pmedpharmФармация и фармакологияPharmacy & Pharmacology2307-92662413-2241Pyatigorsk Medical and Pharmaceutical Institute - branch of Volgograd State Medical Univer10.19163/2307-9266-2021-9-6-454-464pmedpharm-981Research ArticleФАРМАКОЛОГИЯ И КЛИНИЧЕСКАЯ ФАРМАКОЛОГИЯPHARMACOLOGY AND CLINICAL PHARMACOLOGYИЗУЧЕНИЕ КЛИНИКО-ПАТОГЕНЕТИЧЕСКИХ ЭФФЕКТОВ ПРОТИВОВИРУСНОГО ПРЕПАРАТА НА ОСНОВЕ ФАВИПИРАВИРА У КОМОРБИДНЫХ ПАЦИЕНТОВ С COVID-19 НА АМБУЛАТОРНОМ ЭТАПЕ ЛЕЧЕНИЯSTUDY OF CLINICAL AND PATHOGENETIC EFFECTS OF ANTI-VIRAL DRUG BASED ON FAVIPIRAVIR IN COMORBID PATIENTS WITH COVID-19 AT THE OUTPATIENT STAGE OF TREATMENThttps://orcid.org/0000-0002-2290-0013БалыковаЛ. А.BalykovaL. A.

доктор медицинских наук, профессор, член-корреспондент РАН, заведующий кафедрой педиатрии, директор Медицинского института

Doctor of Sciences (Medicine), Professor, Corresponding Member of the Russian Academy of Sciences, Head of the Department of Pediatrics

larisabalykova@yandex.ruhttps://orcid.org/0000-0003-1383-2474РадаеваО. А.RadaevaO. A.

доктор медицинских наук, доцент, заведующий кафедрой иммунологии, микробиологии и вирусологии с курсом клинической иммунологии и аллергологии Медицинского института

Doctor of Sciences (Medicine), Associate Professor, Head of the Department of Immunology, Microbiology and Virology with the Course of Clinical Immunology and Allergology

radaevamed@mail.ruhttps://orcid.org/0000-0002-7348-9412ЗаславскаяК. Я.ZaslavskayaK. Ya.

директор по новым продуктам 

director for new products

kiryonok@yandex.ruhttps://orcid.org/0000-0003-1383-2474КостинаЮ. А.KostinaYu. A.

кандидат медицинских наук, доцент кафедры иммунологии, микробиологии и вирусологии с курсом клинической иммунологии и аллергологии Медицинского института 

Candidate of Sciences (Medicine), Associate Professor of the Department of Immunology, Microbiology and Virology with the Course of Clinical Immunology and Allergology

bazunova.2013@mail.ruhttps://orcid.org/0000-0001-9465-7668ИскандяроваМ. С.IskandyarovaM. S.

ассистент кафедры иммунологии, микробиологии и вирусологии с курсом клинической иммунологии и аллергологии Медицинского института 

Assistant of the Department of Immunology, Microbiology and Virology with the course in Clinical Immunology and Allergology

iskandiarova.m@yandex.ruhttps://orcid.org/0000-0002-1581-618XНегодноваЕ. В.NegodnovaE. V.

ассистент кафедры иммунологии, микробиологии и вирусологии с курсом клинической иммунологии и аллергологии 

Assistant of the Department of Immunology, Microbiology and Virology with the course in Clinical Immunology and Allergology

el.negodnova@gmail.comhttps://orcid.org/0000-0002-2293-1987ЕремеевВ. В.EremeevV. V.

аспирант кафедры иммунологии, микробиологии и вирусологии с курсом клинической иммунологии и аллергологии Медицинского института 

post-graduate student of the Department of Immunology, Microbiology and Virology with the course in Clinical Immunology and Allergology

vital.eremeev2010@mail.ruhttps://orcid.org/0000-0001-8331-5523СабировЛ. Ф.SabirovL. F.

заместитель Руководителя Администрации Главы Республики Мордовия и Правительства Республики Мордовия

Vice Head of the Administration of the Republic of Mordovia and the Government of the Republic of Mordovia

lenar.sabirov.79@mail.ruhttps://orcid.org/0000-0001-6692-4968СемелеваЕ. В.SemelevaE. V.

доктор медицинских наук, доцент, и.о. заведующего кафедрой общественного здоровья и организации здравоохранения с курсом гигиены 

Doctor of Sciences (Medicine), Associate Professor, Acting Head of the Department of Public Health and Health Organization with the course of hygiene

shtanina37@mail.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Национальный исследовательский Мордовский государственный университет имени Н.П. Огарёва» 430005, Россия, Республика Мордовия, г. Саранск, ул. Ульянова, д. 26аРоссияNational Research Mordovia State University Bld. A, 26, Ulyanov St., Saransk, Republic of Mordovia, Russia, 430005Russian FederationОбщество с ограниченной ответственностью «Промомед ДМ» 129090, Россия, г. Москва, пр-т Мира, д. 13 стр. 1РоссияLimited Liability Company “Promomed RUS” Bld. 1, 13, Mir Ave., Moscow, Russia, 129090Russian FederationАдминистрация Главы Республики Мордовия 430005, Россия, Республика Мордовия, г. Саранск, ул. Советская, 35РоссияAdministration of the Head of the Republic of Mordovia 35, Sovetskaya Str., Saransk, Republic of Mordovia, Russia, 430005Russian Federation20210712202196454464Copyright © Балыкова Л.А., Радаева О.А., Заславская К.Я., Костина Ю.А., Искандярова М.С., Негоднова Е.В., Еремеев В.В., Сабиров Л.Ф., Семелева Е.В., 20212021Балыкова Л.А., Радаева О.А., Заславская К.Я., Костина Ю.А., Искандярова М.С., Негоднова Е.В., Еремеев В.В., Сабиров Л.Ф., Семелева Е.В.Balykova L.A., Radaeva O.A., Zaslavskaya K.Y., Kostina Y.A., Iskandyarova M.S., Negodnova E.V., Eremeev V.V., Sabirov L.F., Semeleva E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.pharmpharm.ru/jour/article/view/981

Артериальная гипертензия и ожирение, во многом, определяют вероятность тяжелого течения и летальных исходов при COVID-19. Этот факт обосновывает целесообразность раннего применения лекарственных средств прямого противовирусного действия с анализом эффективности не только в остром, но и постковидном периоде.

Цель

Цель. Провести анализ амбулаторных карт и историй болезни пациентов с COVID-19 для изучения влияния раннего (до 5-го дня от момента появления первых симптомов болезни) применения препарата на основе фавипиравира на частоту госпитализаций у пациентов с артериальной гипертензией и ожирением, а также определить особенности цитокинового статуса пациентов данной категории в постковидном периоде.

Материалы и методы

Материалы и методы. Проведено «Открытое проспективное сравнительное исследование эффективности применения препарата «Арепливир®» (фавипиравир) в дебюте COVID-19 у коморбидных пациентов» в Республике Мордовия (анализ частоты госпитализации и содержания в крови M-CSF, EPO у 218-ти больных в зависимости от применения противовирусного препарата).

Результаты

Результаты. По результатам проведенного анализа установлено, что, не смотря на наличие коморбидных состояний, повышающих риск развития тяжелого течения COVID-19, а именно ожирения и эссенциальной артериальной гипертензии, в группе пациентов, принимавших фавипиравир, необходимость в госпитализации была в 2 раза ниже (p<0,05), по отношению к группе сравнения. Анализ цитокинового статуса выявил, что в группе, принимавшей препарат на основе фавипиравира на амбулаторном этапе, средний уровень M-CSF в постковидном периоде был достоверно ниже (р>0,05), а EPO – выше (р>0,05), чем у пациентов из группы «без противовирусных препаратов на амбулаторном этапе», что косвенно, по полученным ранее данным, выступает потенциальным маркером снижения риска отдаленных сердечно-сосудистых осложнений COVID-19.

Заключение

Заключение. Раннее назначение фавипиравира способствует снижению частоты госпитализации пациентов с COVID-19 даже на фоне сопутствующих АГ и ожирения из-за уменьшения вероятности среднетяжелого и тяжелого течения заболевания, а также приводит к более раннему объективному и субъективному выздоровлению. Показана высокая потенциальная польза раннего применения фавипиравира при новой коронавирусной инфекции и в отношении профилактики постковидных осложнений.

In many ways, arterial hypertension and obesity determine the likelihood of a severe course and lethal outcomes in COVID-19. This fact justifies the expediency of an early use of drugs with a direct antiviral action, the analysis of their efficacy not only in the acute, but also in the postcovid period.

The aim of the research was to analyze the outpatient cards and case histories of the COVID-19 patients to study the effect of the early (up to the 5th day after the onset of the first symptoms of the disease) use of the drug based on favipiravir, on the frequency of patients’ hospitalizations with arterial hypertension and obesity, as well as to determine the cytokine status characteristics of this patient category in the postcovid period.

Materials and methods

Materials and methods. “An open prospective comparative study of the “Areplivir®” (favipiravir) efficacy in the debut of COVID-19 in comorbid patients” was carried out in the Republic of Mordovia (the analysis of the hospitalizations frequency and blood levels of M-CSF, EPO in 218 patients, in terms of the use of the antiviral preparation).

Results

Results. According to the results of the analysis, it was found out that, despite the presence of comorbid conditions that increase the risk of developing a severe course of COVID-19, i.e. obesity and essential arterial hypertension, in the group of patients taking favipiravir, the need for hospitalization was twice as low (p < 0.05), in relation to the comparison group. The analysis of the cytokine status revealed that in the postcovid period, in the group that took the drug based on favipiravir at the outpatient stage, the average level of M-CSF was significantly lower (p> 0.05), and EPO was higher (p> 0.05) than in the patients from the group “without antiviral drugs at the outpatient stage”. Indirectly, according to the previously obtained data, that acts as a potential marker for reducing the risk of long-term cardiovascular complications of COVID-19.

Conclusion

Conclusion. This study showed that an early prescription of favipiravir contributes to a decrease in the rate of COVID-19 patients’ hospitalization even against the background of concomitant hypertension and obesity, due to a decrease in the likelihood of moderate and severe courses of the disease, and also leads to an earlier objective and subjective recovery. The results demonstrated a high potential benefit of an early favipiravir use in the novel coronavirus infection and in the prevention of postcovid complications.

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The authors declare that there are no conflicts of interest present.