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Muacevic A, Adler JR, Zárate-Yuyes FM, Fernández-Rodríguez LJ, Bardales-Zuta VH. Use of Ivermectin and Chlorine Dioxide for COVID-19 Treatment and Prophylaxis in Peru: A Narrative Review. Cureus 2022; 14:e31836. [PMID: 36579243 PMCID: PMC9788901 DOI: 10.7759/cureus.31836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2022] [Indexed: 11/25/2022] Open
Abstract
The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, created a rapidly unfolding health crisis, especially in the initial phases of the pandemic. In the early stages of the pandemic, various strategies were proposed for COVID-19 prophylaxis and treatment with very little scientific evidence available. Among these proposed treatments were ivermectin and chlorine dioxide, which were both used widely in Peru for both disease prevention and treatment without considering their problematic side effects. For instance, ivermectin was part of an approved therapeutic scheme based on in vitro data, although its efficacy in humans was not demonstrated. In addition, chlorine dioxide was never shown to be effective but causes threatening side effects. In this article, we discuss current information regarding chlorine dioxide and ivermectin in the context of the COVID-19 pandemic, with a focus on experiences in Peru.
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Tejada D, Juanbeltz R, Rivero M, San Miguel R, Capdevila F, Beloqui JJ, Sarobe M. Clinical course of patients with severe COVID-19 pneumonia treated with remdesivir: A real-life study. PLoS One 2022; 17:e0267283. [PMID: 35482685 PMCID: PMC9049514 DOI: 10.1371/journal.pone.0267283] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 04/06/2022] [Indexed: 12/20/2022] Open
Abstract
Background There is currently much uncertainty regarding the most optimal treatment for COVID-19. This study analyze the change in the clinical condition of patients hospitalized for severe COVID-19 pneumonia and treated with remdesivir in a real-life setting, based on the WHO Ordinal Scale. Clinical complications, treatment safety, and impact of other associated drugs were also analyzed. Methods We conducted an observational, retrospective study including patients treated with remdesivir. The need for admission to the ICU, the length of ICU and hospital stay, and the need for ventilatory support were analyzed. The laboratory parameters, drugs administered concomitantly, and difference in the length of hospital stay according to the concomitant treatment received were also evaluated. A univariate and multivariate Cox regression analysis was performed to analyze associated factors. Results A total of 92 patients were included. The mean length of hospital stay was 15 days, and 90% of the patients had been discharged from the hospital 28 days after starting treatment with remdesivir. The likelihood of hospital discharge among patients not presenting with hypertension as a comorbidity was significantly higher than that of those with this condition (HR = 3.19, P = 0.008). Nineteen patients had to be admitted to the ICU (mean of 18 days). Approximately 11% required invasive mechanical ventilation (mean of 22 days). Almost 37% of the patients received high-flow oxygen therapy and 14% non-invasive mechanical ventilation. Four deaths were recorded within the first week. Main adverse events were increases in transaminase and creatinine levels. Nosocomial infections were more frequent when remdesivir was combined with immunosuppressive drugs. Conclusions Patients with severe COVID-19 pneumonia and treated with remdesivir require relatively prolonged hospital stays, many with a need for ventilatory support and, in a considerable proportion of cases, admission to the ICU. However, the observed survival rate is high, and the drug is well tolerated.
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Affiliation(s)
- Diana Tejada
- Department of Hospital Pharmacy, Hospital Universitario de Navarra, Pamplona, Navarra, Spain
- Navarre Institute for Health Research (IdiSNA), Pamplona, Navarra, Spain
| | - Regina Juanbeltz
- Department of Hospital Pharmacy, Hospital Universitario de Navarra, Pamplona, Navarra, Spain
- Navarre Institute for Health Research (IdiSNA), Pamplona, Navarra, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Pamplona, Navarra, Spain
- * E-mail:
| | - María Rivero
- Navarre Institute for Health Research (IdiSNA), Pamplona, Navarra, Spain
- Infectious Diseases Unit, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | - Ramón San Miguel
- Department of Hospital Pharmacy, Hospital Universitario de Navarra, Pamplona, Navarra, Spain
- Navarre Institute for Health Research (IdiSNA), Pamplona, Navarra, Spain
| | - Ferrán Capdevila
- Department of Hospital Pharmacy, Hospital Universitario de Navarra, Pamplona, Navarra, Spain
- Navarre Institute for Health Research (IdiSNA), Pamplona, Navarra, Spain
| | - Juan José Beloqui
- Department of Hospital Pharmacy, Hospital Universitario de Navarra, Pamplona, Navarra, Spain
- Centro de Investigación Médica Navarrabiomed, Pamplona, Navarra, Spain
| | - Maite Sarobe
- Department of Hospital Pharmacy, Hospital Universitario de Navarra, Pamplona, Navarra, Spain
- Navarre Institute for Health Research (IdiSNA), Pamplona, Navarra, Spain
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Cebrián Lara L, Hernàndez Lorente E, García Llopis P. Bradycardia due to remdesivir: Report of two cases. MEDICINA CLÍNICA (ENGLISH EDITION) 2022; 158:94-95. [PMID: 35013718 PMCID: PMC8730715 DOI: 10.1016/j.medcle.2021.03.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Delgado A, Stewart S, Urroz M, Rodríguez A, Borobia AM, Akatbach-Bousaid I, González-Muñoz M, Ramírez E. Characterisation of Drug-Induced Liver Injury in Patients with COVID-19 Detected by a Proactive Pharmacovigilance Program from Laboratory Signals. J Clin Med 2021; 10:4432. [PMID: 34640458 PMCID: PMC8509270 DOI: 10.3390/jcm10194432] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/19/2021] [Accepted: 09/23/2021] [Indexed: 02/06/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) has a wide spectrum of clinical manifestations. An elevation of liver damage markers has been observed in numerous cases, which could be related to the empirical use of potentially hepatotoxic drugs. The aim of this study was to describe the clinical and analytical characteristics and perform a causality analysis from laboratory signals available of drug-induced liver injury (DILI) detected by a proactive pharmacovigilance program in patients hospitalised for COVID-19 at La Paz University Hospital in Madrid (Spain) from 1 March 2020 to 31 December 2020. The updated Roussel Uclaf Causality Assessment Method (RUCAM) was employed to assess DILI causality. A lymphocyte transformation test (LTT) was performed on 10 patients. Ultimately, 160 patients were included. The incidence of DILI (alanine aminotransferase >5, upper limit of normal) was 4.9%; of these, 60% had previous COVID-19 hepatitis, the stay was 8.1 days longer and 98.1% were being treated with more than 5 drugs. The most frequent mechanism was hepatocellular (57.5%), with mild severity (87.5%) and subsequent recovery (88.1%). The most commonly associated drugs were hydroxychloroquine, azithromycin, tocilizumab and ceftriaxone. The highest incidence rate of DILI per 10,000 defined daily doses (DDD) was with remdesivir (992.7/10,000 DDD). Some 80% of the LTTs performed were positive, with a RUCAM score of ≥4. The presence of DILI after COVID-19 was associated with longer hospital stays. An immune mechanism has been demonstrated in a small subset of DILI cases.
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Affiliation(s)
- Ana Delgado
- Clinical Pharmacology Department, La Paz University Hospital-IdiPAZ, School of Medicine, Autonomous University of Madrid, 28046 Madrid, Spain; (A.D.); (S.S.); (M.U.); (A.R.); (A.M.B.)
| | - Stefan Stewart
- Clinical Pharmacology Department, La Paz University Hospital-IdiPAZ, School of Medicine, Autonomous University of Madrid, 28046 Madrid, Spain; (A.D.); (S.S.); (M.U.); (A.R.); (A.M.B.)
| | - Mikel Urroz
- Clinical Pharmacology Department, La Paz University Hospital-IdiPAZ, School of Medicine, Autonomous University of Madrid, 28046 Madrid, Spain; (A.D.); (S.S.); (M.U.); (A.R.); (A.M.B.)
| | - Amelia Rodríguez
- Clinical Pharmacology Department, La Paz University Hospital-IdiPAZ, School of Medicine, Autonomous University of Madrid, 28046 Madrid, Spain; (A.D.); (S.S.); (M.U.); (A.R.); (A.M.B.)
| | - Alberto M. Borobia
- Clinical Pharmacology Department, La Paz University Hospital-IdiPAZ, School of Medicine, Autonomous University of Madrid, 28046 Madrid, Spain; (A.D.); (S.S.); (M.U.); (A.R.); (A.M.B.)
| | | | | | - Elena Ramírez
- Clinical Pharmacology Department, La Paz University Hospital-IdiPAZ, School of Medicine, Autonomous University of Madrid, 28046 Madrid, Spain; (A.D.); (S.S.); (M.U.); (A.R.); (A.M.B.)
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Tang M, Cai J, Tan J. Adverse reactions of drugs specifically used for treatment of SARS-CoV-2 infection. MEDICINA CLINICA (ENGLISH ED.) 2021. [PMID: 34109277 DOI: 10.1016/j.medcle.2020.12.022.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 10/01/2022]
Affiliation(s)
- Mi Tang
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu City 610041, China
| | - Jianghui Cai
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu City 610041, China
| | - Jie Tan
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu City 610041, China
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Tang M, Cai J, Tan J. Adverse reactions of drugs specifically used for treatment of SARS-CoV-2 infection. MEDICINA CLÍNICA (ENGLISH EDITION) 2021; 156:576. [PMID: 34109277 PMCID: PMC8178960 DOI: 10.1016/j.medcle.2020.12.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Cebrián Lara L, Hernàndez Lorente E, García Llopis P. Bradycardia due to remdesivir: Report of two cases. Med Clin (Barc) 2021; 158:94-95. [PMID: 34049680 PMCID: PMC8149191 DOI: 10.1016/j.medcli.2021.03.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/17/2021] [Accepted: 03/19/2021] [Indexed: 12/03/2022]
Affiliation(s)
- Laura Cebrián Lara
- Servicio de Farmacia, Hospital Universitario de La Ribera, Alzira, Valencia, España
| | | | - Paula García Llopis
- Servicio de Farmacia, Hospital Universitario de La Ribera, Alzira, Valencia, España.
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Tang M, Cai J, Tan J. Adverse reactions of drugs specifically used for treatment of SARS-CoV-2 infection. Med Clin (Barc) 2021; 156:576. [PMID: 33593637 PMCID: PMC7843060 DOI: 10.1016/j.medcli.2020.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Mi Tang
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu City 610041, China
| | - Jianghui Cai
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu City 610041, China.
| | - Jie Tan
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu City 610041, China
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Sharma NK, Sarode SC, Sarode G, Patil S. Is a COVID-19 vaccine developed by nature already at work? Med Hypotheses 2020; 145:110335. [PMID: 33059225 PMCID: PMC7538374 DOI: 10.1016/j.mehy.2020.110335] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/17/2020] [Accepted: 10/02/2020] [Indexed: 12/17/2022]
Abstract
The COVID-19 positive cases are increasing at an alarming rate across the world. On the contrary, the morbidity and mortality are showing decreasing trend as time progresses. The most intriguing part is the rise in asymptomatic Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) positive cases in the population, which made us speculate some kind of gradual development of immunity in the population. To date, no attention has been given to the accumulation of killed/inactivated/degenerated SARS-CoV-2 associated molecular particle patterns (SAMPPs). In this paper, we introduced the concept of SAMMPs and its existence on inanimate objects is quite conceivable due to the size of SARS-CoV-2 and exuberant shedding of the virus in respiratory secretions. SAMPPs can come into the contact with mucosal surfaces and thereof associated antigen-presenting dendritic cells. Thus, we hypothesized the existence of SAMPPs mediated the development of immunity against SARS-CoV-2 infection, which has caused an increase in the incidence rate of asymptomatic cases and a decrease in mortality rate. To understand the existence of SAMPPs associated natural immunity against SARS-CoV-2, future population based serological testing are recommended to investigate serum antibody levels against various molecular particles associated with SAMPPs.
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Affiliation(s)
- Nilesh Kumar Sharma
- Cancer and Translational Research Lab, Dr. D.Y. Patil Biotechnology & Bioinformatics Institute, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra 411033, India
| | - Sachin C Sarode
- Department of Oral Pathology and Microbiology, Dr. D.Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune 411018, India.
| | - Gargi Sarode
- Department of Oral Pathology and Microbiology, Dr. D.Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune 411018, India.
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia.
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