Evidence map›Paper›PMID 42549359›Full record

ArticleERJ open research2026

The relationship between plasma favipiravir concentrations and clinical outcomes in COVID-19.

Rebecca E Wawman, Pallav L Shah, Marta Boffito, James Tonkin, Francesca Conway, Anand Tana, Breno R Santos, Beatriz Grinsztejn, Brenda Crabtree Ramírez, Henry Pertinez and 9 more

Abstract read
In one paragraph

Article in ERJ open research, 2026. 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

19 authors.

Rebecca E WawmanNational Heart and Lung Institute, Imperial College London, London, UK.
Pallav L ShahNational Heart and Lung Institute, Imperial College London, London, UK.ORCID https://orcid.org/0000-0002-9052-4638
Marta BoffitoNational Heart and Lung Institute, Imperial College London, London, UK.
James TonkinNational Heart and Lung Institute, Imperial College London, London, UK.
Francesca ConwayNational Heart and Lung Institute, Imperial College London, London, UK.
Anand TanaNational Heart and Lung Institute, Imperial College London, London, UK.ORCID https://orcid.org/0009-0009-4287-149X
Breno R SantosDepartamento de Infectología, Hospital Nossa Senhora da Conceição-Grupo Hospitalar Conceição, Porto Alegre, Brazil.
Beatriz GrinsztejnInstituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, Brazil.
Brenda Crabtree RamírezDepartamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Mexico City, Mexico.
Henry PertinezDepartment of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK.
Andrew OwenDepartment of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK.ORCID https://orcid.org/0000-0002-9819-7651
Paul CurleyDepartment of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK.
Usman ArshadDepartment of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK.
Helen CoxDepartment of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK.
Mark R JohnsonChelsea and Westminster NHS Foundation Trust, London, UK.
Anton PozniakChelsea and Westminster NHS Foundation Trust, London, UK.
Michael PellyChelsea and Westminster NHS Foundation Trust, London, UK.
Christopher M OrtonNational Heart and Lung Institute, Imperial College London, London, UK.
Pankaj K BhavsarNational Heart and Lung Institute, Imperial College London, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Favipiravir has shown efficacy against SARS-CoV-2 in patients <60 years old, but data linking plasma concentrations to clinical outcomes are limited. This study investigated whether favipiravir plasma concentrations influence clinical efficacy and outcomes in patients hospitalised with COVID-19. The main research question was, How can antiviral dosing strategies be optimised to improve pandemic preparedness and treatment efficacy? Methods: Adult participants were drawn from the PIONEER trial, in which patients received oral favipiravir (1800 mg twice daily for 1 day, then 800 mg twice daily for 9 days) plus standard care. This analysis included patients with confirmed COVID-19 and ≥75% study adherence. Samples were collected between days 5 and 10 post-treatment initiation. The primary outcome was time to clinical improvement. Secondary outcomes included achievement of clinical improvement and mortality risk. Results: Out of 140 patients (50% male; mean±sd age 59.5±14.8 years), target plasma concentrations were reached in 29 (21%). Mean time to improvement was 7.7±5.9 days in target achievers Conclusion: Most patients did not reach target favipiravir levels. Concentrations were influenced by sex, body mass index and liver function, confirming the need for pharmacokinetically guided dosing and therapeutic monitoring to optimise antiviral efficacy in future pandemic responses.

Identifiers

PMID42549359
PMCPMC13432959

What Socratic holds

Textmetadata
LicenceCC BY
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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.