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Biţă A, Scorei IR, Mogoantă L, Bejenaru C, Mogoşanu GD, Bejenaru LE. Natural and semisynthetic candidate molecules for COVID-19 prophylaxis and treatment. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY = REVUE ROUMAINE DE MORPHOLOGIE ET EMBRYOLOGIE 2020; 61:321-334. [PMID: 33544784 PMCID: PMC7864303 DOI: 10.47162/rjme.61.2.02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 09/25/2020] [Indexed: 12/11/2022]
Abstract
Coronaviruses (CoVs) represent a family of viruses that have numerous animal hosts, and they cause severe respiratory, as well as systemic and enteric infections, in humans. Currently, there are limited antiviral strategies for treating patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The lack of specific antiviral medicines and SARS-CoV-2 vaccines continues to aggravate the situation. Natural product-based antiviral drugs have been used in the two previous CoV outbreaks: Middle East respiratory syndrome coronavirus (MERS-CoV) and the first SARS-CoV. This review emphasizes the role of natural and semisynthetic candidate molecules for coronavirus disease 2019 (COVID-19) prophylaxis and treatment. The experimental evidence suggests that nature could offer huge possibilities for treatment of the COVID-19 pandemic.
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Affiliation(s)
- Andrei Biţă
- BioBoron Research Institute, S.C. Natural Research S.R.L., Podari, Dolj County, Romania;
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3152
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Khan G, Sheek-Hussein M, Al Suwaidi AR, Idris K, Abu-Zidan FM. Novel coronavirus pandemic: A global health threat. Turk J Emerg Med 2020; 20:55-62. [PMID: 32587923 PMCID: PMC7305662 DOI: 10.4103/2452-2473.285016] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 03/25/2020] [Indexed: 01/08/2023] Open
Abstract
The world is facing one of its worst public health crises in modern history. Coronavirus 2019 (COVID-19) has shown how fragile our global preparedness for infectious diseases is. The world is a small-connected globe with short travel time between its remote parts. COVID-19 has spread globally and swiftly with major impacts on health, economy, and quality of life of communities. At this point in the time, April 9, 2020, >1,500,000 patients have been infected and >88,000 patients have died worldwide within the last 3 months. The status is evolving and the costly lessons learned over time are increasing. These lessons are global as this virus is. They involve different domains of health sciences including virology, public health, clinical, critical care, and disaster management. This review addresses our current knowledge of COVID-19 pandemic from the basic virology and transmission, through prevention, infection control, clinical management, and finally disaster management including the recovery period. This review has a multidisciplinary approach, which is needed at this time. After this difficult period passes, we have to carry the lessons we learned for the future so that we can be better prepared. One thing that has clearly emerged from this ongoing crisis is that infectious diseases have no borders and we have to work together, using the one world, one health approach, if we are to minimize the enormous impact such pandemics can cause.
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Affiliation(s)
- Gulfaraz Khan
- Department of Microbiolgy, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Mohamud Sheek-Hussein
- Department of Community Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Ahmed R. Al Suwaidi
- Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Kamal Idris
- Department of Critical Care, Al-Ain Hospital, Al-Ain, United Arab Emirates
| | - Fikri M. Abu-Zidan
- Department of Surgery, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
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3153
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McCreary EK, Pogue JM. Coronavirus Disease 2019 Treatment: A Review of Early and Emerging Options. Open Forum Infect Dis 2020; 7:ofaa105. [PMID: 32284951 PMCID: PMC7144823 DOI: 10.1093/ofid/ofaa105] [Citation(s) in RCA: 192] [Impact Index Per Article: 48.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 03/23/2020] [Indexed: 12/27/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), has spread across the globe resulting in a pandemic. At the time of this review, COVID-19 has been diagnosed in more than 200 000 patients and associated with over 8000 deaths (Centers for Disease Control and Prevention, World Health Organization). On behalf of the Society of Infectious Diseases Pharmacists, we herein summarize the current evidence as of March 18, 2020 to provide guidance on potential COVID-19 treatment options. It is important to caution readers that new data emerges daily regarding clinical characteristics, treatment options, and outcomes for COVID-19. Optimized supportive care remains the mainstay of therapy, and the clinical efficacy for the subsequent agents is still under investigation. Antimicrobial stewardship programs, including infectious diseases pharmacists and physicians, are at the forefront of COVID-19 emergency preparedness. We encourage all readers to continue to assess clinical data as it emerges and share their experience within our community in a well-controlled, adequately powered fashion.
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Affiliation(s)
- Erin K McCreary
- Department of Pharmacy, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Jason M Pogue
- Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, Michigan, USA
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3154
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3155
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3156
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Stawicki SP, Jeanmonod R, Miller AC, Paladino L, Gaieski DF, Yaffee AQ, De Wulf A, Grover J, Papadimos TJ, Bloem C, Galwankar SC, Chauhan V, Firstenberg MS, Di Somma S, Jeanmonod D, Garg SM, Tucci V, Anderson HL, Fatimah L, Worlton TJ, Dubhashi SP, Glaze KS, Sinha S, Opara IN, Yellapu V, Kelkar D, El-Menyar A, Krishnan V, Venkataramanaiah S, Leyfman Y, Saoud Al Thani HA, WB Nanayakkara P, Nanda S, Cioè-Peña E, Sardesai I, Chandra S, Munasinghe A, Dutta V, Dal Ponte ST, Izurieta R, Asensio JA, Garg M. The 2019-2020 Novel Coronavirus (Severe Acute Respiratory Syndrome Coronavirus 2) Pandemic: A Joint American College of Academic International Medicine-World Academic Council of Emergency Medicine Multidisciplinary COVID-19 Working Group Consensus Paper. J Glob Infect Dis 2020; 12:47-93. [PMID: 32773996 PMCID: PMC7384689 DOI: 10.4103/jgid.jgid_86_20] [Citation(s) in RCA: 186] [Impact Index Per Article: 46.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 04/25/2020] [Accepted: 05/04/2020] [Indexed: 02/06/2023] Open
Abstract
What started as a cluster of patients with a mysterious respiratory illness in Wuhan, China, in December 2019, was later determined to be coronavirus disease 2019 (COVID-19). The pathogen severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel Betacoronavirus, was subsequently isolated as the causative agent. SARS-CoV-2 is transmitted by respiratory droplets and fomites and presents clinically with fever, fatigue, myalgias, conjunctivitis, anosmia, dysgeusia, sore throat, nasal congestion, cough, dyspnea, nausea, vomiting, and/or diarrhea. In most critical cases, symptoms can escalate into acute respiratory distress syndrome accompanied by a runaway inflammatory cytokine response and multiorgan failure. As of this article's publication date, COVID-19 has spread to approximately 200 countries and territories, with over 4.3 million infections and more than 290,000 deaths as it has escalated into a global pandemic. Public health concerns mount as the situation evolves with an increasing number of infection hotspots around the globe. New information about the virus is emerging just as rapidly. This has led to the prompt development of clinical patient risk stratification tools to aid in determining the need for testing, isolation, monitoring, ventilator support, and disposition. COVID-19 spread is rapid, including imported cases in travelers, cases among close contacts of known infected individuals, and community-acquired cases without a readily identifiable source of infection. Critical shortages of personal protective equipment and ventilators are compounding the stress on overburdened healthcare systems. The continued challenges of social distancing, containment, isolation, and surge capacity in already stressed hospitals, clinics, and emergency departments have led to a swell in technologically-assisted care delivery strategies, such as telemedicine and web-based triage. As the race to develop an effective vaccine intensifies, several clinical trials of antivirals and immune modulators are underway, though no reliable COVID-19-specific therapeutics (inclusive of some potentially effective single and multi-drug regimens) have been identified as of yet. With many nations and regions declaring a state of emergency, unprecedented quarantine, social distancing, and border closing efforts are underway. Implementation of social and physical isolation measures has caused sudden and profound economic hardship, with marked decreases in global trade and local small business activity alike, and full ramifications likely yet to be felt. Current state-of-science, mitigation strategies, possible therapies, ethical considerations for healthcare workers and policymakers, as well as lessons learned for this evolving global threat and the eventual return to a "new normal" are discussed in this article.
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Affiliation(s)
- Stanislaw P Stawicki
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Rebecca Jeanmonod
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Andrew C Miller
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
| | - Lorenzo Paladino
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - David F Gaieski
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Anna Q Yaffee
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
| | - Annelies De Wulf
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
| | - Joydeep Grover
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Thomas J. Papadimos
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
| | - Christina Bloem
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
| | - Sagar C Galwankar
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Vivek Chauhan
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Michael S. Firstenberg
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Salvatore Di Somma
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Donald Jeanmonod
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Sona M Garg
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
| | - Veronica Tucci
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
| | - Harry L Anderson
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Lateef Fatimah
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Tamara J Worlton
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
| | | | - Krystal S Glaze
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
| | - Sagar Sinha
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Ijeoma Nnodim Opara
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
| | - Vikas Yellapu
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
| | - Dhanashree Kelkar
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Ayman El-Menyar
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Vimal Krishnan
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - S Venkataramanaiah
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Yan Leyfman
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
| | | | | | - Sudip Nanda
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
| | - Eric Cioè-Peña
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
| | - Indrani Sardesai
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Shruti Chandra
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Aruna Munasinghe
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Vibha Dutta
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Silvana Teixeira Dal Ponte
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
| | - Ricardo Izurieta
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
| | - Juan A Asensio
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Manish Garg
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
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3157
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Rada G, Verdugo-Paiva F, Ávila C, Morel-Marambio M, Bravo-Jeria R, Pesce F, Madrid E, Izcovich A. Evidence synthesis relevant to COVID-19: a protocol for multiple systematic reviews and overviews of systematic reviews. Medwave 2020; 20:e7868. [PMID: 32255438 DOI: 10.5867/medwave.2020.03.7867] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 03/30/2020] [Indexed: 11/27/2022] Open
Abstract
Introduction The evidence on COVID-19 is being produced at high speed, so it is challenging for decision-makers to keep up. It seems appropriate, then, to put into practice a novel approach able to provide the scientific community and other interested parties with quality evidence that is actionable, and rapidly and efficiently produced. Methods and analysis We designed a protocol for multiple parallel systematic reviews and overviews of systematic reviews in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P). We will search for primary studies and systematic reviews that answer different questions related to COVID-19 using both a centralized repository (Epistemonikos database) and a manual search in MEDLINE/PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials. We will also search for literature in several other sources. At least two researchers will independently undertake the selection of studies, data extraction, and assessment of the quality of the included studies. We will synthesize data for each question using meta-analysis, when possible, and we will prepare Summary of Findings tables according to the GRADE approach. All the evidence will be organized in an open platform (L·OVE - Living OVerview of Evidence) that will be continuously updated using artificial intelligence and a broad network of experts. Ethics and dissemination No ethics approval is considered necessary. The results of these articles will be widely disseminated via peer-reviewed publications, social networks, and traditional media, and will be sent to relevant international organizations discussing this topic.
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Affiliation(s)
- Gabriel Rada
- Epistemonikos Foundation, Santiago, Chile. Centro Evidencia UC, Cochrane Chile partner center, Pontificia Universidad Católica de Chile, Santiago, Chile. Internal Medicine Department, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile. . ORCID: 0000-0003-2435-0710
| | - Francisca Verdugo-Paiva
- Epistemonikos Foundation, Santiago, Chile. Centro Evidencia UC, Cochrane Chile partner center, Pontificia Universidad Católica de Chile, Santiago, Chile. ORCID: 0000-0003-0199-9744
| | - Camila Ávila
- Epistemonikos Foundation, Santiago, Chile. ORCID: 0000-0001-5348-6284
| | - Macarena Morel-Marambio
- Centro Evidencia UC, Cochrane Chile partner center, Pontificia Universidad Católica de Chile, Santiago, Chile. ORCID: 0000-0003-3410-3131
| | - Rocío Bravo-Jeria
- Centro Evidencia UC, Cochrane Chile partner center, Pontificia Universidad Católica de Chile, Santiago, Chile. ORCID: 0000-0002-3744-5578
| | - Franco Pesce
- Living Knowledge, Santiago, Chile. ORCID: 0000-0002-9209-4109
| | - Eva Madrid
- Centro Interdisciplinario de Estudios en Salud (CIESAL), Escuela de Medicina, Universidad de Valparaíso, Viña del Mar, Chile. Cochrane Chile partner center, Universidad de Valparaíso, Valparaíso, Chile. ORCID: 0000-0002-8095-5549
| | - Ariel Izcovich
- Servicio de Medicina Interna, Hospital Alemán, Buenos Aires, Argentina. ORCID: 0000-0001-9053-4396
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3158
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Lin JY, Kang EYC, Yeh PH, Ling XC, Chen HC, Chen KJ, Hwang YS, Lai CC, Wu WC. Proposed measures to be taken by ophthalmologists during the coronavirus disease 2019 pandemic: Experience from Chang Gung Memorial Hospital, Linkou, Taiwan. Taiwan J Ophthalmol 2020; 10:80-86. [PMID: 32874834 PMCID: PMC7442097 DOI: 10.4103/tjo.tjo_21_20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 04/22/2020] [Indexed: 12/27/2022] Open
Abstract
PURPOSE Although Taiwan was one of the first countries to develop coronavirus disease 2019 (COVID-19), with effective antiepidemic measures, Taiwan has effectively controlled the spread of the disease. The purpose of this article is to provide useful safety strategies for ophthalmologists in daily practice during the COVID-19 pandemic. MATERIALS AND METHODS Infection control strategies in the hospital and Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, are discussed. RESULTS Ophthalmologists are at high risk of contracting COVID-19 infection, as they have close contact with patients during ocular examinations, and are also facing high patient volume in outpatient clinics as well as emergency consultations. Furthermore, ocular symptoms, such as conjunctivitis, may be the presenting signs of COVID-19 infection. We provide our strategies, which include hospital's gate control with triage station, patient volume control, proper personal protective equipment, and consultation with telemedicine technology, to decrease the risk of cross-infection between medical staffs and patients. CONCLUSION To achieve the goal of preventing viral spread and maximizing patient and medical staffs' safety, besides providing proper protective equipment, it is also crucial for staffs and patients to strictly follow antiepidemic measures. We hope that our experience can help ophthalmologists and health-care workers to have a safer working environment when facing COVID-19 pandemic.
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Affiliation(s)
- Jui-Yen Lin
- Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | | | - Po-Han Yeh
- Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Xiao Chun Ling
- Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Hung-Chi Chen
- Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Kuan-Jen Chen
- Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yih-Shiou Hwang
- Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chi-Chun Lai
- Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wei-Chi Wu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Amawi H, Abu Deiab GI, A Aljabali AA, Dua K, Tambuwala MM. COVID-19 pandemic: an overview of epidemiology, pathogenesis, diagnostics and potential vaccines and therapeutics. Ther Deliv 2020; 11:245-268. [PMID: 32397911 PMCID: PMC7222554 DOI: 10.4155/tde-2020-0035] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 04/22/2020] [Indexed: 02/07/2023] Open
Abstract
At the time of writing this review, severe acute respiratory coronavirus syndrome-2 (SARS-CoV-2) has infected more than 2,355,853 patients and resulted in more than 164,656 deaths worldwide (as of 20 April 2020). This review highlights the preventive measures, available clinical therapies and the potential of vaccine development against SARS-CoV-2 by taking into consideration the strong genetic similarities of the 2003 epidemic SARS-CoV. Recent studies are investigating the repurposing of US FDA-approved drugs as there is no available vaccine yet with many attempts under clinical evaluation. Several antivirals, antimalarials and immunomodulators that have shown activity against SARS-CoV and Middle East coronavirus respiratory syndromes are being evaluated. In particular, hydroxychloroquine, remdesivir, favipiravir, arbidol, tocilizumab and bevacizumab have shown promising results. The main aim of this review is to provide an overview of this pandemic and where we currently stand.
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Affiliation(s)
- Haneen Amawi
- Faculty of Pharmacy, Department of Pharmacy Practice, Yarmouk University, Irbid-Jordan
| | - Ghina'a I Abu Deiab
- Faculty of Pharmacy, Department of Medicinal Chemistry & Pharmacognosy, Yarmouk University, Irbid-Jordan
| | - Alaa A A Aljabali
- Faculty of Pharmacy, Department of Pharmaceutics & Pharmaceutical Technology, Yarmouk University, Irbid-Jordan
| | - Kamal Dua
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - Murtaza M Tambuwala
- School of Pharmacy & Pharmaceutical Sciences, Ulster University, Coleraine, County Londonderry, BT52 1SA, Northern Ireland, UK
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3160
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Teitelbaum J. COVID 19: A Clinical Primer-Overview and Plaquenil/Zithromax. Integr Med (Encinitas) 2020; 19:12-14. [PMID: 33041701 PMCID: PMC7482323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
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3161
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Naksuk N, Lazar S, Peeraphatdit T(B. Cardiac safety of off-label COVID-19 drug therapy: a review and proposed monitoring protocol. EUROPEAN HEART JOURNAL. ACUTE CARDIOVASCULAR CARE 2020; 9:215-221. [PMID: 32372695 PMCID: PMC7235441 DOI: 10.1177/2048872620922784] [Citation(s) in RCA: 94] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 04/09/2020] [Indexed: 02/06/2023]
Abstract
More than 2,000,000 individuals worldwide have had coronavirus 2019 disease infection (COVID-19), yet there is no effective medical therapy. Multiple off-label and investigational drugs, such as chloroquine and hydroxychloroquine, have gained broad interest due to positive pre-clinical data and are currently used for treatment of COVID-19. However, some of these medications have potential cardiac adverse effects. This is important because up to one-third of patients with COVID-19 have cardiac injury, which can further increase the risk of cardiomyopathy and arrhythmias. Adverse effects of chloroquine and hydroxychloroquine on cardiac function and conduction are broad and can be fatal. Both drugs have an anti-arrhythmic property and are proarrhythmic. The American Heart Association has listed chloroquine and hydroxychloroquine as agents which can cause direct myocardial toxicity. Similarly, other investigational drugs such as favipiravir and lopinavir/ritonavir can prolong QT interval and cause Torsade de Pointes. Many antibiotics commonly used for the treatment of patients with COVID-19, for instance azithromycin, can also prolong QT interval. This review summarizes evidenced-based data regarding potential cardiac adverse effects due to off-label and investigational drugs including chloroquine and hydroxychloroquine, antiviral therapy, monoclonal antibodies, as well as common antibiotics used for the treatment of COVID-19. The article focuses on practical points and offers a point-of-care protocol for providers who are taking care of patients with COVID-19 in an inpatient and outpatient setting. The proposed protocol is taking into consideration that resources during the pandemic are limited.
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Affiliation(s)
- Niyada Naksuk
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Division of Cardiology, University of Illinois at Chicago, USA
| | - Sorin Lazar
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Division of Cardiology, University of Illinois at Chicago, USA
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Ranganathan LN, Shivaraman MA, Ramamurthy G, Shrivarthan R. The Socially Distanced Social Animal - In The New Covid-19 Era. Ann Indian Acad Neurol 2020; 23:S1-S4. [PMID: 32419747 PMCID: PMC7213034 DOI: 10.4103/aian.aian_263_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 04/06/2020] [Indexed: 11/24/2022] Open
Affiliation(s)
| | | | - Guhan Ramamurthy
- Institute of Neurology, Madras Medical College, Chennai, Tamil Nadu, India
| | - R. Shrivarthan
- Institute of Neurology, Madras Medical College, Chennai, Tamil Nadu, India
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3163
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Iyer M, Jayaramayya K, Subramaniam MD, Lee SB, Dayem AA, Cho SG, Vellingiri B. COVID-19: an update on diagnostic and therapeutic approaches. BMB Rep 2020; 53:191-205. [PMID: 32336317 PMCID: PMC7196187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Indexed: 11/04/2023] Open
Abstract
The unexpected pandemic set off by the novel coronavirus 2019 (COVID-19) has caused severe panic among people worldwide. COVID-19 has created havoc, and scientists and physicians are urged to test the efficiency and safety of drugs used to treat this disease. In such a pandemic situation, various steps have been taken by the government to control and prevent the Severe Acute Respiratory Syndrome coronavirus 2 (SARSCoV- 2). This pandemic situation has forced scientists to rework strategies to combat infectious diseases through drugs, treatment, and control measures. COVID-19 treatment requires both limiting viral multiplication and neutralizing tissue damage induced by an inappropriate immune reaction. Currently, various diagnostic kits to test for COVID-19 are available, and repurposing therapeutics for COVID-19 has shown to be clinically effective. As the global demand for diagnostics and therapeutics continues to rise, it is essential to rapidly develop various algorithms to successfully identify and contain the virus. This review discusses the updates on specimens/samples, recent efficient diagnostics, and therapeutic approaches to control the disease and repurposed drugs mainly focusing on chloroquine/hydroxychloroquine and convalescent plasma (CP). More research is required for further understanding of the influence of diagnostics and therapeutic approaches to develop vaccines and drugs for COVID-19. [BMB Reports 2020; 53(4): 191-205].
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Affiliation(s)
- Mahalaxmi Iyer
- Department of Zoology, Avinashilingam Institute for Home Science and Higher Education for Women, Coimbatore 641-043, India
| | - Kaavya Jayaramayya
- Department of Zoology, Avinashilingam Institute for Home Science and Higher Education for Women, Coimbatore 641-043, India
| | - Mohana Devi Subramaniam
- Department of Genetics and Molecular Biology, Vision Research Foundation, Chennai 600-006, India
| | - Soo Bin Lee
- Department of Stem Cell and Regenerative Biotechnology, Konkuk University, Seoul 05029, Korea
| | - Ahmed Abdal Dayem
- Department of Stem Cell and Regenerative Biotechnology, Konkuk University, Seoul 05029, Korea
| | - Ssang-Goo Cho
- Department of Stem Cell and Regenerative Biotechnology, Konkuk University, Seoul 05029, Korea
| | - Balachandar Vellingiri
- Human Molecular Cytogenetics and Stem Cell Laboratory, Department of Human Genetics and Molecular Biology, Bharathiar University, Coimbatore 641-046, India
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3164
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Pastick KA, Okafor EC, Wang F, Lofgren SM, Skipper CP, Nicol MR, Pullen MF, Rajasingham R, McDonald EG, Lee TC, Schwartz IS, Kelly LE, Lother SA, Mitjà O, Letang E, Abassi M, Boulware DR. Review: Hydroxychloroquine and Chloroquine for Treatment of SARS-CoV-2 (COVID-19). Open Forum Infect Dis 2020; 7:ofaa130. [PMID: 32363212 PMCID: PMC7184359 DOI: 10.1093/ofid/ofaa130] [Citation(s) in RCA: 130] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 04/13/2020] [Indexed: 12/12/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a rapidly emerging viral infection causing coronavirus disease 2019 (COVID-19). Hydroxychloroquine and chloroquine have garnered unprecedented attention as potential therapeutic agents against COVID-19 following several small clinical trials, uncontrolled case series, and public figure endorsements. While there is a growing body of scientific data, there is also concern for harm, particularly QTc prolongation and cardiac arrhythmias. Here, we perform a rapid narrative review and discuss the strengths and limitations of existing in vitro and clinical studies. We call for additional randomized controlled trial evidence prior to the widespread incorporation of hydroxychloroquine and chloroquine into national and international treatment guidelines.
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Affiliation(s)
- Katelyn A Pastick
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | | | - Fan Wang
- Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, Minnesota
| | - Sarah M Lofgren
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Caleb P Skipper
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Melanie R Nicol
- Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, Minnesota
| | - Matthew F Pullen
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Radha Rajasingham
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Emily G McDonald
- Clinical Practice Assessment Unit, Department of Medicine, McGill University Health Centre, Montreal, Canada
| | - Todd C Lee
- Clinical Practice Assessment Unit, Department of Medicine, McGill University Health Centre, Montreal, Canada
| | - Ilan S Schwartz
- Division of Infectious Diseases, Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta
| | - Lauren E Kelly
- Department of Pediatrics and Child Health, Department of Pharmacology, University of Manitoba, Winnipeg, Canada
| | - Sylvain A Lother
- Department of Medicine, Sections of Critical Care and Infectious Diseases, University of Manitoba, Winnipeg, Canada
| | - Oriol Mitjà
- Fight AIDS and Inf Dis Foundation, Hospital Germans Trias i Pujol, Barcelona, Spain
| | - Emili Letang
- Department of Infectious Diseases, Hospital del Mar/Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- ISGlobal, Barcelona Institute for Global Health, Universitat de Barcelona, Barcelona, Spain
| | - Mahsa Abassi
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - David R Boulware
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota
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3165
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Brown C, Noble J, Coralic Z. Brief Summary of Potential SARS-CoV-2 Prophylactic and Treatment Drugs in the Emergency Department. West J Emerg Med 2020; 21:510-513. [PMID: 32302280 PMCID: PMC7234712 DOI: 10.5811/westjem.2020.3.47328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 03/27/2020] [Indexed: 12/27/2022] Open
Abstract
As of March 30th, 2020 there were 161,807 total cases and 2,953 total deaths of SARS-CoV-2 in the United States, with the number of cases expected to rise. Other than supportive care, there are no SARS-CoV-2 specific treatments available for patients discharged from the emergency department (ED) or those admitted to the hospital. In addition, there are no vaccines available to protect our at-risk healthcare workers. The National Institutes of Health is conducting a Phase 1 clinical trial to evaluate for a potential vaccine and the recipients have started to receive the investigational vaccine.2 We present a brief overview of the potential prophylactic and treatment agents under investigation, some which could be initiated in the ED if proven effective.
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Affiliation(s)
- Cortlyn Brown
- University of California San Francisco, Department of Emergency Medicine, San Francisco, California
| | - Jeanne Noble
- University of California San Francisco, Department of Emergency Medicine, San Francisco, California
| | - Zlatan Coralic
- University of California San Francisco School of Pharmacy, San Francisco, California
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3166
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Poschet JF, Perkett EA, Timmins GS, Deretic V. Azithromycin and ciprofloxacin have a chloroquine-like effect on respiratory epithelial cells. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2020:2020.03.29.008631. [PMID: 32511331 PMCID: PMC7239066 DOI: 10.1101/2020.03.29.008631] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
There is interest in the use of chloroquine/hydroxychloroquine (CQ/HCQ) and azithromycin (AZT) in COVID-19 therapy. Employing cystic fibrosis respiratory epithelial cells, here we show that drugs AZT and ciprofloxacin (CPX) act as acidotropic lipophilic weak bases and confer in vitro effects on intracellular organelles similar to the effects of CQ. These seemingly disparate FDA-approved antimicrobials display a common property of modulating pH of endosomes and trans-Golgi network. We believe this may in part help understand the potentially beneficial effects of CQ/HCQ and AZT in COVID-19, and that the present considerations of HCQ and AZT for clinical trials should be extended to CPX.
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Affiliation(s)
- Jens F. Poschet
- Departments of Molecular Genetics and Microbiology, University of New Mexico Health Science Center
| | - Elizabeth A. Perkett
- Departments of Pediatrics, University of New Mexico Health Science Center
- Departments of Internal Medicine, University of New Mexico Health Science Center
| | - Graham S. Timmins
- Pharmaceutical Sciences, University of New Mexico Health Science Center
| | - Vojo Deretic
- Departments of Molecular Genetics and Microbiology, University of New Mexico Health Science Center
- Autophagy, Inflammation and Metabolism Center of Biomedical Research Excellence, University of New Mexico Health Science Center
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3167
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Bergquist R, Rinaldi L. Covid-19: Pandemonium in our time. GEOSPATIAL HEALTH 2020; 15. [PMID: 32238978 DOI: 10.4081/gh.2020.880] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 03/30/2020] [Indexed: 06/11/2023]
Abstract
While pandemonium has come to mean wild and noisy disorder, the reference here is to John Milton's epic poem Paradise Lost and the upheaval following Lucifer's banishment from Heaven and his construction of Pandæmonium as his hub. Today's avalanche of conflicting news on how to deal with the coronavirus disease 2019 (Covid-19) brings to mind the Trinity nuclear bomb test with Enrico Fermi estimating its strength by releasing small pieces of paper into the air and measuring their displacement by the shock wave. Fermi's result, in fact not far from the true value, emphasised his ability to make good approximations with few or no actual data. The current wave of Covid-19 presents just this kind of situation as it engulfs the world from ground zero in Wuhan, China. Much information is indeed missing, but datasets that might lead to useful ideas on how to handle this pandemic are steadily accumulating.
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3168
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Sargiacomo C, Sotgia F, Lisanti MP. COVID-19 and chronological aging: senolytics and other anti-aging drugs for the treatment or prevention of corona virus infection? Aging (Albany NY) 2020; 12:6511-6517. [PMID: 32229706 PMCID: PMC7202514 DOI: 10.18632/aging.103001] [Citation(s) in RCA: 139] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 03/29/2020] [Indexed: 04/08/2023]
Abstract
COVID-19, also known as SARS-CoV-2, is a new emerging zoonotic corona virus of the SARS (Severe Acute Respiratory Syndrome) and the MERS (Middle East Respiratory Syndrome) family. COVID-19 originated in China and spread world-wide, resulting in the pandemic of 2020. For some reason, COVID-19 shows a considerably higher mortality rate in patients with advanced chronological age. This begs the question as to whether there is a functional association between COVID-19 infection and the process of chronological aging. Two host receptors have been proposed for COVID-19. One is CD26 and the other is ACE-2 (angiotensin-converting enzyme 2). Interestingly, both CD26 and the angiotensin system show associations with senescence. Similarly, two proposed therapeutics for the treatment of COVID-19 infection are Azithromycin and Quercetin, both drugs with significant senolytic activity. Also, Chloroquine-related compounds inhibit the induction of the well-known senescence marker, Beta-galactosidase. Other anti-aging drugs should also be considered, such as Rapamycin and Doxycycline, as they behave as inhibitors of protein synthesis, blocking both SASP and viral replication. Therefore, we wish to speculate that the fight against COVID-19 disease should involve testing the hypothesis that senolytics and other anti-aging drugs may have a prominent role in preventing the transmission of the virus, as well as aid in its treatment. Thus, we propose that new clinical trials may be warranted, as several senolytic and anti-aging therapeutics are existing FDA-approved drugs, with excellent safety profiles, and would be readily available for drug repurposing efforts. As Azithromycin and Doxycycline are both commonly used antibiotics that inhibit viral replication and IL-6 production, we may want to consider this general class of antibiotics that functionally inhibits cellular protein synthesis as a side-effect, for the treatment and prevention of COVID-19 disease.
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Affiliation(s)
- Camillo Sargiacomo
- Translational Medicine, School of Science, Engineering and Environment (SEE), University of Salford, Greater Manchester, United Kingdom
| | - Federica Sotgia
- Translational Medicine, School of Science, Engineering and Environment (SEE), University of Salford, Greater Manchester, United Kingdom
| | - Michael P. Lisanti
- Translational Medicine, School of Science, Engineering and Environment (SEE), University of Salford, Greater Manchester, United Kingdom
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3169
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No evidence of rapid antiviral clearance or clinical benefit with the combination of hydroxychloroquine and azithromycin in patients with severe COVID-19 infection. Med Mal Infect 2020; 50:384. [PMID: 32240719 PMCID: PMC7195369 DOI: 10.1016/j.medmal.2020.03.006] [Citation(s) in RCA: 506] [Impact Index Per Article: 126.5] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 03/29/2020] [Indexed: 12/12/2022]
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3170
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Mehta M, Patharkar J. Current Treatment Options Available for COVID-19 : A Review. ASIAN JOURNAL OF PHARMACEUTICAL RESEARCH AND HEALTH CARE 2020. [DOI: 10.18311/ajprhc/2020/25540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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3171
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Georgiev T. Coronavirus disease 2019 (COVID-19) and anti-rheumatic drugs. Rheumatol Int 2020; 40:825-826. [PMID: 32232552 PMCID: PMC7103900 DOI: 10.1007/s00296-020-04570-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 03/24/2020] [Indexed: 12/19/2022]
Affiliation(s)
- Tsvetoslav Georgiev
- Clinic of Rheumatology, University Hospital "St. Marina", Medical University-Varna, 1, Hristo Smirnenski, 9010, Varna, Bulgaria.
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3172
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Ravikumar N, Nallasamy K, Bansal A, Angurana SK, Basavaraja GV, Sundaram M, Lodha R, Gupta D, Jayashree M. Novel Coronavirus 2019 (2019-nCoV) Infection: Part I - Preparedness and Management in the Pediatric Intensive Care Unit in Resource-limited Settings. Indian Pediatr 2020. [PMID: 32238612 PMCID: PMC7182738 DOI: 10.1007/s13312-020-1785-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
First reported in China, the 2019 novel coronavirus has been spreading across the globe. Till 26 March, 2020, 416,686 cases have been diagnosed and 18,589 have died the world over. The coronavirus disease mainly starts with a respiratory illness and about 5-16% require intensive care management for acute respiratory distress syndrome (ARDS) and multi-organ dysfunction. Children account for about 1-2% of the total cases, and 6% of these fall under severe or critical category requiring pediatric intensive care unit (PICU) care. Diagnosis involves a combination of clinical and epidemiological features with laboratory confirmation. Preparedness strategies for managing this pandemic are the need of the hour, and involve setting up cohort ICUs with isolation rooms. Re-allocation of resources in managing this crisis involves careful planning, halting elective surgeries and training of healthcare workers. Strict adherence to infection control like personal protective equipment and disinfection is the key to contain the disease transmission. Although many therapies have been tried in various regions, there is a lack of strong evidence to recommend anti-virals or immunomodulatory drugs.
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Affiliation(s)
- Namita Ravikumar
- Division of Pediatric Critical Care, Department of Paediatrics, Advanced Paediatrics Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Karthi Nallasamy
- Division of Pediatric Critical Care, Department of Paediatrics, Advanced Paediatrics Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Arun Bansal
- Division of Pediatric Critical Care, Department of Paediatrics, Advanced Paediatrics Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India. Correspondence to: Dr Arun Bansal, Professor, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
| | - Suresh Kumar Angurana
- Division of Pediatric Critical Care, Department of Paediatrics, Advanced Paediatrics Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - G V Basavaraja
- Paediatric Intensive Care Unit, Indira Gandhi Institute of Child Health, Bangalore Karnataka, India
| | - Manu Sundaram
- Division of Critical Care Medicine, Sidra Medicine, Doha, Qatar
| | - Rakesh Lodha
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Dhiren Gupta
- Pediatric Intensive Care Unit, Sir Ganga Ram Hospital, New Delhi, India
| | - Muralidharan Jayashree
- Division of Pediatric Critical Care, Department of Paediatrics, Advanced Paediatrics Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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3173
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Affiliation(s)
- M Lecuit
- Institut Pasteur, Biology of Infection Unit, 75015 Paris, France; Inserm U1117, 75015 Paris, France; Université de Paris, Necker-Enfants Malades University Hospital, Division of Infectious Diseases and Tropical Medicine; Institut Imagine; APHP, 75006 Paris, France.
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3174
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Sharma M, Surani S. Searching an Effective Therapy for the Coronavirus Pandemic: Do We See Light at the End of the Tunnel? Cureus 2020; 12:e7415. [PMID: 32337139 PMCID: PMC7182165 DOI: 10.7759/cureus.7415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 03/25/2020] [Indexed: 11/28/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). First reported at the end of December 2019 as a cause for clusters of pneumonia cases in Wuhan city in China, the rapid spread of this condition was declared a pandemic on March 11, 2020, by the World Health Organization (WHO). Apart from the mortality and morbidity associated with COVID-19, the massive social and financial havoc inflicted by this pandemic has left the entire world pondering if medical science can innovate and curtail the ongoing damage due to SARS-CoV-2. Recent findings of an open-label study that investigated the use of hydroxychloroquine and azithromycin in COVID-19 patients in Marseille, France, has garnered some optimism in scientific quarters and the general public alike in terms of finding a treatment regimen to control the rampant rise of COVID-19. We will discuss the potential off-label therapy and studies as it pertains to COVID-19.
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Affiliation(s)
- Munish Sharma
- Internal Medicine, Corpus Christi Medical Center, Corpus Christi, USA
| | - Salim Surani
- Internal Medicine, Texas A&M Health Science Center, Bryan, USA
- Internal Medicine, Corpus Christi Medical Center, Corpus Christi, USA
- Internal Medicine, University of North Texas, Dallas, USA
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3175
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Sarzi-Puttini P, Giorgi V, Sirotti S, Marotto D, Ardizzone S, Rizzardini G, Antinori S, Galli M. COVID-19, cytokines and immunosuppression: what can we learn from severe acute respiratory syndrome? Clin Exp Rheumatol 2020; 19:102574. [PMID: 32376399 PMCID: PMC7200131 DOI: 10.1016/j.autrev.2020.102574] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 04/09/2020] [Indexed: 12/17/2022]
Abstract
A correct patient risk stratification is of paramount importance for the proper management of economic and human resources. Clinical trials are crucial to assessing immunosuppressant prophylaxis and treatment to avoid overuse and treatment shortage. Controlled studies may highlight a potential preventive role of immunosuppressant in the development of Covid-19 severe forms Despite the risk of infection in rheumatic and gastroenterological diseases a conclusive link with COV-19 remains questionable
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Affiliation(s)
- Piercarlo Sarzi-Puttini
- Rheumatology Unit, ASST-Fatebenefratelli L. Sacco University Hospital, University of Milan, Italy.
| | - Valeria Giorgi
- Rheumatology Unit, ASST-Fatebenefratelli L. Sacco University Hospital, University of Milan, Italy
| | - Silvia Sirotti
- Rheumatology Unit, ASST-Fatebenefratelli L. Sacco University Hospital, University of Milan, Italy
| | - Daniela Marotto
- Rheumatology Unit, ATS Sardegna, P. Dettori Hospital, Tempio Pausania, Italy
| | - Sandro Ardizzone
- Gastrointestinal Unit, ASST-Fatebenefratelli Sacco. L. Sacco Department of Biochemical and Clinical Sciences, University of Milan, Italy
| | - Giuliano Rizzardini
- Department of Infectious Diseases, I Division of Infectious Diseases ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Spinello Antinori
- Department of Biomedical and Clinical Sciences 'Luigi Sacco', University of Milan, and III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Massimo Galli
- Department of Biomedical and Clinical Sciences 'Luigi Sacco', University of Milan, and III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
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3176
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Rosa SGV, Santos WC. Clinical trials on drug repositioning for COVID-19 treatment. Rev Panam Salud Publica 2020; 44:e40. [PMID: 32256547 PMCID: PMC7105280 DOI: 10.26633/rpsp.2020.40] [Citation(s) in RCA: 234] [Impact Index Per Article: 58.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 03/20/2020] [Indexed: 02/05/2023] Open
Abstract
The World Health Organization (WHO) was informed on December 2019 about a coronavirus pneumonia outbreak in Wuhan, Hubei province (China). Subsequently, on March 12, 2020, 125,048 cases and 4,614 deaths were reported. Coronavirus is an enveloped RNA virus, from the genus Betacoronavirus, that is distributed in birds, humans, and other mammals. WHO has named the novel coronavirus disease as COVID-19. More than 80 clinical trials have been launched to test coronavirus treatment, including some drug repurposing or repositioning for COVID-19. Hence, we performed a search in March 2020 of the clinicaltrials.gov database. The eligibility criteria for the retrieved studies were: contain a clinicaltrials.gov base identifier number; describe the number of participants and the period for the study; describe the participants' clinical conditions; and utilize interventions with medicines already studied or approved for any other disease in patients infected with the novel coronavirus SARS-CoV-2 (2019-nCoV). It is essential to emphasize that this article only captured trials listed in the clinicaltrials.gov database. We identified 24 clinical trials, involving more than 20 medicines, such as human immunoglobulin, interferons, chloroquine, hydroxychloroquine, arbidol, remdesivir, favipiravir, lopinavir, ritonavir, oseltamivir, methylprednisolone, bevacizumab, and traditional Chinese medicines (TCM). Although drug repurposing has some limitations, repositioning clinical trials may represent an attractive strategy because they facilitate the discovery of new classes of medicines; they have lower costs and take less time to reach the market; and there are existing pharmaceutical supply chains for formulation and distribution.
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Affiliation(s)
- Sandro G. Viveiros Rosa
- Universidade Federal FluminenseUniversidade Federal FluminenseBrazilUniversidade Federal Fluminense, Rio de Janeiro, Brazil.
| | - Wilson C. Santos
- Universidade Federal FluminenseUniversidade Federal FluminenseBrazilUniversidade Federal Fluminense, Rio de Janeiro, Brazil.
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3177
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Kaul D. An overview of coronaviruses including the SARS-2 coronavirus - Molecular biology, epidemiology and clinical implications. CURRENT MEDICINE RESEARCH AND PRACTICE 2020; 10:54-64. [PMID: 32363221 PMCID: PMC7194867 DOI: 10.1016/j.cmrp.2020.04.001] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 04/05/2020] [Accepted: 04/06/2020] [Indexed: 01/08/2023]
Abstract
Coronavirus infections have emerged as epidemic and pandemic threats in last two decades. After the H1N1 influenza pandemic in 2009, recently diagnosed novel betacoronavirus or severe acute respiratory syndrome coronavirus (SARS-CoV)-2 has spread across 203 countries and territories in all 5 major continents. World Health Organization (WHO) declared this as a public health emergency of international concern on January 30, 2020. Subsequently on February 11, 2020 a new name was given to this disease i.e. COVID-19 by an expert group from WHO. As of April 12, 2020, 10:00 CET, GMT+2:00, 1,696,588 confirmed cases and 105,952 confirmed deaths have been reported to the WHO. (Coronavirus disease 2019, situation report 83). It possibly originated from a small animal market in Wuhan, China. A cluster of patients were admitted with unusual pneumonia not responding to treatment in various hospitals. Epidemiological, genomic analysis and correlation with other coronaviruses led to the isolation of new coronavirus, closely resembling the bat coronaviruses, from such patients in Wuhan. They were identified as the SARS-CoV-2. This virus infection presents as influenza like illness in the affected people. Fever, cough, respiratory distress with fatigue, diarrhea, nausea and vomiting are common symptoms seen in adults. This may progress on to severe respiratory distress, hypoxia, need for oxygen supplementation and ventilator support as seen in patients in the SARS-CoV-1 epidemic (2003) in Guangdong, China. The transmissibility of SARS-CoV-1 was less as compared to SARS-CoV-2 infection, and it was well controlled with good public health efforts. The present COVID-19 epidemic is still in the acceleration phase of 3 and 4 in various countries. Without any effective antiviral agents available at present, the need of the hour is early case detection, isolation of cases, use of good preventive care measures by the household contacts and in the hospital set up. The results of ongoing clinical trials on hydroxychloroquine, azithromycin alone or in combination and a new antiviral agent remdesivir may help to treat some of the infections. A need for effective vaccine is being seen an as good preventive strategy in this pandemic. However the results of clinical trials and incorporation of vaccines in public health programs is a long way to go.
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Affiliation(s)
- Dinesh Kaul
- Pediatric Infectious Diseases, Department of Pediatrics, Sir Ganga Ram Hospital, New Delhi -110060, India
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3178
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Gautret P, Lagier JC, Parola P, Hoang VT, Meddeb L, Sevestre J, Mailhe M, Doudier B, Aubry C, Amrane S, Seng P, Hocquart M, Eldin C, Finance J, Vieira VE, Tissot-Dupont HT, Honoré S, Stein A, Million M, Colson P, La Scola B, Veit V, Jacquier A, Deharo JC, Drancourt M, Fournier PE, Rolain JM, Brouqui P, Raoult D. Clinical and microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up: A pilot observational study. Travel Med Infect Dis 2020; 34:101663. [PMID: 32289548 PMCID: PMC7151271 DOI: 10.1016/j.tmaid.2020.101663] [Citation(s) in RCA: 467] [Impact Index Per Article: 116.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 04/04/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND We need an effective treatment to cure COVID-19 patients and to decrease virus carriage duration. METHODS We conducted an uncontrolled, non-comparative, observational study in a cohort of 80 relatively mildly infected inpatients treated with a combination of hydroxychloroquine and azithromycin over a period of at least three days, with three main measurements: clinical outcome, contagiousness as assessed by PCR and culture, and length of stay in infectious disease unit (IDU). RESULTS All patients improved clinically except one 86 year-old patient who died, and one 74 year-old patient still in intensive care. A rapid fall of nasopharyngeal viral load was noted, with 83% negative at Day7, and 93% at Day8. Virus cultures from patient respiratory samples were negative in 97.5% of patients at Day5. Consequently patients were able to be rapidly discharged from IDU with a mean length of stay of five days. CONCLUSION We believe there is urgency to evaluate the effectiveness of this potentially-life saving therapeutic strategy at a larger scale, both to treat and cure patients at an early stage before irreversible severe respiratory complications take hold and to decrease duration of carriage and avoid the spread of the disease. Furthermore, the cost of treatment is negligible.
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Affiliation(s)
- Philippe Gautret
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Jean-Christophe Lagier
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France
| | - Philippe Parola
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Van Thuan Hoang
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; Thai Binh University of Medicine and Pharmacy, Thai Binh, Viet Nam
| | - Line Meddeb
- IHU-Méditerranée Infection, Marseille, France
| | | | | | | | | | | | - Piseth Seng
- IHU-Méditerranée Infection, Marseille, France
| | | | - Carole Eldin
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Julie Finance
- Assistance Publique de Marseille, Hôpital Nord, Explorations Fonctionnelles Respiratories, Aix Marseille Université, France
| | | | | | - Stéphane Honoré
- Service de Pharmacie, Hôpital Timone, AP-HM, Marseille, France; Laboratoire de Pharmacie Clinique, Aix Marseille Université, Marseille, France
| | - Andreas Stein
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France
| | - Matthieu Million
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France
| | - Philippe Colson
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France
| | - Bernard La Scola
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France
| | - Véronique Veit
- Assistance Publique de Marseille, Médecine Interne, Unité de Médecine Aigue Polyvalente (UMAP), France
| | - Alexis Jacquier
- Department of Radiology and Cardiovascular Imaging, Aix-Marseille Université, UMR 7339, CNRS, CRMBM-CEMEREM (Centre de Résonance Magnétique Biologique et Médicale-Centre d'Exploration Métaboliques par Résonance Magnétique), France
| | - Jean-Claude Deharo
- Assistance Publique de Marseille, Hôpital Timone, Cardiologie, Rythomologie, Aix Marseille Université, France
| | - Michel Drancourt
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France
| | - Pierre Edouard Fournier
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Jean-Marc Rolain
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France
| | - Philippe Brouqui
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France
| | - Didier Raoult
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France.
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3179
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Ruamviboonsuk P, Lai TYY, Chang A, Lai CC, Mieler WF, Lam DSC. Chloroquine and Hydroxychloroquine Retinal Toxicity Consideration in the Treatment of COVID-19. Asia Pac J Ophthalmol (Phila) 2020; 9:85-87. [PMID: 32349115 PMCID: PMC7227199 DOI: 10.1097/apo.0000000000000289] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 03/31/2020] [Indexed: 12/11/2022] Open
Abstract
The proposed doses of chloroquine (CQ) and hydroxychloroquine (HCQ) for treatment of COVID-19 (1000 mg/day for 10 days, CQ; 800 mg first day then 400 mg/day for 5 days, HCQ) in many guidelines worldwide, are considerably higher than the maximum recommended daily safe doses of both agents (≤2.3 mg/kg/day, CQ; ≤5.0 mg/kg/day, HCQ) for development of retinal toxicity. Irreversible retinal damage can occur if the exposure to the safe doses is >5 years. It is not known whether exposure to high doses over a short period of time can also cause the damage. We recommend that before prescribing CQ or HCQ, history of ocular disease should be obtained to avoid the prescription if appropriate. If either agent is to be used, routine baseline ocular examination is not absolutely necessary. Patients who do not have ocular disease should also be informed about the potential risk of retinal toxicity. Both agents, however, have not yet been proven to be beneficial to COVID-19.
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Affiliation(s)
- Paisan Ruamviboonsuk
- Department of Ophthalmology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
| | - Timothy Y. Y. Lai
- Deparment of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Andrew Chang
- Sydney Eye Hospital, Sydney University, Sydney, NSW, Australia
| | - Chi-Chun Lai
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - William F Mieler
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Dennis S. C. Lam
- International Eye Research Institute of the Chinese University of Hong Kong (Shenzhen), Shenzhen, China
- C-MER Dennis Lam Eye Centre, C-MER International Eye Care Group Limited, Hong Kong SAR, China
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3180
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Antiviral Therapy during the Coronavirus Disease (COVID-19) Pandemic: Is It Appropriate to Treat Patients in the Absence of Significant Evidence? Can J Hosp Pharm 2020; 73:167-170. [PMID: 32536693 PMCID: PMC7269638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
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3181
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Mahalmani VM, Mahendru D, Semwal A, Kaur S, Kaur H, Sarma P, Prakash A, Medhi B. COVID-19 pandemic: A review based on current evidence. Indian J Pharmacol 2020; 52:117-129. [PMID: 32565599 PMCID: PMC7282680 DOI: 10.4103/ijp.ijp_310_20] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 04/23/2020] [Accepted: 05/01/2020] [Indexed: 01/08/2023] Open
Abstract
In December 2019, severe acute respiratory syndrome-coronavirus-2, a novel coronavirus, initiated an outbreak of pneumonia from Wuhan in China, which rapidly spread worldwide. The clinical characteristics of the disease range from asymptomatic cases or mild symptoms, which include nonspecific symptoms such as fever, cough, sore throat, headache, and nasal congestion to severe cases such as pneumonia, respiratory failure demanding mechanical ventilation to multi-organ failure, sepsis, and death. As the transmission rate is quite alarming, we require an effective therapeutic strategy to treat symptomatic patients and adopt the preventive measures in order to contain the infection and prevent community transmission. Coronavirus disease 2019 (COVID-19) pandemic is a public health emergency of international concern, hence repurposing of the drugs is an attractive and a feasible option because PK/PD profile, toxicity profile, and drug interactions are already known. This review emphasizes on the different aspects of COVID-19 such as the epidemiology, etiopathogenesis, diagnosis, and preventive measures to be adopted in order to fight this pandemic. It also highlights upon the ethics preparedness and challenges faced by a developing country like India during such an outbreak. The review focuses on the various approaches adopted till date for developing effective therapeutic strategies including combination of drugs, vaccine therapy, and convalescent plasma therapy to combat this viral outbreak.
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Affiliation(s)
| | | | - Ankita Semwal
- Department of Pharmacology, PGIMER, Chandigarh, India
| | - Sukhmeet Kaur
- Department of Pharmacology, PGIMER, Chandigarh, India
| | | | - Phulen Sarma
- Department of Pharmacology, PGIMER, Chandigarh, India
| | - Ajay Prakash
- Department of Pharmacology, PGIMER, Chandigarh, India
| | - Bikash Medhi
- Department of Pharmacology, PGIMER, Chandigarh, India
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3182
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Menzella F, Matucci A, Vultaggio A, Barbieri C, Biava M, Scelfo C, Fontana M, Facciolongo NC. COVID-19: general overview, pharmacological options and ventilatory support strategies. Multidiscip Respir Med 2020; 15:708. [PMID: 33282284 PMCID: PMC7662457 DOI: 10.4081/mrm.2020.708] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 10/19/2020] [Indexed: 12/15/2022] Open
Abstract
The novel coronavirus called "Severe Acute Respiratory Syndrome Coronavirus 2" (SARS-CoV-2) caused an outbreak in December 2019, starting from the Chinese city of Wuhan, in the Hubei province, and rapidly spreading to the rest of the world. Consequently, the World Health Organization (WHO) declared that the coronavirus disease of 2019 (COVID-19) can be characterized as a pandemic. During COVID-19 several immunological alterations have been observed: in plasma of severe patients, inflammatory cytokines are at a much higher concentration ("cytokine storm"). These aspects are associated with pulmonary inflammation and parenchymal infiltrates with an extensive lung tissue damage in COVID-19 patients. To date, clinical evidence and guidelines based on reliable data and randomized clinical trials (RCTs) for the treatment of COVID-19 are lacking. In the absence of definitive management protocols, many treatments are currently being evaluated worldwide. Some of these options were soon abandoned due to ineffectiveness, while others showed promising results. As for ventilatory strategies, at the moment there are still no consistent data published about the different approaches and how they may influence disease progression. What will probably represent the real solution to this pandemic is the identification of a safe and effective vaccine, for which enormous efforts and investments are being put in place. This review will summarize the state-of-the-art of COVID-19 current treatment options and those potentially available in the future, as well as high flow oxygen therapy and non-invasive mechanical ventilation approaches.
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Affiliation(s)
- Francesco Menzella
- Department of Medical Specialties, Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia- IRCCS, Reggio Emilia
| | - Andrea Matucci
- Immunoallergology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence
| | | | - Chiara Barbieri
- Department of Medical Specialties, Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia- IRCCS, Reggio Emilia
| | | | - Chiara Scelfo
- Department of Medical Specialties, Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia- IRCCS, Reggio Emilia
| | - Matteo Fontana
- Department of Medical Specialties, Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia- IRCCS, Reggio Emilia
| | - Nicola Cosimo Facciolongo
- Department of Medical Specialties, Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia- IRCCS, Reggio Emilia
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3183
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Yamamoto V, Bolanos JF, Fiallos J, Strand SE, Morris K, Shahrokhinia S, Cushing TR, Hopp L, Tiwari A, Hariri R, Sokolov R, Wheeler C, Kaushik A, Elsayegh A, Eliashiv D, Hedrick R, Jafari B, Johnson JP, Khorsandi M, Gonzalez N, Balakhani G, Lahiri S, Ghavidel K, Amaya M, Kloor H, Hussain N, Huang E, Cormier J, Wesson Ashford J, Wang JC, Yaghobian S, Khorrami P, Shamloo B, Moon C, Shadi P, Kateb B. COVID-19: Review of a 21st Century Pandemic from Etiology to Neuro-psychiatric Implications. J Alzheimers Dis 2020; 77:459-504. [PMID: 32925078 PMCID: PMC7592693 DOI: 10.3233/jad-200831] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
COVID-19 is a severe infectious disease that has claimed >150,000 lives and infected millions in the United States thus far, especially the elderly population. Emerging evidence has shown the virus to cause hemorrhagic and immunologic responses, which impact all organs, including lungs, kidneys, and the brain, as well as extremities. SARS-CoV-2 also affects patients', families', and society's mental health at large. There is growing evidence of re-infection in some patients. The goal of this paper is to provide a comprehensive review of SARS-CoV-2-induced disease, its mechanism of infection, diagnostics, therapeutics, and treatment strategies, while also focusing on less attended aspects by previous studies, including nutritional support, psychological, and rehabilitation of the pandemic and its management. We performed a systematic review of >1,000 articles and included 425 references from online databases, including, PubMed, Google Scholar, and California Baptist University's library. COVID-19 patients go through acute respiratory distress syndrome, cytokine storm, acute hypercoagulable state, and autonomic dysfunction, which must be managed by a multidisciplinary team including nursing, nutrition, and rehabilitation. The elderly population and those who are suffering from Alzheimer's disease and dementia related illnesses seem to be at the higher risk. There are 28 vaccines under development, and new treatment strategies/protocols are being investigated. The future management for COVID-19 should include B-cell and T-cell immunotherapy in combination with emerging prophylaxis. The mental health and illness aspect of COVID-19 are among the most important side effects of this pandemic which requires a national plan for prevention, diagnosis and treatment.
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Affiliation(s)
- Vicky Yamamoto
- Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA
- Brain Mapping Foundation (BMF), Los Angeles, CA, USA
- USC Keck School of Medicine, The USC Caruso Department of Otolaryngology-Head and Neck Surgery, Los Angeles, CA, USA
- USC-Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Joe F. Bolanos
- Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA
- Brain Mapping Foundation (BMF), Los Angeles, CA, USA
| | - John Fiallos
- Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA
- Brain Mapping Foundation (BMF), Los Angeles, CA, USA
| | - Susanne E. Strand
- Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA
- Brain Mapping Foundation (BMF), Los Angeles, CA, USA
| | - Kevin Morris
- Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA
- Brain Mapping Foundation (BMF), Los Angeles, CA, USA
| | - Sanam Shahrokhinia
- Cedars-Sinai Medical Center, Department of Nutrition, Los Angeles, CA, USA
| | - Tim R. Cushing
- UCLA-Cedar-Sinai California Rehabilitation Institute, Los Angeles, CA, USA
| | - Lawrence Hopp
- Cedars Sinai Medical Center Department of Ophthalmology and UCLA Jules Stein Eye Institute, Los Angeles, CA, USA
| | - Ambooj Tiwari
- Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA
- New York University, Department of Neurology, New York, NY, USA
| | - Robert Hariri
- Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA
- Celularity Corporation, Warren, NJ, USA
- Weill Cornell School of Medicine, Department of Neurosurgery, New York, NY, USA
| | - Rick Sokolov
- Cedars-Sinai Medical Center, Department of Infectious Disease Los Angeles, CA, USA
| | - Christopher Wheeler
- Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA
- Brain Mapping Foundation (BMF), Los Angeles, CA, USA
- T-NeuroPharma, Albuquerque, NM, USA
| | - Ajeet Kaushik
- NanoBioTech Laboratory, Department of Natural Sciences, Division of Sciences, Arts, and Mathematics, Florida Polytechnic University, Lakeland, FL, USA
| | - Ashraf Elsayegh
- Cedars Sinai Medical Center, Department of Pulmonology, Los Angeles, CA, USA
| | - Dawn Eliashiv
- Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA
- UCLA David Geffen, School of Medicine, Department of Neurology, Los Angeles, CA, USA
| | - Rebecca Hedrick
- Cedars Sinai Medical Center, Department of Psychiatry, Los Angeles, CA, USA
| | - Behrouz Jafari
- University of California, Irvine, School of Medicine, Department of Medicine, Irvine, CA, USA
| | - J. Patrick Johnson
- Cedars Sinai Medical Center, Spine Institute, Los Angeles, CA, USA
- Cedars-Sinai Medical Center, Department of Neurosurgery, Los Angeles, CA, USA
| | - Mehran Khorsandi
- Cedars-Sinai Medical Center, Department of Cardiology, Los Angeles, CA, USA
| | - Nestor Gonzalez
- Cedars-Sinai Medical Center, Department of Neurosurgery, Los Angeles, CA, USA
| | - Guita Balakhani
- Cedars-Sinai Medical Center, Department of Nephrology, Los Angeles, CA, USA
| | - Shouri Lahiri
- Cedars-Sinai Medical Center, Department of Neurology, Los Angeles, CA, USA
| | - Kazem Ghavidel
- University of Tehran School of Medicine, Department of Cardiology, Tehran, Iran
| | - Marco Amaya
- Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA
- Brain Mapping Foundation (BMF), Los Angeles, CA, USA
| | - Harry Kloor
- Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA
| | - Namath Hussain
- Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA
- Loma Linda University, Department of Neurosurgery, Loma Linda, CA, USA
| | - Edmund Huang
- Cedars-Sinai Medical Center, Department of Nephrology, Los Angeles, CA, USA
| | - Jason Cormier
- Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA
- Lafayette Surgical Specialty Hospital, Lafayette, Louisiana, USA
| | - J. Wesson Ashford
- Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA
- Stanford University School of Medicine (Affiliated), Department of Psychiatry and Behavioral Science and Department of Veteran’s Affair, Palo Alto, CA, USA
| | - Jeffrey C. Wang
- Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA
- USC-Keck School of Medicine, Department of Orthopedic Surgery, Los Angeles, CA, USA
| | - Shadi Yaghobian
- Cedars-Sinai Medical Center, Department of Internal Medicine, Los Angeles, CA, USA
| | - Payman Khorrami
- Cedars Sinai Medical Center, Department of Gastroenterology, Los Angeles, CA, USA
| | - Bahman Shamloo
- Cedars Sinai Medical Center, Pain Management, Los Angeles, CA, USA
| | - Charles Moon
- Cedars Sinai Orthopaedic Center, Department of Orthopedics, Los Angeles, CA, USA
| | - Payam Shadi
- Cedars-Sinai Medical Center, Department of Internal Medicine, Los Angeles, CA, USA
| | - Babak Kateb
- Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA
- Brain Mapping Foundation (BMF), Los Angeles, CA, USA
- Loma Linda University, Department of Neurosurgery, Loma Linda, CA, USA
- National Center for NanoBioElectronic (NCNBE), Los Angeles, CA, USA
- Brain Technology and Innovation Park, Los Angeles, CA, USA
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3184
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3185
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Das S, Bhowmick S, Tiwari S, Sen S. An Updated Systematic Review of the Therapeutic Role of Hydroxychloroquine in Coronavirus Disease-19 (COVID-19). Clin Drug Investig 2020; 40:591-601. [PMID: 32468425 PMCID: PMC7255448 DOI: 10.1007/s40261-020-00927-1] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND OBJECTIVE The world is currently experiencing the Coronavirus Disease-19 (COVID-19) pandemic. There is no approved drug for the definitive treatment of the disease. Various drugs are being tried for the treatment of COVID-19, including hydroxychloroquine (HCQ). This study was performed to systematically review the therapeutic role of HCQ in COVID-19 from the available literature. METHODS PubMed, Embase, ClinicalTrials.gov, ICTRP (WHO), Cochrane Library databases, and two pre-print servers (medRxiv.org and Research Square) were searched for clinical studies that evaluated the therapeutic role of HCQ on COVID-19 until 10 May 2020. The available studies were critically analyzed and the data were extracted. RESULTS A total of 663 articles were screened and 12 clinical studies (seven peer-reviewed and published studies and five non-peer-reviewed studies from pre-print servers) with a total sample size of 3543 patients were included. Some of the clinical studies demonstrated good virological and clinical outcomes with HCQ alone or in combination with azithromycin in COVID-19 patients, although the studies had major methodological limitations. Some of the other studies showed negative results with HCQ therapy along with the risk of adverse reactions. CONCLUSION The results of efficacy and safety of HCQ in COVID-19, as obtained from the clinical studies, are not satisfactory, although many of these studies had major methodological limitations. Stronger evidence from well-designed robust randomized clinical trials is required before conclusively determining the role of HCQ in the treatment of COVID-19. Clinical prudence is required in advocating HCQ as a therapeutic armamentarium in COVID-19.
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Affiliation(s)
- Saibal Das
- grid.414953.e0000000417678301Department of Clinical Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, 605 006 India
| | - Subhrojyoti Bhowmick
- grid.415509.c0000 0004 1763 8190Department of Pharmacology, KPC Medical College and Hospital, Kolkata, 700 032 India
| | - Sayali Tiwari
- grid.415652.10000 0004 1767 1265Department of Community Medicine, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, 400 022 India
| | - Sukanta Sen
- grid.464903.cDepartment of Pharmacology, ICARE Institute of Medical Sciences and Research, Haldia, 721 645 India
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3186
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Micro and nanoscale technologies in oral drug delivery. Adv Drug Deliv Rev 2020; 157:37-62. [PMID: 32707147 PMCID: PMC7374157 DOI: 10.1016/j.addr.2020.07.012] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/13/2020] [Accepted: 07/17/2020] [Indexed: 12/25/2022]
Abstract
Oral administration is a pillar of the pharmaceutical industry and yet it remains challenging to administer hydrophilic therapeutics by the oral route. Smart and controlled oral drug delivery could bypass the physiological barriers that limit the oral delivery of these therapeutics. Micro- and nanoscale technologies, with an unprecedented ability to create, control, and measure micro- or nanoenvironments, have found tremendous applications in biology and medicine. In particular, significant advances have been made in using these technologies for oral drug delivery. In this review, we briefly describe biological barriers to oral drug delivery and micro and nanoscale fabrication technologies. Micro and nanoscale drug carriers fabricated using these technologies, including bioadhesives, microparticles, micropatches, and nanoparticles, are described. Other applications of micro and nanoscale technologies are discussed, including fabrication of devices and tissue engineering models to precisely control or assess oral drug delivery in vivo and in vitro, respectively. Strategies to advance translation of micro and nanotechnologies into clinical trials for oral drug delivery are mentioned. Finally, challenges and future prospects on further integration of micro and nanoscale technologies with oral drug delivery systems are highlighted.
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3187
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Fernández Colomer B, Sánchez-Luna M, de Alba Romero C, Alarcón A, Baña Souto A, Camba Longueira F, Cernada M, Galve Pradell Z, González López M, López Herrera MC, Ribes Bautista C, Sánchez García L, Zamora Flores E, Pellicer A, Alonso Díaz C, Herraiz Perea C, Romero Ramírez DS, de Las Cuevas Terán I, Pescador Chamorro I, Fernández Trisac JL, Arruza Gómez L, Cardo Fernández LM, García García MJ, Nicolás López M, Hortelano López M, Riaza Gómez M, Hernández González N, González Sánchez R, Zambudio Sert S, Larrosa Capacés S, Matías Del Pozo V. Neonatal Infection Due to SARS-CoV-2: An Epidemiological Study in Spain. Front Pediatr 2020; 8:580584. [PMID: 33194912 PMCID: PMC7644848 DOI: 10.3389/fped.2020.580584] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 09/09/2020] [Indexed: 12/18/2022] Open
Abstract
Objective: Coronavirus disease 2019 (COVID-19) cases caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continue to increase worldwide. Although some data from pediatric series are available, more evidence is required, especially in neonates, a group with specific characteristics that deserve special attention. This study aimed to describe general and clinical characteristics, management, and treatment of postnatal-acquired (community and nosocomial/hospital-acquired) COVID-19 neonatal cases in Spain. Methods: This was a national prospective epidemiological study that included cases from a National Registry supported by the Spanish Society of Neonatology. Neonates with postnatal SARS-CoV-2 infection were included in this study. General data and infection-related information (mode and source of transmission, age at diagnosis, clinical manifestations, need for hospitalization, admission unit, treatment administered, and complementary studies performed, hospital stay associated with the infection) were collected. Results: A total of 40 cases, 26 community-acquired and 14 nosocomial were registered. Ten were preterm newborns (2 community-acquired and 8 nosocomial COVID-19 cases). Mothers (in both groups) and healthcare workers (in nosocomial cases) were the main source of infection. Hospital admission was required in 22 community-acquired cases [18 admitted to the neonatal intermediate care unit (NIMCU) and 4 to the neonatal intensive care unit (NICU)]. Among nosocomial COVID-19 cases (n = 14), previously admitted for other reasons, 4 were admitted to the NIMCU and 10 to the NICU. Ten asymptomatic patients were registered (5 in each group). In the remaining cases, clinical manifestations were generally mild in both groups, including upper respiratory airways infection, febrile syndrome or acute gastroenteritis with good overall health. In both groups, most severe cases occurred in preterm neonates or neonates with concomitant pathologies. Most of the cases did not require respiratory support. Hydroxychloroquine was administered to 4 patients in the community-acquired group and to 2 patients in the nosocomial group. Follow-up after hospital discharge was performed in most patients. Conclusions: This is the largest series of COVID-19 neonatal cases in Spain published to date. Although clinical manifestations were generally mild, prevention, treatment, and management in this group are essential.
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Affiliation(s)
| | - Manuel Sánchez-Luna
- Neonatology Department, Complutense University, Madrid, Spain.,Division of Neonatology, Gregorio Marañón University Hospital, Madrid, Spain
| | | | - Ana Alarcón
- Department of Neonatology, Sant Joan de Déu University Hospital, Barcelona, Spain
| | - Ana Baña Souto
- Department of Neonatology, Clinical Hospital de Santiago, Santiago de Compostela, Spain
| | | | - María Cernada
- Division of Neonatology, La Fe University and Polytechnic Hospital, Valencia, Spain
| | | | - María González López
- Department of Neonatology, Regional de Málaga University Hospital, Málaga, Spain
| | | | | | | | - Elena Zamora Flores
- Division of Neonatology, Gregorio Marañón University Hospital, Madrid, Spain
| | - Adelina Pellicer
- Department of Neonatology, La Paz University Hospital, Madrid, Spain
| | - Clara Alonso Díaz
- Department of Neonatology, 12 de Octubre University Hospital, Madrid, Spain
| | | | | | | | | | | | - Luis Arruza Gómez
- Department of Neonatology, Clinical Hospital San Carlos, Madrid, Spain
| | | | | | - Marta Nicolás López
- Department of Neonatology, Germans Trias i Pujol University Hospital, Badalona, Spain
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3188
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Haseeb S, Gul EE, Çinier G, Bazoukis G, Alvarez-Garcia J, Garcia-Zamora S, Lee S, Yeung C, Liu T, Tse G, Baranchuk A. Value of electrocardiography in coronavirus disease 2019 (COVID-19). J Electrocardiol 2020; 62:39-45. [PMID: 32805546 PMCID: PMC7409871 DOI: 10.1016/j.jelectrocard.2020.08.007] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 08/02/2020] [Accepted: 08/04/2020] [Indexed: 01/08/2023]
Abstract
In December 2019, reports of an unknown pneumonia not responsive to traditional treatments arose in Wuhan, China. The pathogen was subsequently identified as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), known to be responsible for the coronavirus disease-2019 (COVID-19) illness, and public health emergency of international concern was declared by the World Health Organization. There is increasing awareness of the cardiovascular manifestations of COVID-19 disease, and the adverse impact of cardiovascular involvement on its prognosis. In this setting, the electrocardiogram (ECG) is one of the leading tools to assess the extent of cardiac involvement in COVID-19 patients, due to its wide disponibility, low cost, and the possibility of remote evaluation. In this article, we review the role of the ECG in the identification of cardiac involvement in COVID-19, highlighting relevant clinical implications.
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Affiliation(s)
- Sohaib Haseeb
- College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - Enes Elvin Gul
- Division of Cardiac Electrophysiology, Madinah Cardiac Centre, Madinah, Saudi Arabia
| | - Göksel Çinier
- Department of Cardiology, Dr Siyami Ersek Hospital Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - George Bazoukis
- Second Department of Cardiology, Evangelismos General Hospital of Athens, Athens, Greece
| | - Jesus Alvarez-Garcia
- Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, New York, USA,Cardiology Department, Hospital de la Santa Creu i Sant Pau, CIBERCV, Barcelona, Spain
| | - Sebastian Garcia-Zamora
- South American Center of Excellence for Cardiovascular Health (CESCAS), Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina
| | - Sharen Lee
- Laboratory of Cardiovascular Physiology, Chinese University Shenzhen Research Institute, PR China
| | - Cynthia Yeung
- Heart Rhythm Service, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada
| | - Tong Liu
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, PR China
| | - Gary Tse
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, PR China.
| | - Adrian Baranchuk
- Heart Rhythm Service, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada.
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3189
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Alessi J, de Oliveira GB, Schaan BD, Telo GH. Dexamethasone in the era of COVID-19: friend or foe? An essay on the effects of dexamethasone and the potential risks of its inadvertent use in patients with diabetes. Diabetol Metab Syndr 2020; 12:80. [PMID: 32922517 PMCID: PMC7476640 DOI: 10.1186/s13098-020-00583-7] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 08/18/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The disclosure in the media of a benefit with the use of dexamethasone in patients with COVID-19 infection sets precedents for self-medication and inappropriate use of corticosteroids. METHODS This is a critical interpretive synthesis of the data available in the literature on the effects of the use of corticosteroids and the impact that their indiscriminate use may have on patients with diabetes. Reviews and observational and experimental studies published until June 18, 2020 were selected. RESULTS Corticosteroids are substances derived from cholesterol metabolism that interfere with multiple aspects of glucose homeostasis. Interactions between corticoid receptors and target genes seem to be among the mechanisms responsible for the critical functions of glucocorticoids for survival and anti-inflammatory effects observed with these medications. Corticosteroids increase hepatic gluconeogenesis, reduce peripheral use of glucose and increase insulin levels. Previous studies have shown that glucocorticoids have a pro-adipogenic function, increasing deposition of abdominal fat, and lead to glucose intolerance and hypertriglyceridemia. In addition, these drugs play a role in controlling liver metabolism and can lead to the development of hepatic steatosis. Glucocorticoids reduce the recruitment of osteoblasts and increase the number of osteoclasts, which results in increased bone resorption and greater bone fragility. Moreover, these medications cause water and sodium retention and increase the response to circulating vasoconstrictors, which results in increased blood pressure levels. Chronic or high-dose use of corticosteroids can, by itself, lead to the onset of diabetes. For those who were already diagnosed with diabetes, studies show that chronic use of corticosteroids leads to a 94% higher risk of hospitalization due to diabetes complications. In addition to the direct effects on glycemic control, the effects on arterial pressure control, lipids and bone metabolism also have a potential for severe consequences in patients with diabetes. CONCLUSION Fear and uncertainty toward a potentially serious infection may lead people to self-medication and the inappropriate and abusive use of corticosteroids. More than ever, it is necessary for health professionals to be alert and able to predict damages related to the use of these drugs, which is the first step to minimize the potential damages to come.
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Affiliation(s)
- Janine Alessi
- Medical Science Program: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Internal Medicine Department, Hospital São Lucas-Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
- Endocrinology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Giovana B. de Oliveira
- School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Beatriz D. Schaan
- Medical Science Program: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Endocrinology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- National Institute of Science and Technology for Health Technology Assessment (IATS), CNPq, Porto Alegre, Brazil
| | - Gabriela H. Telo
- Internal Medicine Department, Hospital São Lucas-Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
- School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
- National Institute of Science and Technology for Health Technology Assessment (IATS), CNPq, Porto Alegre, Brazil
- Medicine and Health Sciences Program, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
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3190
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Rathore V, Galhotra A, Pal R, Sahu KK. COVID-19 Pandemic and Children: A Review. J Pediatr Pharmacol Ther 2020; 25:574-585. [PMID: 33041712 PMCID: PMC7541032 DOI: 10.5863/1551-6776-25.7.574] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2020] [Indexed: 12/15/2022]
Abstract
The severe respiratory disease COVID-19 (coronavirus disease 2019) was first reported in late December 2019 in Wuhan City, China. Soon thereafter, the World Health Organization (WHO) officially declared it a pandemic. The adult population is highly affected by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2); however, infants and children are also not spared. Transmission in the pediatric population appears to be primarily from COVID-19-positive adults, largely from family contacts through droplets, direct contacts, and aerosols. There is also evidence of fecal-oral route of transmission. The incubation period of COVID-19 in children ranges from 2 to 10 days. Most children are asymptomatic. The most common symptoms amongst symptomatic children are fever and cough. Shortness of breath, sore throat, rhinorrhea, conjunctivitis, fatigue, and headache are other common symptoms. Diarrhea, vomiting, and abdominal pain are the common gastrointestinal symptoms that may be present with or without respiratory symptoms. Very few children are likely to develop severe disease.Supportive care is the mainstay of treatment. Though data are limited, antiviral therapies such as remdesivir, favipiravir, lopinavir/ritonavir, and other drugs like hydroxychloroquine/chloroquine have been used for severe COVID-19 cases, with remdesivir showing the greatest promise. A few children may develop an exaggerated immune response, characterized by exaggerated cytokine release and manifests with features similar to Kawasaki disease. The syndrome has been referred to by many names including pediatric inflammatory multisystem syndrome (PIMS) and more recently, as multisystem inflammatory syndrome in children (MIS-C); this life-threatening condition often requires a multidisciplinary team effort and use of immunomodulators.
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3191
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Gbinigie K, Frie K. Should chloroquine and hydroxychloroquine be used to treat COVID-19? A rapid review. BJGP Open 2020. [PMID: 32265182 DOI: 10.14322/publons.r7750240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND On the 11 March 2020, the World Health Organization (WHO) declared that COVID-19 was a pandemic. To date, there are no medical treatments for COVID-19 with proven effectiveness. Novel treatments and/or vaccines will take time to be developed and distributed to patients. In light of this, there has been growing interest in the use of existing medications, such as chloroquine (CQ) and hydroxychloroquine (HCQ), as potential treatments of this disease. AIM To establish the current evidence for the effectiveness of CQ and HCQ in treating COVID-19. DESIGN & SETTING A rapid review of the literature was conducted. METHOD Electronic searches in PubMed and Google Scholar were conducted on 21 March 2020. A further search was conducted in Google for relevant literature on 28 March 2020. RESULTS There is limited evidence of in vitro activity of CQ/HCQ against SARS-CoV-2. A number of in vivo clinical trials are underway. The empirical data available from two of these trials reveal conflicting results. Both trials are characterised by small numbers of participants (n = 30 and n = 36) and suffer methodological limitations. No medium or long-term follow-up data is available. CONCLUSION At present, there is insufficient evidence to determine whether CQ/HCQ are safe and effective treatments for COVID-19. High quality, adequately powered randomised clinical trials in primary and secondary care settings are urgently required to guide policymakers and clinicians. These studies should report medium- and long-term follow-up results, and safety data.
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Affiliation(s)
- Kome Gbinigie
- GP and Doctoral Researcher, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Kerstin Frie
- Post-Doctoral Researcher, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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3192
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Chaturvedi P, Qayyumi B, Sharin F, Singh A, Tuljapurkar V. Management of COVID-19: A brief overview of the various treatment strategies. CANCER RESEARCH, STATISTICS, AND TREATMENT 2020. [DOI: 10.4103/crst.crst_187_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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3193
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Bhadada S, Pal R, Banerjee M, Kumar A. Glycemic efficacy and safety of hydroxychloroquine in type 2 diabetes mellitus: A systematic review and meta.analysis of relevance amid the COVID-19 pandemic. INTERNATIONAL JOURNAL OF NONCOMMUNICABLE DISEASES 2020. [DOI: 10.4103/jncd.jncd_69_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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3194
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Sreepadmanabh M, Sahu AK, Chande A. COVID-19: Advances in diagnostic tools, treatment strategies, and vaccine development. J Biosci 2020; 45:148. [PMID: 33410425 PMCID: PMC7683586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 10/15/2020] [Indexed: 09/18/2023]
Abstract
An unprecedented worldwide spread of the SARS-CoV-2 has imposed severe challenges on healthcare facilities and medical infrastructure. The global research community faces urgent calls for the development of rapid diagnostic tools, effective treatment protocols, and most importantly, vaccines against the pathogen. Pooling together expertise across broad domains to innovate effective solutions is the need of the hour. With these requirements in mind, in this review, we provide detailed critical accounts on the leading efforts at developing diagnostics tools, therapeutic agents, and vaccine candidates. Importantly, we furnish the reader with a multidisciplinary perspective on how conventional methods like serology and RT-PCR, as well as cutting-edge technologies like CRISPR/Cas and artificial intelligence/machine learning, are being employed to inform and guide such investigations. We expect this narrative to serve a broad audience of both active and aspiring researchers in the field of biomedical sciences and engineering and help inspire radical new approaches towards effective detection, treatment, and prevention of this global pandemic.
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Affiliation(s)
- M Sreepadmanabh
- Molecular Virology Laboratory, Indian Institute of Science Education and Research, Bhopal, India
| | - Amit Kumar Sahu
- Molecular Virology Laboratory, Indian Institute of Science Education and Research, Bhopal, India
| | - Ajit Chande
- Molecular Virology Laboratory, Indian Institute of Science Education and Research, Bhopal, India
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3195
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Gul MH, Htun ZM, Shaukat N, Imran M, Khan A. Potential specific therapies in COVID-19. Ther Adv Respir Dis 2020; 14:1753466620926853. [PMID: 32436445 PMCID: PMC7243039 DOI: 10.1177/1753466620926853] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 04/20/2020] [Indexed: 12/19/2022] Open
Abstract
COVID-19 has grown into a global pandemic that has strained healthcare throughout the world. There is a sense of urgency in finding a cure for this deadly virus. In this study, we reviewed the empiric options used in common practice for COVID-19, based on the literature available online, with an emphasis on human experiences with these treatments on severe acute respiratory syndrome-associated coronavirus (SARS-COV-1) and other viruses. Convalescent blood products are the most promising potential treatment for use in COVID-19. The use of chloroquine or hydroxychloroquine (HCQ), remdesivir, and tocilizumab are some of the other promising potential therapies; however, they are yet to be tested in randomized clinical trials (RCTs). The use of lopinavir-ritonavir did not prove beneficial in a large RCT. The use of corticosteroids should be avoided in COVID-19 pneumonia unless used for other indications, based on the suggestion of harm in patients with SARS-COV-1 and Middle Eastern Respiratory Syndrome (MERS) infection. The reviews of this paper are available via the supplemental material section.
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Affiliation(s)
- Muhammad Hamdan Gul
- Internal Medicine Department, Amita-Presence Saint Joseph Hospital, Chicago, 2900 N Lakeshore Drive, Chicago, IL 60657, USA
| | - Zin Mar Htun
- Internal Medicine Department, Louis A Weiss Memorial Hospital, Chicago, IL, USA
| | - Nauman Shaukat
- Cardiothoracic Surgery, Saint George’s University Hospital, Tooting, London, UK
| | - Muhammad Imran
- Cardiothoracic Surgery, Armed Forces Institute, Rawalpindi, Pakistan
| | - Ahmad Khan
- Internal Medicine Department, West Virginia University- Charleston Division, WV, USA
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3196
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Lauretani F, Ravazzoni G, Roberti MF, Longobucco Y, Adorni E, Grossi M, De Iorio A, La Porta U, Fazio C, Gallini E, Federici R, Salvi M, Ciarrocchi E, Rossi F, Bergamin M, Bussolati G, Grieco I, Broccoli F, Zucchini I, Ielo G, Morganti S, Artoni A, Arisi A, Tagliaferri S, Maggio M. Assessment and treatment of older individuals with COVID 19 multi-system disease: Clinical and ethical implications. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:150-168. [PMID: 32420939 PMCID: PMC7569659 DOI: 10.23750/abm.v91i2.9629] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 04/28/2020] [Indexed: 01/07/2023]
Abstract
Covid-19 infection is a multisystem disease more frequent in older individuals, especially in those with multiple chronic diseases. This multimorbid and frail population requires attention and a personalized comprehensive assessment in order to avoid the occurrence of adverse outcomes. As other diseases, the COVID-19 presentation in older patients is often atypical with less severe and unspecific symptoms. These subjects both at home and during hospitalization suffer isolation and the lack of support of caregivers. The geriatric care in COVID-19 wards is often missing. The application of additional instruments would be necessary to facilitate and personalize the clinical approach, not only based on diseases but also on functional status. This narrative review starts from diagnostic evaluation, continues with adapted pharmacologic treatment and ends with the recovery phase targeting the nutrition and physical exercise. We developed a check-list of respiratory, gastro-intestinal and other less-specific symptoms, summarized in a table and easily to be filled-up by patients, nurses and general practitioners. As second step, we reported the clinical phases of this disease. Far to be considered just viral infective and respiratory, this disease is also an inflammatory and thrombotic condition with frequent bacterial over-infection. We finally considered timing and selection of treatment, which depend on the disease phase, co-administration of other drugs and require the monitoring of renal, liver and cardiac function. This underlines the role of age not just as a limitation, but also an opportunity to increase the quality and the appropriateness of multidisciplinary and multidimensional intervention in this population.
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Affiliation(s)
- Fulvio Lauretani
- Geriatric Clinic Unit, Parma University Hospital of Parma, Italy, Postgraduate School of Geriatric Medicine, Department of Medicine and Surgery, University of Parma, Italy
| | - Giulia Ravazzoni
- Geriatric Clinic Unit, Parma University Hospital of Parma, Italy, Postgraduate School of Geriatric Medicine, Department of Medicine and Surgery, University of Parma, Italy
| | - Maria Federica Roberti
- Geriatric Clinic Unit, Parma University Hospital of Parma, Italy, Postgraduate School of Geriatric Medicine, Department of Medicine and Surgery, University of Parma, Italy
| | - Yari Longobucco
- SPRINTT Team, Department of Medicine and Surgery, University of Parma, Italy
| | - Elisa Adorni
- SPRINTT Team, Department of Medicine and Surgery, University of Parma, Italy
| | - Margherita Grossi
- Geriatric Clinic Unit, Parma University Hospital of Parma, Italy, Postgraduate School of Geriatric Medicine, Department of Medicine and Surgery, University of Parma, Italy
| | - Aurelio De Iorio
- Geriatric Clinic Unit, Parma University Hospital of Parma, Italy, Postgraduate School of Geriatric Medicine, Department of Medicine and Surgery, University of Parma, Italy
| | - Umberto La Porta
- Geriatric Clinic Unit, Parma University Hospital of Parma, Italy, Postgraduate School of Geriatric Medicine, Department of Medicine and Surgery, University of Parma, Italy
| | - Chiara Fazio
- Geriatric Clinic Unit, Parma University Hospital of Parma, Italy, Postgraduate School of Geriatric Medicine, Department of Medicine and Surgery, University of Parma, Italy
| | - Elena Gallini
- Geriatric Clinic Unit, Parma University Hospital of Parma, Italy, Postgraduate School of Geriatric Medicine, Department of Medicine and Surgery, University of Parma, Italy
| | - Raffaele Federici
- Geriatric Clinic Unit, Parma University Hospital of Parma, Italy, Postgraduate School of Geriatric Medicine, Department of Medicine and Surgery, University of Parma, Italy
| | - Marco Salvi
- Geriatric Clinic Unit, Parma University Hospital of Parma, Italy, Postgraduate School of Geriatric Medicine, Department of Medicine and Surgery, University of Parma, Italy
| | - Erika Ciarrocchi
- Geriatric Clinic Unit, Parma University Hospital of Parma, Italy, Postgraduate School of Geriatric Medicine, Department of Medicine and Surgery, University of Parma, Italy
| | - Francesca Rossi
- Geriatric Clinic Unit, Parma University Hospital of Parma, Italy, Postgraduate School of Geriatric Medicine, Department of Medicine and Surgery, University of Parma, Italy
| | - Marina Bergamin
- Geriatric Clinic Unit, Parma University Hospital of Parma, Italy, Postgraduate School of Geriatric Medicine, Department of Medicine and Surgery, University of Parma, Italy
| | - Giacomo Bussolati
- Geriatric Clinic Unit, Parma University Hospital of Parma, Italy, Postgraduate School of Geriatric Medicine, Department of Medicine and Surgery, University of Parma, Italy
| | - Ilaria Grieco
- Geriatric Clinic Unit, Parma University Hospital of Parma, Italy, Postgraduate School of Geriatric Medicine, Department of Medicine and Surgery, University of Parma, Italy
| | - Federica Broccoli
- Geriatric Clinic Unit, Parma University Hospital of Parma, Italy, Postgraduate School of Geriatric Medicine, Department of Medicine and Surgery, University of Parma, Italy
| | - Irene Zucchini
- Geriatric Clinic Unit, Parma University Hospital of Parma, Italy, Postgraduate School of Geriatric Medicine, Department of Medicine and Surgery, University of Parma, Italy
| | - Giuseppe Ielo
- Geriatric Clinic Unit, Parma University Hospital of Parma, Italy, Postgraduate School of Geriatric Medicine, Department of Medicine and Surgery, University of Parma, Italy
| | | | - Andrea Artoni
- Geriatric Clinic Unit, Parma University Hospital of Parma, Italy
| | - Arianna Arisi
- Postgraduate School of Geriatric Medicine, Department of Medicine and Surgery, University of Parma, Italy
| | - Sara Tagliaferri
- SPRINTT Team, Department of Medicine and Surgery, University of Parma, Italy
| | - Marcello Maggio
- Geriatric Clinic Unit, Parma University Hospital of Parma, Italy, Postgraduate School of Geriatric Medicine, Department of Medicine and Surgery, University of Parma, Italy
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3197
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Ray D, Salvatore M, Bhattacharyya R, Wang L, Du J, Mohammed S, Purkayastha S, Halder A, Rix A, Barker D, Kleinsasser M, Zhou Y, Bose D, Song P, Banerjee M, Baladandayuthapani V, Ghosh P, Mukherjee B. Predictions, role of interventions and effects of a historic national lockdown in India's response to the COVID-19 pandemic: data science call to arms. HARVARD DATA SCIENCE REVIEW 2020; 2020. [PMID: 32607504 DOI: 10.1101/2020.04.15.20067256] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023] Open
Abstract
With only 536 cases and 11 fatalities, India took the historic decision of a 21-day national lockdown on March 25. The lockdown was first extended to May 3 soon after the analysis of this paper was completed, and then to May 18 while this paper was being revised. In this paper, we use a Bayesian extension of the Susceptible-Infected-Removed (eSIR) model designed for intervention forecasting to study the short- and long-term impact of an initial 21-day lockdown on the total number of COVID-19 infections in India compared to other less severe non-pharmaceutical interventions. We compare effects of hypothetical durations of lockdown on reducing the number of active and new infections. We find that the lockdown, if implemented correctly, can reduce the total number of cases in the short term, and buy India invaluable time to prepare its healthcare and disease-monitoring system. Our analysis shows we need to have some measures of suppression in place after the lockdown for increased benefit (as measured by reduction in the number of cases). A longer lockdown between 42-56 days is preferable to substantially "flatten the curve" when compared to 21-28 days of lockdown. Our models focus solely on projecting the number of COVID-19 infections and, thus, inform policymakers about one aspect of this multi-faceted decision-making problem. We conclude with a discussion on the pivotal role of increased testing, reliable and transparent data, proper uncertainty quantification, accurate interpretation of forecasting models, reproducible data science methods and tools that can enable data-driven policymaking during a pandemic. Our software products are available at covind19.org.
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Affiliation(s)
- Debashree Ray
- Department of Epidemiology, Johns Hopkins University
- Department of Biostatistics, Johns Hopkins University
| | - Maxwell Salvatore
- Department of Biostatistics, University of Michigan
- Center for Precision Health Data Science, University of Michigan
| | | | - Lili Wang
- Department of Biostatistics, University of Michigan
| | - Jiacong Du
- Department of Biostatistics, University of Michigan
- Center for Precision Health Data Science, University of Michigan
| | - Shariq Mohammed
- Department of Biostatistics, University of Michigan
- Department of Computational Medicine and Bioinformatics, University of Michigan
| | | | | | - Alexander Rix
- Department of Biostatistics, University of Michigan
- Center for Precision Health Data Science, University of Michigan
| | | | | | - Yiwang Zhou
- Department of Biostatistics, University of Michigan
| | - Debraj Bose
- Department of Biostatistics, University of Michigan
| | - Peter Song
- Department of Biostatistics, University of Michigan
| | - Mousumi Banerjee
- Department of Biostatistics, University of Michigan
- Institute for Healthcare Policy and Innovation, University of Michigan
| | | | | | - Bhramar Mukherjee
- Department of Biostatistics, University of Michigan
- Center for Precision Health Data Science, University of Michigan
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3198
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Abstract
As of September 9, 2020, Worldwide coronavirus disease 2019 (COVID-19) has caused 894 000 deaths with over 27.5 million confirmed cases. There is an urgent need for effective treatment. Considerable efforts have been placed on developing novel therapeutics, including antivirals and vaccines. Current management of COVID-19 is supportive, with several experimental drugs. Respiratory failure from acute respiratory distress syndrome overshadowed by severe cytokine storm appears to be the leading cause of mortality. This article has reviewed several unique case studies published from December 2019 through July 31, 2020 with the above perspectives.
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3199
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García-Howard M, Herranz-Aguirre M, Moreno-Galarraga L, Urretavizcaya-Martínez M, Alegría-Echauri J, Gorría-Redondo N, Planas-Serra L, Schlüter A, Gut M, Pujol A, Aguilera-Albesa S. Case Report: Benign Infantile Seizures Temporally Associated With COVID-19. Front Pediatr 2020; 8:507. [PMID: 32850563 PMCID: PMC7423871 DOI: 10.3389/fped.2020.00507] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 07/17/2020] [Indexed: 12/18/2022] Open
Abstract
Background: Non-febrile illness seizures may present in previously healthy children as afebrile seizures associated with minor infections, such as mild gastroenteritis or respiratory tract infections, and are linked to a genetic predisposition. For the novel human coronavirus SARS-CoV-2, causing COVID-19, fever, cough, and gastrointestinal complaints are the most common symptoms in children, and a hyperimmune response may be present. No detailed temporally associated neurological complications have been documented in pediatric case series so far. Case description: We present the case of a 3-months-old girl with non-febrile repeated seizures in a COVID-19 family setting. The infant started with a mild fever and cough that lasted for 2 days. At day 6 from onset, the girl presented with two focal motor seizures with impaired consciousness and awareness. All investigations ruled out signs of meningo-encephalitis or active epilepsy, including normal electroencephalogram and cerebral magnetic resonance imaging. PCR from nasal and throat swabs was positive for SARS-CoV-2. Remarkably, blood ferritin and D-dimer levels were increased. At day 9, the infant presented another afebrile motor seizure, and levetiracetam dose was modified there was a favorable response within 3 months of the follow-up. Much interest has been raised with regards to host genetic determinants to disease severity and susceptibility to COVID-19. We thus performed whole exome sequencing, revealing a pathogenic frameshift mutation in the PRRT2 gene in both the mother and the infant. The mother had presented two late infantile febrile convulsions with normal outcome afterwards. Discussion: The hyperimmune response described in adult cases with COVID-19 can be seen in infants, even in the absence of respiratory symptoms. Moreover, COVID-19 may present in infants as non-febrile seizures, triggering early onset seizures in infants with a genetic predisposition. In this pandemic situation, precision medicine using massive sequencing can shed light on underlying molecular mechanisms driving the host response to COVID-19.
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Affiliation(s)
| | - Mercedes Herranz-Aguirre
- Pediatric Infectious Disease Unit, Department of Pediatrics, CHN, Navarra Health Service Hospital, Pamplona, Spain
| | - Laura Moreno-Galarraga
- NavarraBioMed and IdiSNA, Health Research Institute, Pamplona, Spain.,Pediatric Respiratory Medicine, Department of Pediatrics, CHN, Navarra Health Service Hospital, Pamplona, Spain
| | | | | | - Nerea Gorría-Redondo
- Pediatric Neurology Unit, Department of Pediatrics, CHN, Navarra Health Service Hospital, Pamplona, Spain
| | - Laura Planas-Serra
- Neurometabolic Diseases Laboratory, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.,Center for Biomedical Research on Rare Diseases (CIBERER), ISCIII, Madrid, Spain
| | - Agatha Schlüter
- Neurometabolic Diseases Laboratory, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.,Center for Biomedical Research on Rare Diseases (CIBERER), ISCIII, Madrid, Spain
| | - Marta Gut
- CNAG-CRG, Centre for Genomic Regulation, Barcelona Institute of Science and Technology, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Aurora Pujol
- Neurometabolic Diseases Laboratory, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.,Center for Biomedical Research on Rare Diseases (CIBERER), ISCIII, Madrid, Spain.,Catalan Institution of Research and Advanced Studies (ICREA), Barcelona, Spain
| | - Sergio Aguilera-Albesa
- NavarraBioMed and IdiSNA, Health Research Institute, Pamplona, Spain.,Pediatric Neurology Unit, Department of Pediatrics, CHN, Navarra Health Service Hospital, Pamplona, Spain
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3200
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Berkman SA, Tapson VF. Methodological Issues and Controversies in COVID-19 Coagulopathy: A Tale of Two Storms. Clin Appl Thromb Hemost 2020; 26:1076029620945398. [PMID: 32883088 PMCID: PMC7488609 DOI: 10.1177/1076029620945398] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Venous thromboembolism, occlusion of dialysis catheters, circuit thrombosis in ECMO devices, all in the face of prophylactic and sometimes even therapeutic anti-coagulation, are frequent features of COVID-19 coagulopathy. The trials available to guide clinicians are methodologically limited. There are several unresolved controversies including 1) Should all hospitalized patients with COVID-19 receive prophylactic anti-coagulation? 2) Which patients should have their dosage escalated to intermediate dose? 3) Which patients should be considered for full-dose anti-coagulation even without a measurable thromboembolic event and how should that anti-coagulation be monitored? 4) Should patients receive post-discharge anti-coagulation? 5) What thrombotic issues are related to the various medications being used to treat this coagulopathy? 6) Is anti-phospholipid anti-body part of this syndrome? 7) How do the different treatments for this disease impact the coagulation issues? The aims of this article are to explore these questions and interpret the available data based on the current evidence.
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