The influence of ARVI and influenza treatment start time on the dynamics of clinical symptoms and outcomes of the diseases (the results of the international cohort observational study FLU-EE)

Abstract

Objective - assessment of the influence of the start time of antiviral therapy of acute respiratory viral infection (ARVI) and influenza on dynamics of clinical symptoms and outcome of the disease. Material and methods.The data on 18,946 patients aged 18 to 93 years with previously established clinical diagnosis of ARVI or influenza were obtained and analyzed in the framework of an international multicenter open prospective observational study. The patients were divided into 2 groups: those in the control group received symptomatic treatment without the use of antiviral drugs and patients of group 1 (main group) were given the antiviral drug Kagocel a component of combined therapy. The clinical symptoms, bacterial aggravations, efficacy and safety of prescribed therapy (including antibiotics) were assessed. Results. About a quarter of patients (23.2%) with ARVI and influenza did not seek professional medical help with in the first 24-48 hours after onset of the disease and started treatment on the 3rd day or later. The most common symptom of ARVI or influenza in the first 24-48 hours was hyperthermia that was followed during the next 72 hours or more (in the absence of adequate treatment) by other symptoms, such as coughing the severity of which correlated with the development of bacterial aggravations most often diagnosed on day 5. Administration of interferon inducer Kagocel resulted infaster normalization of body temperature than in the control group regardless of the time of onset of drug administration (both at early and late treatment start time). Therapy with Kagocel led to significant regression of the clinical symptoms of the disease as early as days 2 and 3 with the reduction of the frequency of bacterial aggravations from 13% to 7.9%. The frequency of complete recovery by the 3rd visit was 70.8% in the control group and 77.9% in the main group. The study demonstrated the inexpediency of prophylactic antibiotic treatment for ARVI and influenza (complete recovery rate decreased by 6%) as well as the ambiguity of positive antibiotic effectsonthe outcomeof complications (complete recovery only in 57.7% cases vs 77.4% in the absence of antibiotics). Conclusion. The absence of antiviral treatment for ARVI and influenza is a wrong tactic leading to prolongation of the disease and increased frequency of aggravations. The earlier the antiviral treatment starts, the milder the symptoms are, the lower the aggravation rate is and the earler complete recovery comes. It was shown on a large cohort of patients that administration of antiviral drug Kagocel is effective in case of both the early (24-72 hours after the onset of the disease) and late (72 hours and later) beginning of the treatment.