Oseltamivir recipients recover faster from coronaviruses other than SARS-CoV-2
Patients with influenza-like illness who tested positive for coronaviruses besides SARS-CoV-2 and received oseltamivir plus usual care recovered faster than patients who received only usual care, according to researchers.
“Though our study has not proven that SARS-CoV-2 responds to oseltamivir, this drug could be considered for evaluation in a trial to manage primary care patients with suspected COVID-19 in the early stages of the illness,” Samuel Coenen, PhD, professor of clinical epidemiology at the University of Antwerp Centre for General Practice in Belgium, told Healio Primary Care.
Researchers conducted an exploratory analysis of data from an open-label, randomized controlled trial. They focused on 308 Europeans who had tested positive for CoV-229E, CoV-OC43, CoV-KU1 and CoV-NL63 during three influenza seasons, from 2016 to 2018. Patients were randomly assigned in an approximate 1:1 ratio to receive usual care — defined as over-the-counter analgesics and antipyretics for symptomatic relief — or usual care plus a weight-based dose of 30 mg, 45 mg, 60 mg or 75 mg of oseltamivir twice daily for 5 days. They kept daily symptom diaries and were contacted three times during a 28-day period to gauge their adherence and response to treatment.
Consistent with European and CDC guidelines, “oseltamivir was prescribed immediately in patients presenting to primary care with influenza-like illness with symptom duration of 72 hours or less,” Coenen said.
Researchers wrote that among those had tested positive for CoV-229E, CoV-OC43, CoV-KU1 and CoV-NL63 and in the usual care group, seven patients presented at the hospital during the study vs. only one patient who had tested positive for those same viruses in the oseltamivir group. The study’s primary outcome was the patient’s reported time to recovery — resumption of usual activities and minor or no fever, headache and muscle ache — was achieved in 136 of 153 (89%) patients who received usual care and 147 of the 155 (95%) patients who received usual care plus oseltamivir. The median time to recovery was longer in patients who received only usual care: 5 days (interquartile range [IQR], 3–8) vs. 4 days for those who received usual care plus oseltamivir (IQR range, 3–6; HR = 1.31; 95% CI, 1.03-1.66).
“Our study was part of the European Union project called Platform for European Preparedness Against (Re-) emerging Epidemics, or PREPARE,” Coenen said. "With PREPARE, we have established a European primary care research infrastructure that would be capable of rapidly starting and executing a trial in primary care patients with COVID-19-like illness to help elucidate a causal effect for the benefit of an antiviral or any other relevant drug.”
- Coenen S, et al. Br J Gen Pract. 2020;doi:10.3399/bjgp20X711941.
- Postma MJ, et al. J Med Econ. 2008;doi:10.3111/13696990802505557.