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Singh S, Sinha N, Lohani P, Agarwal N, Singh P, Singh CM. Impact of Remdesivir on inflammatory and prognostic markers of COVID-19: Findings of an event-monitoring study. J Family Med Prim Care 2023; 12:3135-3141. [PMID: 38361897 PMCID: PMC10866280 DOI: 10.4103/jfmpc.jfmpc_334_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 07/04/2023] [Accepted: 07/06/2023] [Indexed: 02/17/2024] Open
Abstract
Introduction Remdesivir is currently approved for treating hospitalised patients with COVID-19. However, it is a priority to monitor its safety and effectiveness in various clinical settings. This study was undertaken to assess the impact of remdesivir on inflammatory and prognostic markers of COVID-19. Materials and Methods A hospital-based prospective longitudinal study was conducted over two months comprising event monitoring of COVID-19 patients administered remdesivir as per standard guidelines. The demographic details, risk factors and all baseline parameters were collected. The patients were followed up for the appearance of any adverse drug reactions (ADRs) after the start of remdesivir therapy from Day 1 to discharge or death every day. Repeat Lab tests were done on days 2, 4, 6 and 10 days to assess the impact of remdesivir on inflammatory and prognostic markers of COVID-19 over time. Significant predictors of survival in the cohort were also assessed. Results A total of 60 COVID-19 patients were administered remdesivir. The mean age of the patients was 59.2 (+13.7) years. There was a significant improvement in the serum creatinine (decreased from 0.9 to 0.7 mg/dL), lymphocyte count {decreased from 9.2 to 7.3 (109 cells/L)} and serum sodium (increased from 134.6 to 137.4) of the patients over six days after the administration of remdesivir. The significant survival predictors were multiple organ failure (P 0.046) and WBC count on Day 10 (P 0.001). Conclusion Remdesivir administration improved the prognostic biomarker profile in COVID-19 patients.
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Affiliation(s)
- Shruti Singh
- Department of Pharmacology, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Nishi Sinha
- Department of Pharmacology, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Pallavi Lohani
- Department of Community Medicine, HI-TECH Medical College, Rourkela, Orissa, India
| | - Neha Agarwal
- Department of Pharmacology, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Pratibha Singh
- Department of Anaesthesiology, Maharshi Devraha Baba State Autonomous Medical College, Deoria, Uttar Pradesh, India
| | - CM Singh
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Patna, Bihar, India
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Blair HA. Remdesivir: A Review in COVID-19. Drugs 2023; 83:1215-1237. [PMID: 37589788 PMCID: PMC10474216 DOI: 10.1007/s40265-023-01926-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2023] [Indexed: 08/18/2023]
Abstract
Remdesivir (Veklury®), a nucleotide analogue prodrug with broad-spectrum antiviral activity, is approved for the treatment of coronavirus disease 2019 (COVID-19), the illness caused by severe acute respiratory syndrome coronavirus 2 infection. Unlike some antivirals, remdesivir has a low potential for drug-drug interactions. In the pivotal ACTT-1 trial in hospitalized patients with COVID-19, daily intravenous infusions of remdesivir significantly reduced time to recovery relative to placebo. Subsequent trials provided additional support for the efficacy of remdesivir in hospitalized patients with moderate or severe COVID-19, with a greater benefit seen in patients with minimal oxygen requirements at baseline. Clinical trials also demonstrated the efficacy of remdesivir in other patient populations, including outpatients at high risk for progression to severe COVID-19, as well as hospitalized paediatric patients. In terms of mortality, results were equivocal. However, remdesivir appeared to have a small mortality benefit in hospitalized patients who were not already being ventilated at baseline. Remdesivir was generally well tolerated in clinical trials, but pharmacovigilance data found an increased risk of hepatic, renal and cardiovascular adverse drug reactions in the real-world setting. In conclusion, remdesivir represents a useful treatment option for patients with COVID-19, particularly those who require supplemental oxygen.
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Affiliation(s)
- Hannah A Blair
- Springer Nature, Private Bag 65901, Mairangi Bay, Auckland, 0754, New Zealand.
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Paidi RK, Jana M, Raha S, Mishra RK, Jeong B, Sheinin M, Pahan K. Prenol, but Not Vitamin C, of Fruit Binds to SARS-CoV-2 Spike S1 to Inhibit Viral Entry: Implications for COVID-19. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2023; 210:1938-1949. [PMID: 37144841 PMCID: PMC10615733 DOI: 10.4049/jimmunol.2200279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 02/23/2023] [Indexed: 05/06/2023]
Abstract
Fruit consumption may be beneficial for fighting infection. Although vitamin C is the celebrity component of fruit, its role in COVID-19 is unclear. Because spike S1 of SARS-CoV-2 binds to angiotensin-converting enzyme 2 (ACE2) on host cells to enter the cell and initiate COVID-19, using an α-screen-based assay, we screened vitamin C and other components of fruit for inhibiting the interaction between spike S1 and ACE2. We found that prenol, but neither vitamin C nor other major components of fruit (e.g., cyanidin and rutin), reduced the interaction between spike S1 and ACE2. Thermal shift assays indicated that prenol associated with spike S1, but not ACE2, and that vitamin C remained unable to do so. Although prenol inhibited the entry of pseudotyped SARS-CoV-2, but not vesicular stomatitis virus, into human ACE2-expressing HEK293 cells, vitamin C blocked the entry of pseudotyped vesicular stomatitis virus, not SARS-CoV-2, indicating the specificity of the effect. Prenol, but not vitamin C, decreased SARS-CoV-2 spike S1-induced activation of NF-κB and the expression of proinflammatory cytokines in human A549 lung cells. Moreover, prenol also decreased the expression of proinflammatory cytokines induced by spike S1 of N501Y, E484K, Omicron, and Delta variants of SARS-CoV-2. Finally, oral treatment with prenol reduced fever, decreased lung inflammation, enhanced heart function, and improved locomotor activities in SARS-CoV-2 spike S1-intoxicated mice. These results suggest that prenol and prenol-containing fruits, but not vitamin C, may be more beneficial for fighting against COVID-19.
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Affiliation(s)
- Ramesh K. Paidi
- Department of Neurological Sciences, Rush University Medical Center, Chicago, USA
| | - Malabendu Jana
- Department of Neurological Sciences, Rush University Medical Center, Chicago, USA
| | - Sumita Raha
- Department of Neurological Sciences, Rush University Medical Center, Chicago, USA
| | - Rama K. Mishra
- Department of Biochemistry and Molecular Genetics, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Brian Jeong
- Department of Neurological Sciences, Rush University Medical Center, Chicago, USA
| | - Monica Sheinin
- Department of Neurological Sciences, Rush University Medical Center, Chicago, USA
| | - Kalipada Pahan
- Department of Neurological Sciences, Rush University Medical Center, Chicago, USA
- Division of Research and Development, Jesse Brown Veterans Affairs Medical Center, Chicago, USA
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Marocco R, Del Borgo C, Tortellini E, Garattini S, Carraro A, Di Trento D, Gasperin A, Grimaldi A, Tieghi T, Belvisi V, Kertusha B, Guardiani M, Zuccalà P, Alunni Fegatelli D, Spagnoli A, Lichtner M. Use of Remdesivir in Patients with SARS-CoV-2 Pneumonia in a Real-Life Setting during the Second and Third COVID-19 Epidemic Waves. Viruses 2023; 15:v15040947. [PMID: 37112927 PMCID: PMC10143300 DOI: 10.3390/v15040947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 04/08/2023] [Accepted: 04/08/2023] [Indexed: 04/29/2023] Open
Abstract
In this retrospective comparative study, we evaluated the effectiveness of remdesivir (RDSV) in patients with SARS-CoV-2 pneumonia. Individuals hospitalized between March 2020 and August 2022 at S.M. Goretti Hospital, Latina, with a positive test for SARS-CoV-2 and, concomitantly, pneumonia, were included. The overall survival was the primary endpoint. The composite secondary endpoint included death or progression in severe ARDS at 40 days. The study population was stratified according to treatment into two groups: the RDSV group (patients treated with RDSV-based regimens) and the no-RDSV group (patients treated with any other, not RDSV-based, regimens). Factors associated with death and progression to severe ARDS or death were assessed by multivariable analysis. A total of 1153 patients (632 belonging to the RDSV group and 521 to the no-RDSV group) were studied. The groups were comparable in terms of sex, PaO2/FiO2 at admission, and duration of symptoms before hospitalization. Further, 54 patients (8.5%) in the RDSV group and 113 (21.7%) in the no-RDSV group (p < 0.001) died. RDSV was associated with a significantly reduced hazard ratio (HR) of death (HR, 0.69 [95% CI, 0.49-0.97]; p = 0.03), compared to the no-RDSV group, as well as a significantly reduced OR of progression in severe ARDS or death (OR, 0.70 [95% CI 0.49-0.98]; p = 0.04). An overall significantly higher survival rate was observed in the RDSV group (p < 0.001, by log-rank test). These findings reinforce the survival benefit of RDSV and support its routine clinical use for the treatment of COVID-19 patients.
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Affiliation(s)
- Raffaella Marocco
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Cosmo Del Borgo
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Eeva Tortellini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Silvia Garattini
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Anna Carraro
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Daniela Di Trento
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Andrea Gasperin
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Alessandra Grimaldi
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Tiziana Tieghi
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Valeria Belvisi
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Blerta Kertusha
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Mariasilvia Guardiani
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Paola Zuccalà
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Danilo Alunni Fegatelli
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Alessandra Spagnoli
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Miriam Lichtner
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
- Department of Neurosciences, Mental Health, and Sense Organs, NESMOS, Sapienza University of Rome, 00189 Rome, Italy
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