Impact of Favipiravir Toxicity on Liver Function in Hospitalized Adult Covid-19 Patients in Taif, Saudi Arabia

Background: Favipiravir is an antiviral medication for the treatment of coronavirus disease 2019 (COVID-19). There were a limited number of studies investigating the hepatotoxic adverse effects of favipiravir. Aim of the Study: The study aimed to assess the potential toxic impact of loading and maintenance doses of favipiravir on liver function through liver function evaluation. Materials and Methods: In this cross-sectional retrospective observational study, 476 adult COVID-19 patients hospitalized at King Faisal Medical Complex (KFMC) in Taif City, Saudi Arabia, used favipiravir. Liver functions (aspartate aminotransferase (AST), alanine aminotransferase (ALT), and Free bilirubin) were taken from randomly selected subjects. Pre- and post-treatment liver function results were randomly assigned. Results: The age of the patients varied between 18 and 65 years. All participants enrolled in this trial were diagnosed with COVID-19 and received treatment with favipiravir. The majority of patients, treated with favipiravir, exhibited normal liver function test results, with 78.2% showing normal levels of AST and 45% showing normal levels of ALT. A smaller percentage of patients, 20.2% and 48.7% respectively, experienced a modest increase in these enzyme levels. After undergoing favipiravir therapy, the majority of patients (95.59%) showed normal bilirubin levels. A notable disparity was observed in the levels of AST, ALT, and bilirubin before and after favipiravir treatment, with a p-value < 0.001 for all patients included in the study. Conclusion: According to the study, antiviral favipiravir had no major liver side effects; it caused hepatic function elevations but not serious and is reversible after discontinuation.