVID-19 patients. Utilizing a retrospective cohort design from a single institution, the authors aimed to analyze the impact of these two antivirals on symptom improvement time and duration of hospitalization. The findings indicate a statistically significant difference between remdesivir and favipiravir in both improving symptoms (p=0.015) and reducing treatment duration (p=0.018), suggesting a differential efficacy in this patient population. This research offers valuable insights into managing severe COVID-19 cases, particularly during the period when specific therapies were still under intense investigation. The strength of this study lies in its direct comparison of two widely used antiviral agents for COVID-19 in a real-world clinical setting, with clear objectives and the use of relevant clinical endpoints. However, several methodological aspects warrant consideration. As a retrospective observational study, it is inherently susceptible to confounding factors and potential selection biases that might influence treatment assignment, especially given the notable imbalance in sample sizes between the remdesivir (n=27) and favipiravir (n=103) groups. While the Mann-Whitney test is appropriate for non-parametric data and unequal groups, a detailed account of baseline characteristics between the two treatment arms would strengthen the internal validity. Crucially, the abstract concludes a significant difference in effectiveness but does not specify which antiviral was superior for the observed outcomes, which is a critical piece of information for clinical interpretation. The single-center nature and limited data collection period (May-June 2021) also limit the generalizability of these findings. In conclusion, this study provides preliminary evidence for a differential effectiveness between remdesivir and favipiravir in treating moderate to critical COVID-19 patients, impacting both symptom resolution and length of hospital stay. While the findings are statistically significant and contribute to the understanding of COVID-19 therapeutics, the methodological limitations, particularly the retrospective design and the undisclosed direction of the observed difference, necessitate cautious interpretation. Future research would greatly benefit from larger, prospective, and multicenter studies with rigorous control for confounding variables and clear reporting on which antiviral demonstrates superior outcomes for the specified endpoints. Such studies would further elucidate the optimal antiviral strategy for different COVID-19 severities and patient profiles, ultimately informing clinical guidelines and improving patient care.

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