COVID-19 Drug Treatment in China

Factors Influencing the Use and Demand of New Coronavirus Therapy Drugs Among the Adults During COVID-19 in China

Background

This alteration in the policy of COVID-19 resulted in widespread infections throughout China. Most people only need some antiviral drugs such as lopinavir/ritonavir or Chinese herbal preparations for treatment. In this context, the lack of drug knowledge and inadequate drug availability are evident. This study aims to explore the factors influencing drug use and demand during the COVID-19 epidemic.

Methods

This study used quota sampling based on gender, age, and place of residence to perform a cross-sectional survey on a sample of 771 adults. The researchers used chi-square tests to understand differences in drug use and demand across characteristics, and binary logistic regression to analyse the influencing factors.

Results

The study revealed that 85.9% of the participants used drugs following the COVID-19 infection. Participants with college and above, (OR=2.49, 95% CI=1.27-4.88) annual personal income between 30,000 and 80,000CNY (OR=2.19, 95% CI=1.35-3.55) and over 80,000CNY (OR=1.96, 95% CI=1.05-3.66) were more knowledgeable about using drugs. Gender, (OR=0.69, 95% CI=0.50-0.95) age, (OR=2.11, 95% CI=1.15-3.88) residence, (OR=1.58, 95% CI=1.06-2.37) chronic disease conditions (OR=0.46, 95% CI=0.27-0.78) and infection symptoms (OR=0.60, 95% CI=0.38-0.93) as factors influencing the need for drug delivery services. (P<0.05).

Conclusion

Research has revealed that a significant proportion of infected people in China chose drug treatment during COVID-19. Individuals with severe symptoms use more medication and require more drug delivery and storage. Low-education and low-income populations are lacking in drug knowledge, and older adults with underlying medical conditions are more likely to need drug delivery services. Therefore, governments should prioritize vulnerable groups when formulating drug policies and target drug literacy and guidance. In addition, it is recommended that a drug distribution system be set up within the community so that those in need can have quick and easy access to drugs.

Effect of probiotics as an immune modulator for the management of COVID-19

COVID-19, an acute respiratory viral infection conveyed by pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has affected millions of individuals globally, and is a public health emergency of international concern. Till now, there are no highly effective therapies for this infection without vaccination. As they can evolve quickly and cross the strain level easily, these viruses are causing epidemics or pandemics that are allied with more severe clinical diseases. A new approach is needed to improve immunity to confirm the protection against emerging viral infections. Probiotics can modify gut microbial dysbiosis, improve the host immune system, and stimulate immune signaling, increasing systemic immunity. Several probiotic bacterial therapies have been proven to decrease the period of bacterial or viral infections. Superinduction of inflammation, termed cytokine storm, has been directly linked with pneumonia and severe complications of viral respiratory infections. In this case, probiotics as potential immunomodulatory agents can be an appropriate candidate to improve the host's response to respiratory viral infections. During this COVID-19 pandemic, any approach that can induce mucosal and systemic immunity could be helpful. Here, we summarize contexts regarding the effectiveness of various probiotics for preventing virus-induced respiratory infectious diseases, especially those that could be employed for COVID-19 patients. In addition, the effects of probiotics, their mechanisms on different aspects of immune responses against respiratory viral infection, and their antiviral properties in clinical findings have been described in detail.

Endurance of COVID 19 in wastewater, natural prescription and antiviral medication for the analysis of COVID 19 and its effects on the development of new antiseptic strategies

The continuous worldwide pandemic of COVID-19 brought about by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been a public health emergency of international concern, which was formally announced by the World Health Organization (WHO). The antivirals utilized to restrict the spread of virus and the procedures for the recognition of SARS-COV-2 in wastewater has been reviewed. A main tool Wastewater-based epidemiology (WBE) played a notable role in tracking the spread of corona virus in large community. This review signifies the upgraded clinical impacts and components of Traditional Chinese Medicine (TCM), the function of various antiviral drugs against COVID 19 and the role of human covid to exist in the habitat and the viability countered; with specific spotlight on the advancement of latest strategies to assess the action of latest antiseptic-disinfectants on infections.

Impact of COVID-19 on in-hospital cardiac arrest outcomes: An updated meta-analysis

BACKGROUND

The main purposes of this meta-analysis are to update the information about the impact of coronavirus disease 2019 (COVID-19) pandemic on outcomes of in-hospital cardiac arrest (IHCA) and to investigate the impact of being infected by by severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) on IHCA outcomes.

METHODS

The current meta-analysis is an update and follows the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).

RESULTS

In analyses, pre- and intra-COVID-19 periods were observed for: shockable rhythms in 17.6% vs. 16.2% (odds ratio [OR]: 1.11; 95% confidence interval [CI]: 0.71-1.72; p = 0.65), return of spontaneous circulation (ROSC) in 47.4% vs. 44.0% (OR: 1.36; 95% CI: 0.90-2.07; p = 0.15), 30-day mortality in 59.8% vs. 60.9% (OR: 0.95; 95% CI: 0.75-1.22; p = 0.69) and overall mortality 75.8% vs. 74.7% (OR: 0.80; 95% CI: 0.49-1.28; p = 0.35), respectively. In analyses, SARS-CoV-2 positive and negative patients were observed for: shockable rhythms in 9.6% vs. 19.8% (OR: 0.51; 95% CI: 0.35-0.73; p < 0.001), ROSC in 33.9% vs. 52.1% (OR: 0.47; 95% CI: 0.30-0.73; p < 0.001), 30-day mortality in 77.2% vs. 59.7% (OR: 2.08; 95% CI: 1.28-3.38; p = 0.003) and overall mortality in 94.9% vs. 76.7% (OR: 3.20; 95% CI: 0.98-10.49; p = 0.05), respectively.

CONCLUSIONS

Despite ROSC, 30-day and overall mortality rate were not statistically different in pre- vs. intra-COVID-19 periods, a lower incidence of ROSC and higher 20-day mortality rate were observed in SARS-CoV-2 (+) compared to SARS-CoV-2 (-) patients.

Economic evaluation of remdesivir for the treatment of severe COVID-19 patients in China under different scenarios

AIMS

The present study aimed to evaluate the cost-effectiveness of the 5-day remdesivir regimen compared with standard of care among severe COVID-19 patients in China, the evidence on which is essential to inform the necessity of securing access to remdesivir.

METHODS

A dynamic transmission model that extended the susceptible-exposed-infected-recovered framework by incorporating asymptomatic, presymptomatic and waiting-to-be-diagnosed patients was constructed to conduct the cost-effectiveness analysis from the healthcare system perspective. To estimate epidemic parameters, the model was first calibrated to the observed epidemic curve in Wuhan from 23 January to 19 March 2020. Following the calibration, the infected compartment was replaced by 3 severity-defined health states to reflect differential costs and quality of life associated with disease gravity. Costs and quality-adjusted life year (QALY) outcomes of 9 million simulated people were accrued across time to evaluate the incremental cost-effectiveness ratio of remdesivir. As robustness checks, an alternative modelling technique using decision tree, additional epidemic scenarios representing different epidemic intensities, and 1-way parameter variations were also analysed.

RESULTS

Remdesivir treatment cost CN¥97.93 million more than standard of care. Also, the net QALY gain from 5-day remdesivir treatment was 6947 QALYs. As such, the incremental cost-effectiveness ratio was CN¥14 098/QALY, substantially lower than the gross domestic product per capita threshold. The peak daily number of severe cases was 19% lower in the remdesivir treatment strategy. Overall, results were robust in alternative scenarios and sensitivity analyses.

CONCLUSION

Given the cost-effectiveness profile, access to remdesivir for severe COVID-19 patients in China should be considered.

Impact of diabetes mellitus on in-hospital mortality in adult patients with COVID-19: a systematic review and meta-analysis

BACKGROUND

The novel coronavirus disease 2019 (COVID-19) has spread worldwide since the beginning of 2020, placing the heavy burden on the health systems all over the world. The population that particularly has been affected by the pandemic is the group of patients suffering from diabetes mellitus. Having taken the public health in considerations, we have decided to perform a systematic review and meta-analysis of diabetes mellitus on in-hospital mortality in patients with COVID-19.

METHODS

A systematic literature review (MEDLINE, EMBASE, Web of Science, Scopus, Cochrane) including all published clinical trials or observational studies published till December 10, 2020, was performed using following terms "diabetes mellitus" OR "diabetes" OR "DM" AND "survival" OR "mortality" AND "SARS-CoV-2" OR "COVID-19".

RESULTS

Nineteen studies were included out of the 7327 initially identified studies. Mortality of DM patients vs non-DM patients was 21.3 versus 6.1%, respectively (OR = 2.39; 95%CI: 1.65, 3.64; P < 0.001), while severe disease in DM and non-DM group varied and amounted to 34.8% versus 22.8% (OR = 1.43; 95%CI: 0.82, 2.50; P = 0.20). In the DM group, the complications were observed far more often when compared with non-DM group, both in acute respiratory distress (31.4 vs. 17.2%; OR = 2.38; 95%CI:1.80, 3.13; P < 0.001), acute cardiac injury (22.0% vs. 12.8%; OR = 2.59; 95%CI: 1.81, 3.73; P < 0.001), and acute kidney injury (19.1 vs. 10.2%; OR = 1.97; 95%CI: 1.36, 2.85; P < 0.001).

CONCLUSIONS

Based on the findings, we shall conclude that diabetes is an independent risk factor of the severity of COVID-19 in-hospital settings; therefore, patients with diabetes shall aim to reduce the exposure to the potential infection of COVID-19.

Nanomedicine for COVID-19: the role of nanotechnology in the treatment and diagnosis of COVID-19

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused the recent outbreak of coronavirus 2019 (COVID-19). Although nearly two decades have passed since the emergence of pandemics such as SARS-CoV and Middle East respiratory syndrome coronavirus (MERS-CoV), no effective drug against the CoV family has yet been approved, so there is a need to find newer therapeutic targets. Currently, simultaneous research across the globe is being performed to discover efficient vaccines or drugs, including both conventional therapies used to treat previous similar diseases and emerging therapies like nanomedicine. Nanomedicine has already proven its value through its application drug delivery and nanosensors in other diseases. Nanomedicine and its components can play an important role in various stages of prevention, diagnosis, treatment, vaccination, and research related to COVID-19. Nano-based antimicrobial technology can be integrated into personal equipment for the greater safety of healthcare workers and people. Various nanomaterials such as quantum dots can be used as biosensors to diagnose COVID-19. Nanotechnology offers benefits from the use of nanosystems, such as liposomes, polymeric and lipid nanoparticles, metallic nanoparticles, and micelles, for drug encapsulation, and facilitates the improvement of pharmacological drug properties. Antiviral functions for nanoparticles can target the binding, entry, replication, and budding of COVID-19. The toxicity-related inorganic nanoparticles are one of the limiting factors of its use that should be further investigated and modified. In this review, we are going to discuss nanomedicine options for COVID-19 management, similar applications for related viral diseases, and their gap of knowledge.