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Entrenas-Castillo M, Entrenas-Costa LM, Pata MP, Gámez BJ, Muñoz-Corroto C, Gómez-Rebollo C, Mira-Padilla E, Bouillon R, Quesada-Gomez JM. Latent Class Analysis Reveals, in patient profiles, COVID-19-related better prognosis by calcifediol treatment than glucocorticoids. J Steroid Biochem Mol Biol 2024:106609. [PMID: 39218235 DOI: 10.1016/j.jsbmb.2024.106609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Revised: 08/25/2024] [Accepted: 08/26/2024] [Indexed: 09/04/2024]
Abstract
Calcifediol and glucocorticoids have been repositioned for the treatment of COVID-19 and may reduce severity, the need for intensive care unit admission and death. OBJECTIVE to identify class or profiles of patients hospitalized and treated with COVID-19 pneumonia using latent class clustering methods to assess the clinical and prognostic relevance of the resulting patients' profiles. Poor prognosis was defined as death or need for ICU admission, good prognosis, the opposite. With special interest in differential responses to calcifediol. SETTING Reina Sofia University Hospital, Córdoba Spain. Patients Retrospective observational cohort study of patients admitted for COVID-19. CLINICALTRIALS gov public database (NCT05819918). INCLUSION CRITERIA (i) Age ≥ 18 and ≤ 90 years, (ii) Pneumonia characterized by the presence of infiltrates on chest X-ray or CT scan, (iii) SARS-CoV-2 infection, confirmed, and (iv) CURB Scale 65 >1. DESIGN Latent class analysis, for obtaining homogeneous clusters, without specifying a priori the belonging group, and selecting the optimal number of clusters by minimizing information criteria. Evaluating the differences between groups for each variable by means of chi-square, Fisher's exact test and Kruskal-Wallis test. RESULTS 707 patients hospitalized from 10 March 2020 until 4 March 2022 were included. For the treatment variable, differences were found between class 3 (60% treated with calcifediol only) and classes 1 (less than 1% calcifediol only vs. 82% treated with both), 2 (less than 1% calcifediol only vs. 82% treated with both) and 4 (1% calcifediol only vs. 84% treated with both). Class 3, (60% with calcifediol), had a significantly better prognosis compared to patients treated with glucocorticoids alone (OR: 15.2, 95% CI: [3.73 - 142], p<0.001) or no treatment (OR: 7.38, 95% CI: [2.63 - 30.2], p<0.001). CONCLUSIONS our real-life study shows that calcifediol treatment significantly reduces the need for ICU admission and improved prognosis in patients hospitalized for COVID-19 pneumonia, especially in the profile of patients receiving it without glucocorticoids.
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Affiliation(s)
- Marta Entrenas-Castillo
- Hospital QuironSalud Córdoba, 14004 Córdoba, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, 14004 Córdoba, Spain
| | - Luis Manuel Entrenas-Costa
- Hospital QuironSalud Córdoba, 14004 Córdoba, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, 14004 Córdoba, Spain; Unidad de Gestión Clínica de Neumología, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain
| | | | - Bernabé Jurado Gámez
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, 14004 Córdoba, Spain; Unidad de Gestión Clínica de Neumología, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain
| | - Cristina Muñoz-Corroto
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, 14004 Córdoba, Spain; Unidad de Gestión Clínica de Neumología, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain
| | - Cristina Gómez-Rebollo
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, 14004 Córdoba, Spain; Unidad de Gestión Clínica de Neumología, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain
| | - Estefanía Mira-Padilla
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, 14004 Córdoba, Spain; Unidad de Gestión Clínica de Neumología, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain
| | - Roger Bouillon
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, 3000 Leuven, Belgium.
| | - Jose Manuel Quesada-Gomez
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, 14004 Córdoba, Spain; Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain; CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES), 28029 Madrid, Spain; Departamento de Enfermería, Farmacología y Fisioterapia, Universidad de Córdoba. 14004 Córdoba, Spain.
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2
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Ashraf S, Ashraf S, Ashraf M, Imran MA, Kalsoom L, Siddiqui UN, Farooq I, Akmal R, Akram MK, Ashraf S, Ghufran M, Majeed N, Habib Z, Rafique S, -Abdin ZU, Arshad S, Shahab MS, Ahmad S, Zheng H, Mirza AR, Zulfiqar S, Anwar MI, Humayun A, Mahmud T, Saboor QA, Ahmad A, Ashraf M, Izhar M. Honey and Nigella sativa against COVID-19 in Pakistan (HNS-COVID-PK): A multicenter placebo-controlled randomized clinical trial. Phytother Res 2023; 37:627-644. [PMID: 36420866 DOI: 10.1002/ptr.7640] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 07/07/2022] [Accepted: 09/18/2022] [Indexed: 11/25/2022]
Abstract
Until now, no specific and effective treatment exists for coronavirus disease 2019 (COVID-19). Since honey and Nigella sativa (HNS) have established antiviral, antibacterial, antiinflammatory, antioxidant, and immunomodulatory properties, we tested their efficacy for this disease in a multicenter, placebo-controlled, and randomized clinical trial at four medical care facilities in Pakistan. RT-PCR confirmed COVID-19 adults showing moderate or severe disease were enrolled in the trial. Patients were randomly assigned in a 1:1 ratio to receive either honey (1 g kg-1 day-1 ) and Nigella sativa seeds (80 mg kg-1 day-1 ) or a placebo for up to 13 days along with standard care. The outcomes included symptoms' alleviation, viral clearance, and 30-day mortality in the intention-to-treat population. Three hundred and thirteen patients, 210 with moderate and 103 with severe disease, underwent randomization from April 30 to July 29, 2020. Among the moderate cases, 107 were assigned to HNS, whereas 103 were assigned to the placebo group. Among the severe cases, 50 were given HNS, and 53 were given the placebo. HNS resulted in ~50% reduction in time taken to alleviate symptoms as compared to placebo (moderate cases: 4 vs. 7 days, Hazard Ratio [HR]: 6.11; 95% Confidence Interval [CI]: 4.23-8.84, p < 0.0001 and for severe cases: 6 vs. 13 days, HR: 4.04; 95% CI: 2.46-6.64; p < 0.0001). HNS also cleared the virus earlier than placebo in both moderate cases (6 vs. 10 days, HR: 5.53; 95% CI: 3.76-8.14, p < 0.0001) and severe cases (8.5 vs. 12 days, HR: 4.32; 95% CI: 2.62-7.13, p < 0.0001). HNS further led to a better clinical score on day 6 with normal activity resumption in 63.6% vs. 10.9% among moderate cases (OR: 0.07; 95% CI: 0.03-0.13, p < 0.0001) and hospital discharge in 50% versus 2.8% in severe cases (OR: 0.03; 95% CI: 0.01-0.09, p < 0.0001). In severe cases, the mortality rate was less than 1/4th in the HNS group than in placebo (4% vs. 18.87%, OR: 0.18; 95% CI: 0.02-0.92, p = 0.029). No HNS-related adverse effects were observed. HNS, compared with placebo, significantly improved symptoms, expedited viral load clearance, and reduced mortality in COVID-19 patients. This trial was registered on April 15, 2020 with ClinicalTrials.gov Identifier: NCT04347382.
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Affiliation(s)
- Sohaib Ashraf
- Department of Cardiology, Shaikh Zayed Post-Graduate Medical Institute, Lahore, Pakistan
| | - Shoaib Ashraf
- Department of Pathobiology, Riphah University, Lahore, Pakistan
| | - Moneeb Ashraf
- Department of Pharmacology, King Edward Medical University, Mayo Hospital, Lahore, Pakistan
| | - Muhammad Ahmad Imran
- Department of Microbiology, Shaikh Zayed Post-Graduate Medical Institute, Lahore, Pakistan
| | - Larab Kalsoom
- Department of Internal Medicine, Services Institute of Medical Sciences, Lahore, Pakistan
| | - Uzma N Siddiqui
- Department of Medicine, Port Macquarie Base Hospital, Port Macquarie, New South Wales, Australia.,Department of Internal Medicine, Shaikh Zayed Post-Graduate Medical Institute, Lahore, Pakistan
| | - Iqra Farooq
- Department of Pediatrics Surgery, Children Hospital, Lahore, Pakistan
| | - Rutaba Akmal
- Department of Medicine, Sahara Medical College, Narowal, Pakistan
| | - Muhammad Kiwan Akram
- Department of Nutrition, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Sidra Ashraf
- Department of Biochemistry, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Muhammad Ghufran
- Medico Cirujano, ESACHS (Empresa de Servico Externo de la Asociacion Chilena de Seguridad), Santiago, Chile
| | - Nighat Majeed
- Department of Internal Medicine, Services Institute of Medical Sciences, Lahore, Pakistan
| | - Zaighum Habib
- Department of Orthopedics, Shaikh Zayed Post-Graduate Medical Complex, Lahore, Pakistan
| | - Sundas Rafique
- Department of Oncology, Mayo Hospital, King Edward Medical University, Lahore, Pakistan
| | - Zain-Ul -Abdin
- Department of Cardiology, Shaikh Zayed Post-Graduate Medical Institute, Lahore, Pakistan
| | - Shahroze Arshad
- Department of Internal Medicine, Shaikh Zayed Post-Graduate Medical Institute, Lahore, Pakistan
| | - Muhammad Sarmad Shahab
- Department of Internal Medicine, Allied Hospital, Faisalabad Medical University, Faisalabad, Pakistan
| | - Sohail Ahmad
- Department of Poultry Production, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Hui Zheng
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Ali Rafique Mirza
- Department of Plastic Surgery, Shaikh Zayed Post-Graduate Medical Institute, Lahore, Pakistan
| | - Sibgha Zulfiqar
- Department of Physiology, Shaikh Khalifa Bin Zayed Al-Nahyan Medical and Dental College, Lahore, Pakistan
| | - Muhamad Imran Anwar
- Department of General Surgery, Shaikh Zayed Post-Graduate Medical Institute, Lahore, Pakistan
| | - Ayesha Humayun
- Department of Public Health and Community Medicine, Shaikh Zayed Postgraduate Medical Institute Lahore, Pakistan
| | - Talha Mahmud
- Department of Pulmonology, Shaikh Zayed Post-Graduate Medical Institute, Lahore, Pakistan
| | - Qazi Abdul Saboor
- Department of Cardiology, Shaikh Zayed Post-Graduate Medical Institute, Lahore, Pakistan
| | - Ali Ahmad
- Department of Microbiology, Infectious Diseases & Immunology, Centre Hospitalier Universitaire (CHU) Sainte Justine/University of Montreal, Montreal, Quebec, Canada
| | - Muhammad Ashraf
- Department of Pharmacology and Toxicology, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Mateen Izhar
- Department of Microbiology, Shaikh Zayed Post-Graduate Medical Institute, Lahore, Pakistan
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3
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Dhibar DP, Arora N, Chaudhary D, Prakash A, Medhi B, Singla N, Mohindra R, Suri V, Bhalla A, Sharma N, Singh MP, Lakshmi PVM, Goyal K, Ghosh A. The 'myth of Hydroxychloroquine (HCQ) as post-exposure prophylaxis (PEP) for the prevention of COVID-19' is far from reality. Sci Rep 2023; 13:378. [PMID: 36611040 PMCID: PMC9825075 DOI: 10.1038/s41598-022-26053-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 12/08/2022] [Indexed: 01/09/2023] Open
Abstract
The efficacy of Hydroxychloroquine (HCQ) as post-exposure prophylaxis (PEP) for the prevention of COVID-19 was contentious. In this randomized control double-blind clinical trial, asymptomatic individuals with direct contact with laboratory-confirmed COVID-19 cases were randomized into PEP/HCQ (N = 574) and control/placebo (N = 594) group. The PEP/HCQ group received tablet HCQ 400 mg q 12 hourly on day one followed by 400 mg once weekly for 3 weeks, and the control/Placebo group received matching Placebo. The incidence of COVID-19 was similar (p = 0.761) in PEP [N = 24 out of 574, (4.2%)] and control [N = 27 out of 594, (4.5%)] groups. Total absolute risk reduction for the incidence of new-onset COVID-19 was -0.3% points with an overall relative risk of 0.91 (95% confidence interval, 0.52 to 1.60) and the number needed to treat (NNT) was 333 to prevent the incident of one case of COVID-19. The study found that, PEP with HCQ was not advantageous for the prevention of COVID-19 in asymptomatic individuals with high risk for SARS-CoV-2 infection. Though HCQ is a safer drug, the practice of irrational and indiscriminate use of HCQ for COVID-19 should be restrained with better pharmacovigilance.
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Affiliation(s)
- Deba Prasad Dhibar
- Department of Internal Medicine, PGIMER, Chandigarh, India. .,Department of Internal Medicine, F-Block, Neheru Hospital PGIMER, Chandigarh, 160012, India.
| | - Navneet Arora
- grid.415131.30000 0004 1767 2903Department of Internal Medicine, PGIMER, Chandigarh, India
| | - Deepak Chaudhary
- grid.415131.30000 0004 1767 2903Department of Internal Medicine, PGIMER, Chandigarh, India
| | - Ajay Prakash
- grid.415131.30000 0004 1767 2903Department of Pharmacology, PGIMER, Chandigarh, India
| | - Bikash Medhi
- grid.415131.30000 0004 1767 2903Department of Pharmacology, PGIMER, Chandigarh, India
| | - Neeraj Singla
- grid.415131.30000 0004 1767 2903Department of Internal Medicine, PGIMER, Chandigarh, India
| | - Ritin Mohindra
- grid.415131.30000 0004 1767 2903Department of Internal Medicine, PGIMER, Chandigarh, India
| | - Vikas Suri
- grid.415131.30000 0004 1767 2903Department of Internal Medicine, PGIMER, Chandigarh, India
| | - Ashish Bhalla
- grid.415131.30000 0004 1767 2903Department of Internal Medicine, PGIMER, Chandigarh, India
| | - Navneet Sharma
- grid.415131.30000 0004 1767 2903Department of Internal Medicine, PGIMER, Chandigarh, India
| | - Mini P. Singh
- grid.415131.30000 0004 1767 2903Department of Virology, PGIMER, Chandigarh, India
| | - P. V. M. Lakshmi
- grid.415131.30000 0004 1767 2903Community Medicine and School of Public Health, PGIMER, Chandigarh, India
| | - Kapil Goyal
- grid.415131.30000 0004 1767 2903Department of Virology, PGIMER, Chandigarh, India
| | - Arnab Ghosh
- grid.415131.30000 0004 1767 2903Department of Virology, PGIMER, Chandigarh, India
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4
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Karolyi M, Kaltenegger L, Pawelka E, Kuran A, Platzer M, Totschnig D, Koenig F, Hoepler W, Laferl H, Omid S, Seitz T, Traugott M, Arthofer S, Erlbeck L, Jaeger S, Kettenbach A, Assinger A, Wenisch C, Zoufaly A. Early administration of remdesivir may reduce mortality in hospitalized COVID-19 patients : A propensity score matched analysis. Wien Klin Wochenschr 2022; 134:883-891. [PMID: 36301355 PMCID: PMC9610353 DOI: 10.1007/s00508-022-02098-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 09/15/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Remdesivir is the only antiviral agent approved for the treatment of hospitalized coronavirus disease 2019 (COVID-19) patients requiring supplemental oxygen. Studies show conflicting results regarding its effect on mortality. METHODS In this single center observational study, we included adult hospitalized COVID-19 patients. Patients who were treated with remdesivir were compared to controls. Remdesivir was administered for 5 days. To adjust for any imbalances in our cohort, a propensity score matched analysis was performed. The aim of our study was to analyze the effect of remdesivir on in-hospital mortality and length of stay (LOS). RESULTS After propensity score matching, 350 patients (175 remdesivir, 175 controls) were included in our analysis. Overall, in-hospital mortality was not significantly different between groups remdesivir 5.7% [10/175] vs. control 8.6% [15/175], hazard ratio 0.50, 95% confidence interval (CI) 0.22-1.12, p = 0.091. Subgroup analysis showed a significant reduction of in-hospital mortality in patients who were treated with remdesivir ≤ 7 days of symptom onset remdesivir 4.2% [5/121] vs. control 10.4% [13/125], hazard ratio 0.26, 95% CI 0.09 to 0.75, p = 0.012 and in female patients remdesivir 2.9% [2/69] vs. control 12.2% [9/74], hazard ratio 0.18 95%CI 0.04 to 0.85, p = 0.03. Patients in the remdesivir group had a significantly longer LOS (11 days vs. 9 days, p = 0.046). CONCLUSION Remdesivir did not reduce in-hospital mortality in our whole propensity score matched cohort, but subgroup analysis showed a significant mortality reduction in female patients and in patients treated within ≤ 7 days of symptom onset. Remdesivir may reduce mortality in patients who are treated in the early stages of illness.
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Affiliation(s)
- Mario Karolyi
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Kundratstraße 3, 1100, Vienna, Austria.
| | - Lukas Kaltenegger
- Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Erich Pawelka
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Kundratstraße 3, 1100, Vienna, Austria
| | - Avelino Kuran
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Kundratstraße 3, 1100, Vienna, Austria
| | - Moritz Platzer
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Kundratstraße 3, 1100, Vienna, Austria
| | - David Totschnig
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Kundratstraße 3, 1100, Vienna, Austria
| | - Franz Koenig
- Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Wolfgang Hoepler
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Kundratstraße 3, 1100, Vienna, Austria
| | - Hermann Laferl
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Kundratstraße 3, 1100, Vienna, Austria
| | - Sara Omid
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Kundratstraße 3, 1100, Vienna, Austria
| | - Tamara Seitz
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Kundratstraße 3, 1100, Vienna, Austria
| | - Marianna Traugott
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Kundratstraße 3, 1100, Vienna, Austria
| | | | | | | | | | - Alice Assinger
- Department of Vascular Biology and Thrombosis Research, Center of Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Christoph Wenisch
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Kundratstraße 3, 1100, Vienna, Austria
| | - Alexander Zoufaly
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Kundratstraße 3, 1100, Vienna, Austria
- Sigmund Freud University, Vienna, Austria
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5
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Karolyi M, Pawelka E, Omid S, Koenig F, Kauer V, Rumpf B, Hoepler W, Kuran A, Laferl H, Seitz T, Traugott M, Rathkolb V, Mueller M, Abrahamowicz A, Schoergenhofer C, Hecking M, Assinger A, Wenisch C, Zeitlinger M, Jilma B, Zoufaly A. Camostat Mesylate Versus Lopinavir/Ritonavir in Hospitalized Patients With COVID-19-Results From a Randomized, Controlled, Open Label, Platform Trial (ACOVACT). Front Pharmacol 2022; 13:870493. [PMID: 35935856 PMCID: PMC9354138 DOI: 10.3389/fphar.2022.870493] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 06/14/2022] [Indexed: 01/08/2023] Open
Abstract
Background: To date, no oral antiviral drug has proven to be beneficial in hospitalized patients with COVID-19. Methods: In this randomized, controlled, open-label, platform trial, we randomly assigned patients ≥18 years hospitalized with COVID-19 pneumonia to receive either camostat mesylate (CM) (considered standard-of-care) or lopinavir/ritonavir (LPV/RTV). The primary endpoint was time to sustained clinical improvement (≥48 h) of at least one point on the 7-category WHO scale. Secondary endpoints included length of stay (LOS), need for mechanical ventilation (MV) or death, and 29-day mortality. Results: 201 patients were included in the study (101 CM and 100 LPV/RTV) between 20 April 2020 and 14 May 2021. Mean age was 58.7 years, and 67% were male. The median time from symptom onset to randomization was 7 days (IQR 5-9). Patients in the CM group had a significantly shorter time to sustained clinical improvement (HR = 0.67, 95%-CI 0.49-0.90; 9 vs. 11 days, p = 0.008) and demonstrated less progression to MV or death [6/101 (5.9%) vs. 15/100 (15%), p = 0.036] and a shorter LOS (12 vs. 14 days, p = 0.023). A statistically nonsignificant trend toward a lower 29-day mortality in the CM group than the LPV/RTV group [2/101 (2%) vs. 7/100 (7%), p = 0.089] was observed. Conclusion: In patients hospitalized for COVID-19, the use of CM was associated with shorter time to clinical improvement, reduced need for MV or death, and shorter LOS than the use of LPV/RTV. Furthermore, research is needed to confirm the efficacy of CM in larger placebo-controlled trials. Systematic Review Registration: [https://clinicaltrials.gov/ct2/show/NCT04351724, https://www.clinicaltrialsregister.eu/ctr-search/trial/2020-001302-30/AT], identifier [NCT04351724, EUDRACT-NR: 2020-001302-30].
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Affiliation(s)
- M. Karolyi
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Vienna, Austria
| | - E. Pawelka
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Vienna, Austria
| | - S. Omid
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Vienna, Austria
| | - F. Koenig
- Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - V. Kauer
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - B. Rumpf
- Department of Internal Medicine III, Clinical Division of Nephrology and Dialysis, Medical University of Vienna, Vienna, Austria
| | - W. Hoepler
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Vienna, Austria
| | - A. Kuran
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Vienna, Austria
| | - H. Laferl
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Vienna, Austria
| | - T. Seitz
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Vienna, Austria
| | - M. Traugott
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Vienna, Austria
| | - V. Rathkolb
- Department of Internal Medicine III, Clinical Division of Nephrology and Dialysis, Medical University of Vienna, Vienna, Austria
| | - M. Mueller
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - A. Abrahamowicz
- Faculty of Medicine, Sigmund Freud University, Vienna, Austria
| | - C. Schoergenhofer
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - M. Hecking
- Department of Internal Medicine III, Clinical Division of Nephrology and Dialysis, Medical University of Vienna, Vienna, Austria
| | - A. Assinger
- Department of Vascular Biology and Thrombosis Research, Center of Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
| | - C. Wenisch
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Vienna, Austria
| | - M. Zeitlinger
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - B. Jilma
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - A. Zoufaly
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Vienna, Austria
- Faculty of Medicine, Sigmund Freud University, Vienna, Austria
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6
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Mahmud N, Anik MI, Hossain MK, Khan MI, Uddin S, Ashrafuzzaman M, Rahaman MM. Advances in Nanomaterial-Based Platforms to Combat COVID-19: Diagnostics, Preventions, Therapeutics, and Vaccine Developments. ACS APPLIED BIO MATERIALS 2022; 5:2431-2460. [PMID: 35583460 PMCID: PMC9128020 DOI: 10.1021/acsabm.2c00123] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 04/24/2022] [Indexed: 12/12/2022]
Abstract
The COVID-19 pandemic caused by the SARS-CoV-2, a ribonucleic acid (RNA) virus that emerged less than two years ago but has caused nearly 6.1 million deaths to date. Recently developed variants of the SARS-CoV-2 virus have been shown to be more potent and expanded at a faster rate. Until now, there is no specific and effective treatment for SARS-CoV-2 in terms of reliable and sustainable recovery. Precaution, prevention, and vaccinations are the only ways to keep the pandemic situation under control. Medical and scientific professionals are now focusing on the repurposing of previous technology and trying to develop more fruitful methodologies to detect the presence of viruses, treat the patients, precautionary items, and vaccine developments. Nanomedicine or nanobased platforms can play a crucial role in these fronts. Researchers are working on many effective approaches by nanosized particles to combat SARS-CoV-2. The role of a nanobased platform to combat SARS-CoV-2 is extremely diverse (i.e., mark to personal protective suit, rapid diagnostic tool to targeted treatment, and vaccine developments). Although there are many theoretical possibilities of a nanobased platform to combat SARS-CoV-2, until now there is an inadequate number of research targeting SARS-CoV-2 to explore such scenarios. This unique mini-review aims to compile and elaborate on the recent advances of nanobased approaches from prevention, diagnostics, treatment to vaccine developments against SARS-CoV-2, and associated challenges.
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Affiliation(s)
- Niaz Mahmud
- Department of Biomedical Engineering,
Military Institute of Science and Technology, Dhaka 1216,
Bangladesh
| | - Muzahidul I. Anik
- Department of Chemical Engineering,
University of Rhode Island, Kingston, Rhode Island 02881,
United States
| | - M. Khalid Hossain
- Interdisciplinary Graduate School of Engineering
Science, Kyushu University, Fukuoka 816-8580,
Japan
- Atomic Energy Research Establishment,
Bangladesh Atomic Energy Commission, Dhaka 1349,
Bangladesh
| | - Md Ishak Khan
- Department of Neurosurgery, University of
Pennsylvania, Philadelphia, Pennsylvania 19104, United
States
| | - Shihab Uddin
- Department of Applied Chemistry, Graduate School of
Engineering, Kyushu University, Fukuoka 819-0395,
Japan
- Department of Chemical Engineering,
Massachusetts Institute of Technology, Cambridge
Massachusetts 02139, United States
| | - Md. Ashrafuzzaman
- Department of Biomedical Engineering,
Military Institute of Science and Technology, Dhaka 1216,
Bangladesh
| | - Md Mushfiqur Rahaman
- Department of Emergency Medicine, NYU
Langone Health, New York, New York 10016, United
States
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7
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Amani B, Zareei S, Amani B, Zareei M, Zareei N, Shabestan R, Akbarzadeh A. Artesunate, imatinib, and infliximab in COVID‐19: A rapid review and meta‐analysis of current evidence. Immun Inflamm Dis 2022; 10:e628. [PMID: 35634954 PMCID: PMC9092000 DOI: 10.1002/iid3.628] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 03/26/2022] [Accepted: 03/29/2022] [Indexed: 11/26/2022] Open
Abstract
Background and Objective Despite the pervasive vaccination program against coronavirus disease 2019 (COVID‐19), people who got fully vaccinated are still contaminated by severe acute respiratory syndrome coronavirus 2, making an effective and safe therapeutic intervention a crucial need for the patients' survival. The purpose of the present study is to seek available evidence for the efficacy and safety of three promising medications artesunate, imatinib, and infliximab against COVID‐19. Methods A literature search was conducted in PubMed, Cochrane Library, medRxive, and Google Scholar, and the relevant articles published up to January 2022 were found. Furthermore, the clinical trial databases were screened for finding more citations. Data analysis was carried out applying The Cochrane Collaboration tool and Newcastle–Ottawa scale to assess the included studies. Meta‐analysis was performed using RevMan 5.4.1. Results Five published studies were identified as eligible. Meta‐analysis showed that there was no significant difference between the infliximab and control groups in terms of mortality rate (risk ratio [RR]: 0.65; confidence interval [CI] 95%: 0.40–1.07; p = .09). However, a significant difference was observed between the two groups for the hospital discharge (RR: 1.37; CI 95%: 1.04–1.80; p = .03). No remarkable clinical benefit was observed for using imatinib in COVID‐19 patients. Artesunate showed significant improvement in patients with COVID‐19. Conclusion In the present, limited evidence exists for the efficacy and safety of artesunate, imatinib, and infliximab in patients with COVID‐19. The findings of WHO's Solidarity international trial will provide further information regarding these therapeutic interventions.
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Affiliation(s)
- Bahman Amani
- Department of Health Management and Economics, School of Public Health Tehran University of Medical Sciences Tehran Iran
| | - Sara Zareei
- Department of Cell & Molecular Biology, Faculty of Biological Sciences Kharazmi University Tehran Iran
| | - Behnam Amani
- Department of Health Management and Economics, School of Public Health Tehran University of Medical Sciences Tehran Iran
| | - Mahsa Zareei
- Department of Health Services Management, School of Health Management and Information Sciences Iran University of Medical Sciences Tehran Iran
| | - Neda Zareei
- Shiraz Transplant Research Center Shiraz University of Medical Sciences Shiraz Iran
| | - Rouhollah Shabestan
- Department of Biostatistics and Epidemiology, School of Public Health Tehran University of Medical Sciences Tehran Iran
| | - Arash Akbarzadeh
- Department of Biostatistics and Epidemiology, School of Public Health Tehran University of Medical Sciences Tehran Iran
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8
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Hassan J, Haigh C, Ahmed T, Uddin MJ, Das DB. Potential of Microneedle Systems for COVID-19 Vaccination: Current Trends and Challenges. Pharmaceutics 2022; 14:1066. [PMID: 35631652 PMCID: PMC9144974 DOI: 10.3390/pharmaceutics14051066] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 04/27/2022] [Accepted: 05/09/2022] [Indexed: 12/12/2022] Open
Abstract
To prevent the coronavirus disease 2019 (COVID-19) pandemic and aid restoration to prepandemic normality, global mass vaccination is urgently needed. Inducing herd immunity through mass vaccination has proven to be a highly effective strategy for preventing the spread of many infectious diseases, which protects the most vulnerable population groups that are unable to develop immunity, such as people with immunodeficiencies or weakened immune systems due to underlying medical or debilitating conditions. In achieving global outreach, the maintenance of the vaccine potency, transportation, and needle waste generation become major issues. Moreover, needle phobia and vaccine hesitancy act as hurdles to successful mass vaccination. The use of dissolvable microneedles for COVID-19 vaccination could act as a major paradigm shift in attaining the desired goal to vaccinate billions in the shortest time possible. In addressing these points, we discuss the potential of the use of dissolvable microneedles for COVID-19 vaccination based on the current literature.
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Affiliation(s)
- Jasmin Hassan
- Drug Delivery & Therapeutics Lab, Dhaka 1212, Bangladesh; (J.H.); (T.A.)
| | - Charlotte Haigh
- Department of Chemical Engineering, Loughborough University, Epinal Way, Loughborough LE11 3TU, UK;
| | - Tanvir Ahmed
- Drug Delivery & Therapeutics Lab, Dhaka 1212, Bangladesh; (J.H.); (T.A.)
| | - Md Jasim Uddin
- Drug Delivery & Therapeutics Lab, Dhaka 1212, Bangladesh; (J.H.); (T.A.)
- Faculty of Engineering and Science, University of Greenwich, Chatham Maritime, Kent ME4 4TB, UK
- Department of Pharmacy, Brac University, 66 Mohakhali, Dhaka 1212, Bangladesh
| | - Diganta B. Das
- Department of Chemical Engineering, Loughborough University, Epinal Way, Loughborough LE11 3TU, UK;
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9
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Fazio S, Affuso F, Bellavite P. A Review of the Potential Roles of Antioxidant and Anti-Inflammatory Pharmacological Approaches for the Management of Mild-to-Moderate Symptomatic COVID-19. Med Sci Monit 2022; 28:e936292. [PMID: 35256581 PMCID: PMC8917781 DOI: 10.12659/msm.936292] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 02/22/2022] [Indexed: 01/11/2023] Open
Abstract
In the past 2 years, the coronavirus disease 2019 (COVID-19) pandemic has driven investigational studies and controlled clinical trials on antiviral treatments and vaccines that have undergone regulatory approval. Now that the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its variants may become endemic over time, there remains a need to identify drugs that treat the symptoms of COVID-19 and prevent progression toward severe cases, hospitalization, and death. Understanding the molecular mechanisms of SARS-CoV-2 infection is extremely important for the development of effective therapies against COVID-19. This review outlines the key pathways involved in the host response to SARS-CoV-2 infection and discusses the potential role of antioxidant and anti-inflammatory pharmacological approaches for the management of early mild-to-moderate COVID-19, using the examples of combined indomethacin, low-dose aspirin, omeprazole, hesperidin, quercetin, and vitamin C. The pharmacological targets of these substances are described here for their possible synergism in counteracting SARS-CoV-2 replication and progression of the infection from the upper respiratory airways to the blood, avoiding vascular complications and cytokine and bradykinin storms.
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Affiliation(s)
- Serafino Fazio
- Department of Internal Medicine (retired professor), Medical School University Federico II, Naples, Italy
| | | | - Paolo Bellavite
- Physiopathology Chair, Homeopathic Medical School of Verona, Verona, Italy
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10
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Nappi F, Iervolino A, Avtaar Singh SS. Molecular Insights of SARS-CoV-2 Antivirals Administration: A Balance between Safety Profiles and Impact on Cardiovascular Phenotypes. Biomedicines 2022; 10:437. [PMID: 35203646 PMCID: PMC8962379 DOI: 10.3390/biomedicines10020437] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/09/2022] [Accepted: 02/10/2022] [Indexed: 12/15/2022] Open
Abstract
The COVID-19 pandemic has resulted in a complex clinical challenge, caused by a novel coronavirus, partially similar to previously known coronaviruses but with a different pattern of contagiousness, complications, and mortality. Since its global spread, several therapeutic agents have been developed to address the heterogeneous disease treatment, in terms of severity, hospital or outpatient management, and pre-existing clinical conditions. To better understand the rationale of new or old repurposed medications, the structure and host-virus interaction molecular bases are presented. The recommended agents by EDSA guidelines comprise of corticosteroids, JAK-targeting monoclonal antibodies, IL-6 inhibitors, and antivirals, some of them showing narrow indications due to the lack of large population trials and statistical power. The aim of this review is to present FDA-approved or authorized for emergency use antivirals, namely remdesivir, molnupinavir, and the combination nirmatrelvir-ritonavir and their impact on the cardiovascular system. We reviewed the literature for metanalyses, randomized clinical trials, and case reports and found positive associations between remdesivir and ritonavir administration at therapeutic doses and changes in cardiac conduction, relatable to their previously known pro-arrhythmogenic effects and important ritonavir interactions with cardioactive medications including antiplatelets, anti-arrhythmic agents, and lipid-lowering drugs, possibly interfering with pre-existing therapeutic regimens. Nonetheless, safety profiles of antivirals are largely questioned and addressed by health agencies, in consideration of COVID-19 cardiac and pro-thrombotic complications generally experienced by predisposed subjects. Our advice is to continuously adhere to the strict indications of FDA documents, monitor the possible side effects of antivirals, and increase physicians' awareness on the co-administration of antivirals and cardiovascular-relevant medications. This review dissects the global and local tendency to structure patient-based treatment plans, for a glance towards practical application of precision medicine.
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Affiliation(s)
- Francesco Nappi
- Department of Cardiac Surgery, Centre Cardiologique du Nord de Saint-Denis, 93200 Saint-Denis, France
| | - Adelaide Iervolino
- Department of Internal Medicine, University Policlinic Federico II, 80131 Naples, Italy;
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11
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Stammes MA, Lee JH, Meijer L, Naninck T, Doyle-Meyers LA, White AG, Borish HJ, Hartman AL, Alvarez X, Ganatra S, Kaushal D, Bohm RP, le Grand R, Scanga CA, Langermans JAM, Bontrop RE, Finch CL, Flynn JL, Calcagno C, Crozier I, Kuhn JH. Medical imaging of pulmonary disease in SARS-CoV-2-exposed non-human primates. Trends Mol Med 2022; 28:123-142. [PMID: 34955425 PMCID: PMC8648672 DOI: 10.1016/j.molmed.2021.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/01/2021] [Accepted: 12/01/2021] [Indexed: 12/11/2022]
Abstract
Chest X-ray (CXR), computed tomography (CT), and positron emission tomography-computed tomography (PET-CT) are noninvasive imaging techniques widely used in human and veterinary pulmonary research and medicine. These techniques have recently been applied in studies of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-exposed non-human primates (NHPs) to complement virological assessments with meaningful translational readouts of lung disease. Our review of the literature indicates that medical imaging of SARS-CoV-2-exposed NHPs enables high-resolution qualitative and quantitative characterization of disease otherwise clinically invisible and potentially provides user-independent and unbiased evaluation of medical countermeasures (MCMs). However, we also found high variability in image acquisition and analysis protocols among studies. These findings uncover an urgent need to improve standardization and ensure direct comparability across studies.
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Affiliation(s)
- Marieke A Stammes
- Biomedical Primate Research Centre (BPRC), 2288 GJ, Rijswijk, The Netherlands.
| | - Ji Hyun Lee
- Integrated Research Facility at Fort Detrick (IRF-Frederick), Division of Clinical Research (DCR), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Fort Detrick, Frederick, MD 21702, USA
| | - Lisette Meijer
- Biomedical Primate Research Centre (BPRC), 2288 GJ, Rijswijk, The Netherlands
| | - Thibaut Naninck
- Center for Immunology of Viral, Auto-immune, Hematological and Bacterial diseases (IMVA-HB/IDMIT), Université Paris-Saclay, Inserm, CEA, 92260 Fontenay-aux-Roses, France
| | - Lara A Doyle-Meyers
- Tulane National Primate Research Center, Covington, LA 70433, USA; Department of Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Alexander G White
- Department of Microbiology and Molecular Genetics, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - H Jacob Borish
- Department of Microbiology and Molecular Genetics, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Amy L Hartman
- Center for Vaccine Research, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA; Department of Infectious Diseases and Microbiology, School of Public Health, University of Pittsburgh, Pitt Public Health, Pittsburgh, PA 15261, USA
| | - Xavier Alvarez
- Texas Biomedical Research Institute, San Antonio, TX 78227, USA
| | | | - Deepak Kaushal
- Texas Biomedical Research Institute, San Antonio, TX 78227, USA
| | - Rudolf P Bohm
- Tulane National Primate Research Center, Covington, LA 70433, USA; Department of Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Roger le Grand
- Center for Immunology of Viral, Auto-immune, Hematological and Bacterial diseases (IMVA-HB/IDMIT), Université Paris-Saclay, Inserm, CEA, 92260 Fontenay-aux-Roses, France
| | - Charles A Scanga
- Department of Microbiology and Molecular Genetics, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA; Center for Vaccine Research, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Jan A M Langermans
- Biomedical Primate Research Centre (BPRC), 2288 GJ, Rijswijk, The Netherlands; Department Population Health Sciences, Division of Animals in Science and Society, Faculty of Veterinary Medicine, Utrecht University, 3584 CL, Utrecht, The Netherlands
| | - Ronald E Bontrop
- Biomedical Primate Research Centre (BPRC), 2288 GJ, Rijswijk, The Netherlands; Department of Biology, Theoretical Biology and Bioinformatics, Utrecht University, 3584 CH, Utrecht, The Netherlands
| | - Courtney L Finch
- Integrated Research Facility at Fort Detrick (IRF-Frederick), Division of Clinical Research (DCR), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Fort Detrick, Frederick, MD 21702, USA
| | - JoAnne L Flynn
- Department of Microbiology and Molecular Genetics, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA; Center for Vaccine Research, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Claudia Calcagno
- Integrated Research Facility at Fort Detrick (IRF-Frederick), Division of Clinical Research (DCR), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Fort Detrick, Frederick, MD 21702, USA
| | - Ian Crozier
- Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD 21701, USA
| | - Jens H Kuhn
- Integrated Research Facility at Fort Detrick (IRF-Frederick), Division of Clinical Research (DCR), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Fort Detrick, Frederick, MD 21702, USA
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12
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Drożdżal S, Rosik J, Lechowicz K, Machaj F, Szostak B, Przybyciński J, Lorzadeh S, Kotfis K, Ghavami S, Łos MJ. An update on drugs with therapeutic potential for SARS-CoV-2 (COVID-19) treatment. Drug Resist Updat 2021; 59:100794. [PMID: 34991982 PMCID: PMC8654464 DOI: 10.1016/j.drup.2021.100794] [Citation(s) in RCA: 158] [Impact Index Per Article: 52.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/23/2021] [Accepted: 11/25/2021] [Indexed: 02/07/2023]
Abstract
The COVID-19 pandemic is one of the greatest threats to human health in the 21st century with more than 257 million cases and over 5.17 million deaths reported worldwide (as of November 23, 2021. Various agents were initially proclaimed to be effective against SARS-CoV-2, the etiological agent of COVID-19. Hydroxychloroquine, lopinavir/ritonavir, and ribavirin are all examples of therapeutic agents, whose efficacy against COVID-19 was later disproved. Meanwhile, concentrated efforts of researchers and clinicians worldwide have led to the identification of novel therapeutic options to control the disease including PAXLOVID™ (PF-07321332). Although COVID-19 cases are currently treated using a comprehensive approach of anticoagulants, oxygen, and antibiotics, the novel Pfizer agent PAXLOVID™ (PF-07321332), an investigational COVID-19 oral antiviral candidate, significantly reduced hospitalization time and death rates, based on an interim analysis of the phase 2/3 EPIC-HR (Evaluation of Protease Inhibition for COVID-19 in High-Risk Patients) randomized, double-blind study of non-hospitalized adult patients with COVID-19, who are at high risk of progressing to severe illness. The scheduled interim analysis demonstrated an 89 % reduction in risk of COVID-19-related hospitalization or death from any cause compared to placebo in patients treated within three days of symptom onset (primary endpoint). However, there still exists a great need for the development of additional treatments, as the recommended therapeutic options are insufficient in many cases. Thus far, mRNA and vector vaccines appear to be the most effective modalities to control the pandemic. In the current review, we provide an update on the progress that has been made since April 2020 in clinical trials concerning the effectiveness of therapies available to combat COVID-19. We focus on currently recommended therapeutic agents, including steroids, various monoclonal antibodies, remdesivir, baricitinib, anticoagulants and PAXLOVID™ summarizing the latest original studies and meta-analyses. Moreover, we aim to discuss other currently and previously studied agents targeting COVID-19 that either show no or only limited therapeutic activity. The results of recent studies report that hydroxychloroquine and convalescent plasma demonstrate no efficacy against SARS-CoV-2 infection. Lastly, we summarize the studies on various drugs with incoherent or insufficient data concerning their effectiveness, such as amantadine, ivermectin, or niclosamide.
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Affiliation(s)
- Sylwester Drożdżal
- Department of Nephrology, Transplantation and Internal Medicine, Pomeranian Medical University in Szczecin, Poland
| | - Jakub Rosik
- Department of Physiology, Pomeranian Medical University in Szczecin, Poland
| | - Kacper Lechowicz
- Department of Anesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University in Szczecin, Poland
| | - Filip Machaj
- Department of Physiology, Pomeranian Medical University in Szczecin, Poland
| | - Bartosz Szostak
- Department of Physiology, Pomeranian Medical University in Szczecin, Poland
| | - Jarosław Przybyciński
- Department of Nephrology, Transplantation and Internal Medicine, Pomeranian Medical University in Szczecin, Poland
| | - Shahrokh Lorzadeh
- Department of Molecular Genetics, Science and Research Branch, Marvdasht Branch, Islamic Azad University, Marvdasht, Iran
| | - Katarzyna Kotfis
- Department of Anesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University in Szczecin, Poland
| | - Saeid Ghavami
- Department of Human Anatomy and Cell Science, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; Research Institutes of Oncology and Hematology, Cancer Care Manitoba-University of Manitoba, Winnipeg, MB R3E 0V9, Canada; Biology of Breathing Theme, Children Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB R3E 0V9, Canada; Autophagy Research Center, Shiraz University of Medical Sciences, Shiraz 7134845794, Iran; Faculty of Medicine, Katowice School of Technology, 40-555 Katowice, Poland
| | - Marek J Łos
- Biotechnology Centre, Silesian University of Technology, 44-100 Gliwice, Poland.
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13
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Campione E, Lanna C, Cosio T, Rosa L, Conte MP, Iacovelli F, Romeo A, Falconi M, Del Vecchio C, Franchin E, Lia MS, Minieri M, Chiaramonte C, Ciotti M, Nuccetelli M, Terrinoni A, Iannuzzi I, Coppeta L, Magrini A, Bernardini S, Sabatini S, Rosapepe F, Bartoletti PL, Moricca N, Di Lorenzo A, Andreoni M, Sarmati L, Miani A, Piscitelli P, Squillaci E, Valenti P, Bianchi L. Lactoferrin as Antiviral Treatment in COVID-19 Management: Preliminary Evidence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010985. [PMID: 34682731 PMCID: PMC8535893 DOI: 10.3390/ijerph182010985] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 10/04/2021] [Accepted: 10/13/2021] [Indexed: 01/08/2023]
Abstract
Lactoferrin (Lf), a multifunctional cationic glycoprotein synthesized by exocrine glands and neutrophils, possesses an in vitro antiviral activity against SARS-CoV-2. Thus, we conducted an in vivo preliminary study to investigate the antiviral effect of oral and intranasal liposomal bovine Lf (bLf) in asymptomatic and mild-to-moderate COVID-19 patients. From April 2020 to June 2020, a total of 92 mild-to-moderate (67/92) and asymptomatic (25/92) COVID-19 patients were recruited and divided into three groups. Thirty-two patients (14 hospitalized and 18 in home-based isolation) received only oral and intranasal liposomal bLf; 32 hospitalized patients were treated only with standard of care (SOC) treatment; and 28, in home-based isolation, did not take any medication. Furthermore, 32 COVID-19 negative, untreated, healthy subjects were added for ancillary analysis. Liposomal bLf-treated COVID-19 patients obtained an earlier and significant (p < 0.0001) SARS-CoV-2 RNA negative conversion compared to the SOC-treated and untreated COVID-19 patients (14.25 vs. 27.13 vs. 32.61 days, respectively). Liposomal bLf-treated COVID-19 patients showed fast clinical symptoms recovery compared to the SOC-treated COVID-19 patients. In bLf-treated patients, a significant decrease in serum ferritin, IL-6, and D-dimers levels was observed. No adverse events were reported. These observations led us to speculate a potential role of bLf in the management of mild-to-moderate and asymptomatic COVID-19 patients.
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Affiliation(s)
- Elena Campione
- Dermatology Unit, Department of Systems Medicine, Tor Vergata University Hospital, 00133 Rome, Italy; (C.L.); (T.C.); (L.B.)
- Correspondence:
| | - Caterina Lanna
- Dermatology Unit, Department of Systems Medicine, Tor Vergata University Hospital, 00133 Rome, Italy; (C.L.); (T.C.); (L.B.)
| | - Terenzio Cosio
- Dermatology Unit, Department of Systems Medicine, Tor Vergata University Hospital, 00133 Rome, Italy; (C.L.); (T.C.); (L.B.)
| | - Luigi Rosa
- Department of Public Health and Infectious Diseases, University of Rome “La Sapienza”, 00185 Rome, Italy; (L.R.); (M.P.C.); (P.V.)
| | - Maria Pia Conte
- Department of Public Health and Infectious Diseases, University of Rome “La Sapienza”, 00185 Rome, Italy; (L.R.); (M.P.C.); (P.V.)
| | - Federico Iacovelli
- Structural Bioinformatics Group, Department of Biology, University of Rome “Tor Vergata”, 00133 Rome, Italy; (F.I.); (A.R.); (M.F.)
| | - Alice Romeo
- Structural Bioinformatics Group, Department of Biology, University of Rome “Tor Vergata”, 00133 Rome, Italy; (F.I.); (A.R.); (M.F.)
| | - Mattia Falconi
- Structural Bioinformatics Group, Department of Biology, University of Rome “Tor Vergata”, 00133 Rome, Italy; (F.I.); (A.R.); (M.F.)
| | - Claudia Del Vecchio
- Department of Molecular Medicine, University of Padova, 35122 Padova, Italy; (C.D.V.); (E.F.)
| | - Elisa Franchin
- Department of Molecular Medicine, University of Padova, 35122 Padova, Italy; (C.D.V.); (E.F.)
| | - Maria Stella Lia
- Department of Experimental Medicine, Tor Vergata University Hospital, 00133 Rome, Italy; (M.S.L.); (M.M.); (A.T.)
| | - Marilena Minieri
- Department of Experimental Medicine, Tor Vergata University Hospital, 00133 Rome, Italy; (M.S.L.); (M.M.); (A.T.)
| | - Carlo Chiaramonte
- Department of Statistics, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Marco Ciotti
- Virology Unit, Tor Vergata University Hospital, 00133 Rome, Italy;
| | - Marzia Nuccetelli
- Laboratory Medicine, Department of Experimental Medicine and Surgery, Tor Vergata University Hospital, 00133 Rome, Italy; (M.N.); (S.B.)
| | - Alessandro Terrinoni
- Department of Experimental Medicine, Tor Vergata University Hospital, 00133 Rome, Italy; (M.S.L.); (M.M.); (A.T.)
| | - Ilaria Iannuzzi
- Occupational Medicine Department, University of Rome “Tor Vergata”, 00133 Rome, Italy; (I.I.); (L.C.); (A.M.)
| | - Luca Coppeta
- Occupational Medicine Department, University of Rome “Tor Vergata”, 00133 Rome, Italy; (I.I.); (L.C.); (A.M.)
| | - Andrea Magrini
- Occupational Medicine Department, University of Rome “Tor Vergata”, 00133 Rome, Italy; (I.I.); (L.C.); (A.M.)
| | - Sergio Bernardini
- Laboratory Medicine, Department of Experimental Medicine and Surgery, Tor Vergata University Hospital, 00133 Rome, Italy; (M.N.); (S.B.)
| | | | | | | | - Nicola Moricca
- Villa dei Pini Hospital, 00042 Anzio, Italy; (S.S.); (N.M.)
| | - Andrea Di Lorenzo
- Infectious Disease Unit, Tor Vergata University Hospital, 00133 Rome, Italy; (A.D.L.); (M.A.); (L.S.)
| | - Massimo Andreoni
- Infectious Disease Unit, Tor Vergata University Hospital, 00133 Rome, Italy; (A.D.L.); (M.A.); (L.S.)
| | - Loredana Sarmati
- Infectious Disease Unit, Tor Vergata University Hospital, 00133 Rome, Italy; (A.D.L.); (M.A.); (L.S.)
| | - Alessandro Miani
- Department of Environmental Sciences and Policy, University of Milan, 20133 Milan, Italy;
| | - Prisco Piscitelli
- UNESCO Chair on Health Education and Sustainable Development, University of Naples Federico II, 80131 Naples, Italy;
| | - Ettore Squillaci
- Department of Diagnostic and Molecular Imaging, Radiation Therapy and Interventional Radiology, University Hospital Tor Vergata, 00133 Rome, Italy;
| | - Piera Valenti
- Department of Public Health and Infectious Diseases, University of Rome “La Sapienza”, 00185 Rome, Italy; (L.R.); (M.P.C.); (P.V.)
| | - Luca Bianchi
- Dermatology Unit, Department of Systems Medicine, Tor Vergata University Hospital, 00133 Rome, Italy; (C.L.); (T.C.); (L.B.)
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14
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Antirheumatic Drug Intake Influence on Occurrence of COVID-19 Infection in Ambulatory Patients with Immune-Mediated Inflammatory Diseases: A Cohort Study. Rheumatol Ther 2021; 8:1887-1895. [PMID: 34529226 PMCID: PMC8444183 DOI: 10.1007/s40744-021-00373-1] [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: 07/14/2020] [Accepted: 09/06/2021] [Indexed: 12/01/2022] Open
Abstract
Introduction We aimed to study the prevalence of a history of COVID-19 infection among patients suffering from systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), Sjögren’s syndrome (SjS) or psoriatic arthritis (PsA), and the potential influence of long-term hydroxychloroquine (HCQ) intake. Methods We performed an observational monocentric cohort study at the Adolphe de Rothschild Foundation Hospital ophthalmology division (Paris, France). Electronic medical records (EMR) data were searched for keywords associated with SLE, RA, SjS, or PsA. Patients were contacted by phone and were interviewed using a standardized questionnaire. The primary outcome was the occurrence of a positive COVID-19 test result during the study period. We determined the adjusted association between various antirheumatic drugs intake, COVID-19 risk factors, and occurrence of COVID-19 using a logistic regression model. This study is registered on ClinicalTrials.gov (Identifier: NCT04345159). Results Patients were recruited between Apr 17, 2020, and Apr 30, 2020 and were recontacted between Oct 6, 2020, and Nov 2, 2020. A total of 569 patients were included, of whom 459 patients were eligible for data analysis. One hundred and eighty-one patients were treated with long-term HCQ and 18 patients had tested positive for COVID-19. No antirheumatic drug intake, including HCQ intake, was significantly associated with an increased or decreased risk of developing COVID-19 infection. Conclusions No antirheumatic drug intake was associated with an increased or decreased risk of developing COVID-19 infection in our cohort of patients suffering from immune-mediated inflammatory diseases.
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Zhai G, Li M, Wang Y, Wu J. Drug-Induced Liver Disturbance During the Treatment of COVID-19. Front Pharmacol 2021; 12:719308. [PMID: 34483929 PMCID: PMC8416279 DOI: 10.3389/fphar.2021.719308] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 08/05/2021] [Indexed: 01/08/2023] Open
Abstract
An outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) occurred in Wuhan, China, at the end of 2019. The World Health Organization named the resulting infectious disease as coronavirus disease-2019 (COVID-19). Many studies concluded that patients infected with SARS-CoV-2 have different degrees of liver disturbance. However, the relationship between the drugs used for COVID-19 treatment and liver disturbance remains controversial. It is essential to evaluate the potential liver damage caused by various drugs in order to help guide clinical practice. This review analyzed the effect of drugs on hepatic function during the treatment of COVID-19.
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Affiliation(s)
- Guanghua Zhai
- Department of Clinical Laboratory, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China
| | - Meifen Li
- Department of Clinical Laboratory, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China
| | - Ying Wang
- Department of Infection Management, Suzhou Hosptial Affiliated to Nanjing Medical University, Suzhou, China
| | - Jian Wu
- Department of Clinical Laboratory, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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