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A six-month-old boy who was prescribed an antiviral drug to treat Covid had a strange reaction: His dark brown eyes turned a bright blue 18 hours after therapy.
The anonymous baby from Thailand received favipiravir, a commonly used treatment for influenza and Ebola, which is approved as a Covid treatment in some parts of Asia, but not yet approved in the US.
Bangkok doctors who treated the baby said the antiviral drug had been released. a fluorescent chemical that accumulated in the child’s corneas.
Although the boy’s eyes changed color shortly after receiving the treatment, they returned to their natural color five days after stopping the medication.
The six-month-old’s eyes are naturally dark brown. He was diagnosed with Covid and was given favipiravir as a treatment, making him the youngest patient to receive the drug.
Just 18 hours after the first dose, the boy’s mother noticed that his eyes had turned a bright blue.
In Thailand, favipiravir is the main antiviral given to children infected with SARS-CoV-2.
The most common side effects of treatment include increased uric acid in the body, diarrhea, and a low white blood cell count, which account for about 20 percent of adverse events.
Favipiravir is approved in Japan, Russia, Ukraine, Uzbekistan, Moldova, and Kazakhstan and received emergency use approval in Italy in 2020.
The United States began testing the drug in April 2020 with a small group of 50 people at Brigham and Women’s Hospital, Massachusetts General Hospital, and the University of Massachusetts Medical School.
But the Food and Drug Administration (FDA) has not yet approved favipiravir in the United States.
The report on the baby was published in April 2023, but the exact date of the side effect is unknown.
On the first day, he received 82 milligrams, and 18 hours later, his mother noticed the change in eye color.
‘No bluish coloration was observed in other areas such as the skin, nails or oral and nasal mucosa. Symptoms improved after three days of favipiravir therapy,” the researchers wrote in the study published in the journal Frontiers in pediatrics.
Once the treatment was finished, an ocular examination was performed.
“The patient was able to fix and follow the light in all directions,” the study reads.
The researchers wrote that this fluorescence “may be due to the drug, its metabolites, or additional components of the tablet, such as titanium dioxide and yellow ferric oxide.”
Several drugs can affect the eye, including nonsteroidal anti-inflammatory drugs, blood thinners, and antihistamines.
A class of medication called prostaglandins, which is used to treat glaucoma, has the side effect of darkening the color of the iris that can be permanent.
A 2021 study reports the case of a 20-year-old man in India who suffered from the same eye color change.
He received favipiravir and by the second day, he noticed a discoloration of his eyes: the same deep blue that returned to the natural brown when the treatment was stopped.
The clinicians also found that the cornea was clear and lacked a bluish corneal cast, and no blue pigment deposits were observed on the surface of the iris or in the anterior lens capsule.
While the boy is the youngest patient to receive the treatment, he is not the first to experience the strange side effect.
TO 2021 study reports in case of a 20-year-old man in India who suffered from the same eye color change.
She received favipiravir and by the second day, she noticed a discoloration of her eyes: the same deep blue that returned to natural brown when the treatment was stopped.
“We assumed that the bluish tint of the cornea might be related to favipiravir and we advised the patient to stop using favipiravir immediately. It was remarkable to observe that the next day, when favipiravir was discontinued, the patient’s corneas returned to their normal color,” read the article published by a team from India’s Medicine Healthway hospitals.
After this case, the team reviewed the literature to find other cases, but determined that this man is the first case in which favipiravir causes a bluish discoloration of the corneas.