Evidence mapPaperPMID 40465794Full record

Observational studyPloS one2025

In-hospital mortality outcomes of favipiravir in patients with moderate to severe COVID-19 infection: An emulated target trial using real-world data from the largest field hospital in Thailand.

Lalita Lumkul, Krittai Tanasombatkul, Phongsak Nitikaroon, Thotsaporn Morasert, Phichayut Phinyo

Abstract readObservational Study
In one paragraph

Observational study in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Lalita LumkulCenter for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Krittai TanasombatkulCenter for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Phongsak NitikaroonOffice of the Permanent Secretary Ministry of Public Health, Nonthaburi, Thailand.
Thotsaporn MorasertPulmonary and Critical Care Medicine, Department of Medicine, Suratthani Hospital, Surat Thani, Thailand.
Phichayut PhinyoCenter for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.ORCID https://orcid.org/0000-0002-8543-6254

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFavipiravir, an antiviral agent, has been widely used to treat COVID-19 due to its potential mechanism of action, despite limited evidence of its efficacy in moderate to severe cases.

aimThis study aimed to evaluate the efficacy of favipiravir in improving in-hospital mortality outcomes among patients with moderate to severe COVID-19 through an emulation of a target trial.

methodsWe emulated a target trial using observational data from Bussarakham field hospital, Thailand between May 14 and September 20, 2021. Patients were categorized into three groups: those receiving favipiravir with dexamethasone (FPV with Dexa), favipiravir alone (FPV), and symptomatic treatment (ST). In-hospital mortality within 30 days was the primary outcome.

resultsFrom 18,184 patients admitted to the hospital, a total of 3,193 moderate to severe COVID-19 cases were included. Of these, 2,256 (70.65%) received FPV with Dexa, 828 (25.93%) received FPV, and 109 (3.41%) received ST. The restricted mean survival times were 29.68 days (95% CI: 29.52, 29.84) for FPV with Dexa, 29.46 days (95% CI: 29.22, 29.71) for FPV, and 28.14 days (95% CI: 26.51, 29.76) for ST. Only FPV showed marginally significant difference when compared to ST. However, there was a trend in prolonging survival time in FPV with Dexa group, and the results were more pronounced in severe and hypoxic patients.

conclusionOur emulated target trial suggests favipiravir, especially with dexamethasone, offers a modest survival benefit in moderate to severe COVID-19, particularly in hypoxic patients. It supports favipiravir as a practical antiviral in settings where other antivirals are not available. Further randomized controlled studies are needed to confirm its role, alongside standard corticosteroid therapy.

Indexed as

AmidesAntiviral AgentsCOVID-19COVID-19 Drug TreatmentHospital MortalityPyrazinesAdultAgedDexamethasoneFemaleHumansMaleMiddle AgedSARS-CoV-2ThailandTreatment OutcomeAmidesAntiviral AgentsDexamethasonefavipiravirPyrazines

Identifiers

PMID40465794
PMCPMC12136412

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.