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Berentschot JC, Martine Bek L, Heijenbrok-Kal MH, van den Berg-Emons RJG, Ribbers GM, Aerts JGJV, Hellemons ME. Acute COVID-19 treatment is not associated with health problems 2 years after hospitalization. Int J Infect Dis 2024; 142:106966. [PMID: 38367953 DOI: 10.1016/j.ijid.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/02/2024] [Accepted: 02/12/2024] [Indexed: 02/19/2024] Open
Abstract
OBJECTIVES Various mechanisms, such as immune dysregulation, viral reservoir, and auto-immunity, are hypothesized to underlie the pathogenesis of long-term health problems after hospitalization for COVID-19. We aimed to assess the effect of in-hospital COVID-19 treatments on prominent long-term health problems. METHODS In this prospective multicenter cohort study, we enrolled patients (age ≥18 years) who had been hospitalized for COVID-19 in the Netherlands between July 2020 and October 2021. We retrospectively collected data on in-hospital COVID-19 treatments, including steroid, anti-inflammatory, and antiviral treatments. Patients completed questionnaires on self-reported recovery, dyspnea, fatigue, cognitive failures, and health-related quality of life and performed the 6-minute walk test at the 2-year follow-up visit. RESULTS Five hundred two patients with COVID-19 were included, all were discharged from the hospital between March 2020 and June 2021. The median age at admission was 60.0 (IQR 53.0-68.0) years and 350 (69.7%) patients were male. At hospital admission, 5/405 (1.2%) of the patients had been vaccinated against SARS-CoV-2. Among all 502 patients, the majority (248 [49.4%]) received steroids only, 57 (11.4%) anti-inflammatory treatment, 78 (15.5%) antiviral treatment, and 119 (23.7%) none during hospitalization. Long-term health problems were common in all groups. We found that in-hospital treatments were not significantly associated with health problems at 2 years after hospital discharge, nor after adjusting for confounders. CONCLUSION Many patients with COVID-19 suffer from long-term health problems 2 years after hospital discharge. Acute treatment for COVID-19 is not associated with long-term health problems.
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Affiliation(s)
- Julia C Berentschot
- Department of Respiratory Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
| | - L Martine Bek
- Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Majanka H Heijenbrok-Kal
- Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; Rijndam Rehabilitation, Rotterdam, The Netherlands
| | - Rita J G van den Berg-Emons
- Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Gerard M Ribbers
- Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; Rijndam Rehabilitation, Rotterdam, The Netherlands
| | - Joachim G J V Aerts
- Department of Respiratory Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Merel E Hellemons
- Department of Respiratory Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Marques Vidas M, Muñez Rubio E, Quiroga B, Montejano R, Morales E, Candel FJ. Strategies for prevention and treatment of SARS-COV-2 infection in patients with chronic kidney disease: Literature review. Nefrologia 2024:S2013-2514(24)00068-3. [PMID: 38575481 DOI: 10.1016/j.nefroe.2024.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 10/06/2023] [Indexed: 04/06/2024] Open
Abstract
COVID-19 has proven to be particularly aggressive in patients with chronic kidney disease (CKD). The lower immune response rate and the greater susceptibility to progress to severe forms of the disease have contributed to this phenomenon, which has persisted in the post-vaccination era of the pandemic. Paradoxically, CKD has been excluded from most clinical trials of the main therapeutic tools developed against SARS-CoV-2. However, experience in the use of these drugs has been accumulating in different stages of CKD, supporting their use with guarantees of efficacy and safety. The objective of this review is to gather all treatment indications for COVID-19 in the different phases of the disease, tailored to CKD in its various stages, including renal replacement therapy.
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Affiliation(s)
- María Marques Vidas
- Servicio de Nefrología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain.
| | - Elena Muñez Rubio
- Unidad de Enfermedades Infecciosas, Servicio Medicina Interna, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Borja Quiroga
- ISS-La Princesa, Servicio de Nefrología, Hospital Universitario de la Princesa, Madrid, Spain
| | - Rocío Montejano
- Unidad de Enfermedades Infecciosas y Microbiología Clínica, Hospital Universitario La Paz, CIBER-INFEC, Madrid, Spain
| | - Enrique Morales
- Servicio de Nefrología, Hospital Universitario 12 de Octubre; Instituto de Investigación i+12 del Hospital Universitario 12 de Octubre; Departamento de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Francisco Javier Candel
- Enfermedades Infecciosas y Microbiología Clínica, Coordinación de Trasplantes, Banco de Tejidos, IdISSC, Hospital Universitario Clínico San Carlos, Departamento de Medicina, Universidad Complutense, Madrid, Spain
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Wannigama DL, Hurst C, Phattharapornjaroen P, Hongsing P, Sirichumroonwit N, Chanpiwat K, Rad S.M. AH, Storer RJ, Ounjai P, Kanthawee P, Ngamwongsatit N, Kupwiwat R, Kupwiwat C, Brimson JM, Devanga Ragupathi NK, Charuluxananan S, Leelahavanichkul A, Kanjanabuch T, Higgins PG, Badavath VN, Amarasiri M, Verhasselt V, Kicic A, Chatsuwan T, Pirzada K, Jalali F, Reiersen AM, Abe S, Ishikawa H. Early treatment with fluvoxamine, bromhexine, cyproheptadine, and niclosamide to prevent clinical deterioration in patients with symptomatic COVID-19: a randomized clinical trial. EClinicalMedicine 2024; 70:102517. [PMID: 38516100 PMCID: PMC10955208 DOI: 10.1016/j.eclinm.2024.102517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 02/08/2024] [Accepted: 02/19/2024] [Indexed: 03/23/2024] Open
Abstract
Background Repurposed drugs with host-directed antiviral and immunomodulatory properties have shown promise in the treatment of COVID-19, but few trials have studied combinations of these agents. The aim of this trial was to assess the effectiveness of affordable, widely available, repurposed drugs used in combination for treatment of COVID-19, which may be particularly relevant to low-resource countries. Methods We conducted an open-label, randomized, outpatient, controlled trial in Thailand from October 1, 2021, to June 21, 2022, to assess whether early treatment within 48-h of symptoms onset with combinations of fluvoxamine, bromhexine, cyproheptadine, and niclosamide, given to adults with confirmed mild SARS-CoV-2 infection, can prevent 28-day clinical deterioration compared to standard care. Participants were randomly assigned to receive treatment with fluvoxamine alone, fluvoxamine + bromhexine, fluvoxamine + cyproheptadine, niclosamide + bromhexine, or standard care. The primary outcome measured was clinical deterioration within 9, 14, or 28 days using a 6-point ordinal scale. This trial is registered with ClinicalTrials.gov (NCT05087381). Findings Among 1900 recruited, a total of 995 participants completed the trial. No participants had clinical deterioration by day 9, 14, or 28 days among those treated with fluvoxamine plus bromhexine (0%), fluvoxamine plus cyproheptadine (0%), or niclosamide plus bromhexine (0%). Nine participants (5.6%) in the fluvoxamine arm had clinical deterioration by day 28, requiring low-flow oxygen. In contrast, most standard care arm participants had clinical deterioration by 9, 14, and 28 days. By day 9, 32.7% (110) of patients in the standard care arm had been hospitalized without requiring supplemental oxygen but needing ongoing medical care. By day 28, this percentage increased to 37.5% (21). Additionally, 20.8% (70) of patients in the standard care arm required low-flow oxygen by day 9, and 12.5% (16) needed non-invasive or mechanical ventilation by day 28. All treated groups significantly differed from the standard care group by days 9, 14, and 28 (p < 0.0001). Also, by day 28, the three 2-drug treatments were significantly better than the fluvoxamine arm (p < 0.0001). No deaths occurred in any study group. Compared to standard care, participants treated with the combination agents had significantly decreased viral loads as early as day 3 of treatment (p < 0.0001), decreased levels of serum cytokines interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and interleukin-1 beta (IL-1β) as early as day 5 of treatment, and interleukin-8 (IL-8) by day 7 of treatment (p < 0.0001) and lower incidence of post-acute sequelae of COVID-19 (PASC) symptoms (p < 0.0001). 23 serious adverse events occurred in the standard care arm, while only 1 serious adverse event was reported in the fluvoxamine arm, and zero serious adverse events occurred in the other arms. Interpretation Early treatment with these combinations among outpatients diagnosed with COVID-19 was associated with lower likelihood of clinical deterioration, and with significant and rapid reduction in the viral load and serum cytokines, and with lower burden of PASC symptoms. When started very soon after symptom onset, these repurposed drugs have high potential to prevent clinical deterioration and death in vaccinated and unvaccinated COVID-19 patients. Funding Ped Thai Su Phai (Thai Ducks Fighting Danger) social giver group.
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Affiliation(s)
- Dhammika Leshan Wannigama
- Department of Infectious Diseases and Infection Control, Yamagata Prefectural Central Hospital, Yamagata, Japan
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
- Center of Excellence in Antimicrobial Resistance and Stewardship, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- School of Medicine, Faculty of Health and Medical Sciences, The University of Western Australia, Nedlands, Western Australia, Australia
- Biofilms and Antimicrobial Resistance Consortium of ODA Receiving Countries, The University of Sheffield, Sheffield, United Kingdom
- Pathogen Hunter's Research Collaborative Team, Department of Infectious Diseases and Infection Control, Yamagata Prefectural Central Hospital, Yamagata, Japan
- Yamagata Prefectural University of Health Sciences, Kamiyanagi, Yamagata, 990-2212, Japan
| | - Cameron Hurst
- Molly Wardaguga Research Centre, Charles Darwin University, Queensland, Australia
| | - Phatthranit Phattharapornjaroen
- Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Institute of Clinical Sciences, Department of Surgery, Sahlgrenska Academy, Gothenburg University, 40530, Gothenburg, Sweden
| | - Parichart Hongsing
- Mae Fah Luang University Hospital, Chiang Rai, Thailand
- School of Integrative Medicine, Mae Fah Luang University, Chiang Rai, Thailand
| | - Natchalaikorn Sirichumroonwit
- Institute of Medical Research and Technology Assessment, Department of Medical Services, Ministry of Public Health, Thailand
| | | | - Ali Hosseini Rad S.M.
- Department of Microbiology and Immunology, University of Otago, Dunedin, 9010, Otago, New Zealand
- Center of Excellence in Immunology and Immune-Mediated Diseases, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Robin James Storer
- Office of Research Affairs, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Puey Ounjai
- Department of Biology, Faculty of Science, Mahidol University, Bangkok, Thailand
| | - Phitsanuruk Kanthawee
- Public Health Major, School of Health Science, Mae Fah Luang University, Chiang Rai, Thailand
| | - Natharin Ngamwongsatit
- Department of Clinical Sciences and Public Health, Faculty of Veterinary Science, Mahidol University, Nakhon Pathom, Thailand
| | - Rosalyn Kupwiwat
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chaisit Kupwiwat
- Department of Critical Care Medicine, Vibhavadi Hospital, Bangkok, Thailand
| | - James Michael Brimson
- Department of Innovation and International Affair, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Naveen Kumar Devanga Ragupathi
- Biofilms and Antimicrobial Resistance Consortium of ODA Receiving Countries, The University of Sheffield, Sheffield, United Kingdom
- Department of Chemical and Biological Engineering, The University of Sheffield, Sheffield, United Kingdom
- Division of Microbial Interactions, Department of Research and Development, Bioberrys Healthcare and Research Centre, Vellore, 632009, India
| | - Somrat Charuluxananan
- Department of Anesthesiology, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Asada Leelahavanichkul
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
- Translational Research in Inflammation and Immunology Research Unit (TRIRU), Department of Microbiology, Chulalongkorn University, Bangkok, Thailand
| | - Talerngsak Kanjanabuch
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence in Kidney Metabolic Disorders, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Dialysis Policy and Practice Program (DiP3), School of Global Health, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Peritoneal Dialysis Excellence Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Paul G. Higgins
- Institute for Medical Microbiology, Immunology and Hygiene, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- German Centre for Infection Research, Partner Site Bonn-Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50935, Cologne, Germany
| | - Vishnu Nayak Badavath
- School of Pharmacy & Technology Management, SVKM's Narsee Monjee Institute of Management Studies (NMIMS), Hyderabad, 509301, India
| | - Mohan Amarasiri
- Laboratory of Environmental Hygiene, Department of Health Science, School of Allied Health Sciences, Graduate School of Medical Sciences, Kitasato University, Kitasato, Sagamihara-Minami, Kanagawa, 252-0373, Japan
| | - Valerie Verhasselt
- Centre of Research for Immunology and Breastfeeding (CIBF), Medical School and School of Biomedical Science, University of Western Australia, Perth, Western Australia, 6009, Australia
- Immunology and Breastfeeding Group, Neonatal and Life Course Health Program, Telethon Kids Institute, Perth, Western Australia, 6009, Australia
| | - Anthony Kicic
- Telethon Kids Institute, University of Western Australia, Nedlands, 6009, Western Australia, Australia
- Centre for Cell Therapy and Regenerative Medicine, Medical School, The University of Western Australia, Nedlands, 6009, Western Australia, Australia
- Department of Respiratory and Sleep Medicine, Perth Children's Hospital, Nedlands, 6009, Western Australia, Australia
- School of Public Health, Curtin University, Bentley, 6102, Western Australia, Australia
| | - Tanittha Chatsuwan
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
- Center of Excellence in Antimicrobial Resistance and Stewardship, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Kashif Pirzada
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Ontario, Canada
| | - Farid Jalali
- Department of Gastroenterology, Saddleback Medical Group, Laguna Hills, CA, United States
| | - Angela M. Reiersen
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, St. Louis, MO, United States
| | - Shuichi Abe
- Department of Infectious Diseases and Infection Control, Yamagata Prefectural Central Hospital, Yamagata, Japan
| | - Hitoshi Ishikawa
- Yamagata Prefectural University of Health Sciences, Kamiyanagi, Yamagata, 990-2212, Japan
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Soltaninejad E, Mohammad Hassan Z, Yekaninejad MS, Hassaniazad M, Barahimi E, Samiei A, Ebtekar M. The effects of Annual SZ drug on dynamic changes in lymphocytes and cytokines of COVID-19 patients: A randomized clinical trial. Int Immunopharmacol 2024; 128:111534. [PMID: 38237225 DOI: 10.1016/j.intimp.2024.111534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 12/30/2023] [Accepted: 01/10/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND The search for a potent anti-coronavirus therapy has remained an overwhelming task since the outbreak of COVID-19. Annual SZ is a novel formulation of artemisinin and its derivatives. We aim to investigate the effect of Annual SZ on clinical outcomes, cellular immune responses, and cytokine changes in COVID-19 patients. METHODS This study included 80 COVID-19 hospitalized patients, which were randomly allocated into two groups (intervention and control). Both groups received standard supportive treatment. In addition, the intervention group (n = 40) received Annual SZ syrup, and the control group (n = 40) received a placebo. Dynamic changes in lymphocytes, cytokines, and clinical status were evaluated since hospital admission to 7 and 14 days after treatment. RESULTS The dynamic count of total T lymphocytes and T lymphocyte subsets (CD4+ and CD8+) in the Annual SZ group was significantly higher than the placebo group (p < 0.05). In addition, Programmed Death 1 (PD-1) was significantly increased in the CD4+ and CD8+ T cells in the placebo group compared with the Annual SZ group (p < 0.05). Also, the CD4+/CD8+ ratio was not significantly different between the groups (p > 0.9). Moreover, IL-6 levels were significantly reduced (p < 0.05), while IL-4 and IFN-γ levels were not statistically different between the two groups (p > 0.05). CONCLUSION This research indicated that the Annual SZ syrup significantly improved clinical status and lymphocyte frequency with less exhaustion of T lymphocytes and a reduction of inflammatory responses, which seems to be beneficial in the treatment process of COVID-19 patients.
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Affiliation(s)
- Ehsan Soltaninejad
- Department of Immunology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Zuhair Mohammad Hassan
- Department of Immunology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mir Saeed Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Hassaniazad
- Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Elham Barahimi
- Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Afshin Samiei
- Tobacco and Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran; Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
| | - Masoumeh Ebtekar
- Department of Immunology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
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Abstract
The treatment for COVID-19 has evolved rapidly since the start of the pandemic and now consists mainly of antiviral and immunomodulatory agents. Antivirals, such as remdesivir and nirmatrelvir-ritonavir, have proved to be most useful earlier in illness (e.g., as outpatient therapy) and for less severe disease. Immunomodulatory therapies, such as dexamethasone and interleukin-6 or Janus kinase inhibitors, are most useful in severe disease or critical illness. The role of anti-SARS-CoV-2 monoclonal antibodies has diminished because of the emergence of viral variants that are not anticipated to be susceptible to these treatments, and there still is not a consensus on the use of convalescent plasma. COVID-19 has been associated with increased rates of venous thromboembolism, but the role of antithrombotic therapy is limited. Multiple investigational agents continue to be studied, which will alter current treatment paradigms as new data are released.
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Affiliation(s)
- Hayden S Andrews
- Division of Infectious Diseases, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA; ,
| | - Jonathan D Herman
- Division of Infectious Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA;
- Ragon Institute of Mass General, MIT, and Harvard, Cambridge, Massachusetts, USA
| | - Rajesh T Gandhi
- Division of Infectious Diseases, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA; ,
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Sinha P, Lahare P, Sahu M, Cimler R, Schnitzer M, Hlubenova J, Hudak R, Singh N, Gupta B, Kuca K. Concept and Evolution in 3-D Printing for Excellence in Healthcare. Curr Med Chem 2024; 31:CMC-EPUB-137638. [PMID: 38265395 DOI: 10.2174/0109298673262300231129102520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/05/2023] [Accepted: 10/31/2023] [Indexed: 01/25/2024]
Abstract
Three-dimensional printing (3DP) has gained popularity among scientists and researchers in every field due to its potential to drastically reduce energy costs for the production of customised products by utilising less energy-intensive machines as well as minimising material waste. The 3D printing technology is an additive manufacturing approach that uses material layer-by-layer fabrication to produce the digitally specified 3D model. The use of 3D printing technology in the pharmaceutical sector has the potential to revolutionise research and development by providing a quick and easy means to manufacture personalised one-off batches, each with unique dosages, distinct substances, shapes, and sizes, as well as variable release rates. This overview addresses the concept of 3D printing, its evolution, and its operation, as well as the most popular types of 3D printing processes utilised in the health care industry. It also discusses the application of these cutting-edge technologies to the pharmaceutical industry, advancements in various medical fields and medical equipment, 3D bioprinting, the most recent initiatives to combat COVID-19, regulatory frameworks, and the major challenges that this technology currently faces. In addition, we attempt to provide some futuristic approaches to 3DP applications.
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Affiliation(s)
- Priyank Sinha
- Department of Chemistry, Centre for Basic Sciences, Pt. Ravishankar Shukla University, Raipur 492010, Chhattisgarh, India
| | - Preeti Lahare
- Department of Chemistry, Centre for Basic Sciences, Pt. Ravishankar Shukla University, Raipur 492010, Chhattisgarh, India
| | - Meena Sahu
- Department of Chemistry, Centre for Basic Sciences, Pt. Ravishankar Shukla University, Raipur 492010, Chhattisgarh, India
| | - Richard Cimler
- Faculty of Science, University of Hradec Kralove, Rokitanskeho 62, Hradec Kralove, Czech Republic
| | - Marek Schnitzer
- Department of Biomedical Engineering and Measurement, Faculty of Mechanical Engineering, Technical University of Kosice, Letna 1/9 Kosice, Slovakia
| | - Jana Hlubenova
- Department of Biomedical Engineering and Measurement, Faculty of Mechanical Engineering, Technical University of Kosice, Letna 1/9 Kosice, Slovakia
| | - Radovan Hudak
- Department of Biomedical Engineering and Measurement, Faculty of Mechanical Engineering, Technical University of Kosice, Letna 1/9 Kosice, Slovakia
| | - Namrata Singh
- Faculty of Science, University of Hradec Kralove, Rokitanskeho 62, Hradec Kralove, Czech Republic
- Department of Engineering Sciences, Ramrao Adik Institute of Technology, DY Patil University, Nerul, Navi Mumbai, Maharashtra 400706, India
| | - Bhanushree Gupta
- Department of Chemistry, Centre for Basic Sciences, Pt. Ravishankar Shukla University, Raipur 492010, Chhattisgarh, India
| | - Kamil Kuca
- Faculty of Science, University of Hradec Kralove, Rokitanskeho 62, Hradec Kralove, Czech Republic
- Biomedical Research Center, University Hospital Hradec Kralove, Sokolska 581, 50005 Hradec Kralove, Czech Republic
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Chatterton B, Ascher SB, Duan N, Kravitz RL. Does haste make waste? Prevalence and types of errors reported after publication of studies of COVID-19 therapeutics. Syst Rev 2023; 12:216. [PMID: 37968691 PMCID: PMC10652527 DOI: 10.1186/s13643-023-02381-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 10/26/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic spurred publication of a rapid proliferation of studies on potential therapeutic agents. While important for the advancement of clinical care, pressure to collect, analyze, and report data in an expedited manner could potentially increase the rate of important errors, some of which would be captured in published errata. We hypothesized that COVID-19 therapeutic studies published in the early years of the pandemic would be associated with a high rate of published errata and that, within these errata, there would be a high prevalence of serious errors. METHODS We performed a review of published errata associated with empirical studies of COVID-19 treatments. Errata were identified via a MEDLINE and Embase search spanning January 2020 through September 2022. Errors located within each published erratum were characterized by location within publication, error type, and error seriousness. RESULTS Of 47 studies on COVID-19 treatments with published errata, 18 met inclusion criteria. Median time from publication of the original article to publication of the associated erratum was 76 days (range, 12-511 days). A majority of errata addressed issues with author attribution or conflict of interest disclosures (39.5%) or numerical results (25.6%). Only one erratum contained a serious error: a typographical error which could have misled readers into believing that the treatment in question had serious adverse effects when in fact it did not. CONCLUSIONS Despite accelerated publication times, we found among studies of COVID-19 treatments the majority of errata (17/18) reported minor errors that did not lead to misinterpretation of the study results. Retractions, an indicator of scientific misdirection even more concerning than errata, were beyond the scope of this review.
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Affiliation(s)
- Brittany Chatterton
- Department of Internal Medicine, University of California, Davis, Sacramento, CA, USA.
- Center for Healthcare Policy and Research, University of California, Davis, Sacramento, CA, USA.
| | - Simon B Ascher
- Department of Internal Medicine, University of California, Davis, Sacramento, CA, USA
| | - Naihua Duan
- Division of Mental Health Data Science, Department of Psychiatry, Columbia University, New York City, NY, USA
| | - Richard L Kravitz
- Department of Internal Medicine, University of California, Davis, Sacramento, CA, USA
- Center for Healthcare Policy and Research, University of California, Davis, Sacramento, CA, USA
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Baig AM, Gerlach J. Intranasal Route: A Nasocerebral Approach against SARS-CoV-2 in NeuroCOVID. ACS Chem Neurosci 2023; 14:3560-3563. [PMID: 37698524 DOI: 10.1021/acschemneuro.3c00488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023] Open
Abstract
The nasal cavity is a prime site for viral load of SARS-CoV-2 in COVID-19, as is evident from the fact that this area has been used for sample collection for the diagnosis of COVID-19. The nasal cavity has a connection with the brain across the cribriform plate which has been reported to be a route of SARS-CoV-2 to the olfactory apparatus and the brain. Targeting the SARS-CoV-2 in the nasal cavity in patients presenting with COVID-19 and long-COVID can result in the prevention and treatment of neurological deficits and therefore needs to be prioritized as a route of potential significance.
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Affiliation(s)
- Abdul Mannan Baig
- Senior Researcher, Lead Scientist COVID-19 and Long-COVID, St. George's Hospital, 83043 Bad Aibling, Germany
| | - Joachim Gerlach
- CEO Research and Development, Health-Shield, Vedicinals-9 40764 Langenfeld, Germany
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Annamalai A, Karuppaiya V, Ezhumalai D, Cheruparambath P, Balakrishnan K, Venkatesan A. Nano-based techniques: A revolutionary approach to prevent covid-19 and enhancing human awareness. J Drug Deliv Sci Technol 2023; 86:104567. [PMID: 37313114 PMCID: PMC10183109 DOI: 10.1016/j.jddst.2023.104567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 04/22/2023] [Accepted: 05/13/2023] [Indexed: 06/15/2023]
Abstract
In every century of history, there are many new diseases emerged, which are not even cured by many developed countries. Today, despite of scientific development, new deadly pandemic diseases are caused by microorganisms. Hygiene is considered to be one of the best methods of avoiding such communicable diseases, especially viral diseases. Illness caused by SARS-CoV-2 was termed COVID-19 by the WHO, the acronym derived from "coronavirus disease 2019. The globe is living in the worst epidemic era, with the highest infection and mortality rate owing to COVID-19 reaching 6.89% (data up to March 2023). In recent years, nano biotechnology has become a promising and visible field of nanotechnology. Interestingly, nanotechnology is being used to cure many ailments and it has revolutionized many aspects of our lives. Several COVID-19 diagnostic approaches based on nanomaterial have been developed. The various metal NPs, it is highly anticipated that could be viable and economical alternatives for treating drug resistant in many deadly pandemic diseases in near future. This review focuses on an overview of nanotechnology's increasing involvement in the diagnosis, prevention, and therapy of COVID-19, also this review provides readers with an awareness and knowledge of importance of hygiene.
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Affiliation(s)
- Asaikkutti Annamalai
- Marine Biotechnology Laboratory, Department of Biotechnology, School of Life Sciences, Pondicherry University, Pondicherry, 605 014, Puducherry, India
| | - Vimala Karuppaiya
- Cancer Nanomedicine Laboratory, Department of Zoology, School of Life Sciences, Periyar University, Salem, 636 011, Tamil Nadu, India
| | - Dhineshkumar Ezhumalai
- Dr. Krishnamoorthi Foundation for Advanced Scientific Research, Vellore, 632 001, Tamil Nadu, India
- Manushyaa Blossom Private Limited, Chennai, 600 102, Tamil Nadu, India
| | | | - Kaviarasu Balakrishnan
- Dr. Krishnamoorthi Foundation for Advanced Scientific Research, Vellore, 632 001, Tamil Nadu, India
- Manushyaa Blossom Private Limited, Chennai, 600 102, Tamil Nadu, India
| | - Arul Venkatesan
- Marine Biotechnology Laboratory, Department of Biotechnology, School of Life Sciences, Pondicherry University, Pondicherry, 605 014, Puducherry, India
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Shapiro AE, Sarkis E, Acloque J, Free A, Gonzalez-Rojas Y, Hussain R, Juarez E, Moya J, Parikh N, Inman D, Cebrik D, Nader A, Noormohamed N, Wang Q, Skingsley A, Austin D, Peppercorn A, Agostini ML, Parra S, Chow S, Mogalian E, Pang PS, Hong DK, Sager JE, Yeh WW, Alexander EL, Gaffney LA, Kohli A. Intramuscular vs Intravenous SARS-CoV-2 Neutralizing Antibody Sotrovimab for Treatment of COVID-19 (COMET-TAIL): A Randomized Noninferiority Clinical Trial. Open Forum Infect Dis 2023; 10:ofad354. [PMID: 37577112 PMCID: PMC10414803 DOI: 10.1093/ofid/ofad354] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 07/12/2023] [Indexed: 08/15/2023] Open
Abstract
Background Convenient administration of coronavirus disease 2019 (COVID-19) treatment in community settings is desirable. Sotrovimab is a pan-sarbecovirus dual-action monoclonal antibody formulated for intravenous (IV) or intramuscular (IM) administration for early treatment of mild/moderate COVID-19. Method This multicenter phase 3 study based on a randomized open-label design tested the noninferiority of IM to IV administration according to an absolute noninferiority margin of 3.5%. From June to August 2021, patients aged ≥12 years with COVID-19, who were neither hospitalized nor receiving supplemental oxygen but were at high risk for progression, were randomized 1:1:1 to receive sotrovimab as a single 500-mg IV infusion or a 500- or 250-mg IM injection. The primary composite endpoint was progression to (1) all-cause hospitalization for >24 hours for acute management of illness or (2) all-cause death through day 29. Results Sotrovimab 500 mg IM was noninferior to 500 mg IV: 10 (2.7%) of 376 participants vs 5 (1.3%) of 378 met the primary endpoint, respectively (absolute adjusted risk difference, 1.06%; 95% CI, -1.15% to 3.26%). The 95% CI upper limit was lower than the prespecified noninferiority margin of 3.5%. The 250-mg IM group was discontinued early because of the greater proportion of hospitalizations vs the 500-mg groups. Serious adverse events occurred in <1% to 2% of participants across groups. Four participants experienced serious disease-related events and died (500 mg IM, 2/393, <1%; 250 mg IM, 2/195, 1%). Conclusions Sotrovimab 500-mg IM injection was well tolerated and noninferior to IV administration. IM administration could expand outpatient treatment access for COVID-19. Clinical Trials Registration ClinicalTrials.gov: NCT04913675.
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Affiliation(s)
- Adrienne E Shapiro
- Departments of Global Health and Medicine, University of Washington, Seattle, Washington, USA
- Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Elias Sarkis
- Sarkis Clinical Trials, Gainesville, Florida, USA
| | - Jude Acloque
- BioClinical Research Alliance, Miami, Florida, USA
| | - Almena Free
- Pinnacle Research Group, Anniston, Alabama, USA
| | | | | | - Erick Juarez
- Florida International Medical Research, Miami, Florida, USA
| | - Jaynier Moya
- Pines Care Research Center, Pembroke Pines, Florida, USA
| | | | | | | | | | | | | | | | | | | | | | - Sergio Parra
- Vir Biotechnology, Inc., San Francisco, California, USA
| | - Sophia Chow
- Vir Biotechnology, Inc., San Francisco, California, USA
| | - Erik Mogalian
- Vir Biotechnology, Inc., San Francisco, California, USA
| | | | - David K Hong
- Vir Biotechnology, Inc., San Francisco, California, USA
| | | | - Wendy W Yeh
- Vir Biotechnology, Inc., San Francisco, California, USA
| | | | | | - Anita Kohli
- Arizona Liver Health, Chandler, Arizona, USA
- Arizona Clinical Trials, Tucson, Arizona, USA
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Prabowo NA, Megantara MA, Apriningsih H. The role of N-acetylcysteine in decreasing neutrophil-lymphocyte ratio in COVID-19 patients: A double-blind, randomized controlled trial. Narra J 2023; 3:e121. [PMID: 38454976 PMCID: PMC10919724 DOI: 10.52225/narraj.v3i2.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 05/09/2023] [Indexed: 03/09/2024]
Abstract
N-acetylcysteine has antioxidant and anti-inflammatory activities that could potentially improve the clinical outcomes of coronavirus disease 2019 (COVID-19) patients. N-acetylcysteine potentially inhibits NLRP3 (NOD-, LRR- and pyrin domain-containing protein 3) inflammasome and results in control oxidative stress and cytokine release in COVID-19 patients. The aim of this study was to assess the effect of N-acetylcysteine in reducing the neutrophil-lymphocyte ratio (NLR) in COVID-19 patients. A randomized controlled clinical trial was conducted among severe and moderate COVID-19 patients. The treatment group received oral 1200 mg daily of N-acetylcysteine (three times a day) and the standard care for COVID-19, while the control group received standard care for COVID-19 and a placebo. The NLR was determined on the first day of admission and after the seventh day of treatment. A paired Student t-test was used to compare the NLR before and after treatment while independent Student t-test was used to compare the NLR between treatment and control groups. A total of 40 severe and moderate COVID-19 were enrolled, 20 people in each group, with a mean age was 44.68±13.24 years old. The mean NLR on the first day was 9.44 in the treatment group and 8.84 in the control group. After the seventh day, the mean NLR was 4.27 and 11.54 in the treatment group and control group, respectively. The mean changes of NLR (the pre-treatment compared to post-treatment) in the treatment and control group were reduced 4.05 and increased 3.34, respectively. The NLR in treatment group significantly decreased compared to the control group (p<0.001). In conclusion, N-acetylcysteine 1200 mg daily could reduce the NLR in severe and moderate COVID-19 patients.
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Affiliation(s)
- Nurhasan A. Prabowo
- Department of Internal Medicine, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
- Department of Internal Medicine, Universitas Sebelas Maret Hospital, Kartasura, Indonesia
| | - Marcelino A. Megantara
- Department of Internal Medicine, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
| | - Hendrastutik Apriningsih
- Department of Internal Medicine, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
- Department of Internal Medicine, Universitas Sebelas Maret Hospital, Kartasura, Indonesia
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Pagliarin LG, de Oliveira LM, dos Anjos VNF, de Souza CDBT, Peiter GC, Façanha Wendel C, Dillmann Groto A, Freire de Melo F, Teixeira KN. In silico evidence of Remdesivir action in blood coagulation cascade modulation in COVID-19 treatment. World J Biol Chem 2023; 14:72-83. [PMID: 37547340 PMCID: PMC10401403 DOI: 10.4331/wjbc.v14.i4.72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 04/30/2023] [Accepted: 07/03/2023] [Indexed: 07/25/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) has demonstrated several clinical manifestations which include not only respiratory system issues but also liver, kidney, and other organ injuries. One of these abnormalities is coagulopathies, including thrombosis and disseminated intravascular coagulation. Because of this, the administration of low molecular weight heparin is required for patients that need to be hospitalized. In addition, Remdesivir is an antiviral that was used against Middle East Acute Respiratory Syndrome, Ebola, Acute Respiratory Syndrome, and other diseases, showing satisfactory results on recovery. Besides, there is evidence suggesting that this medication can provide a better prognosis for patients with COVID-19.
AIM To investigate in silico the interaction between Remdesivir and clotting factors, pursuing a possibility of using it as medicine.
METHODS In this in silico study, the 3D structures of angiotensin-converting enzyme 2 (ACE2), Factor I (fibrinogen), Factor II (prothrombin), Factor III (thromboplastin), Factor V (proaccelerin), Factor VII (proconvertin), Factor VIII (antihemophilic factor A), Factor IX (antihemophilic factor B), Factor X (Stuart-Prower factor), and Factor XI (precursor of thromboplastin (these structures are technically called receptors) were selected from the Protein Data Bank. The structures of the antivirals Remdesivir and Osetalmivir (these structures are called ligands) were selected from the PubChem database, while the structure of Atazanavir was selected from the ZINC database. The software AutoDock Tools (ADT) was used to prepare the receptors for molecular docking. Ions, peptides, water molecules, and other ones were removed from each ligand, and then, hydrogen atoms were added to the structures. The grid box was delimited and calculated using the same software ADT. A physiological environment with pH 7.4 is needed to make the ligands interact with the receptors, and still the software Marvin sketch® (ChemAxon®) was used to forecast the protonation state. To perform molecular docking, ADT and Vina software was connected. Using PyMol® software and Discovery studio® software from BIOVIA, it was possible to analyze the amino acid residues from receptors that were involved in the interactions with the ligands. Ligand tortions, atoms that participated in the interactions, and the type, strength, and duration of the interactions were also analyzed using those software.
RESULTS Molecular docking analysis showed that Remdesivir and ACE2 had an affinity energy of -8.8 kcal/moL, forming a complex with eight hydrogen bonds involving seven atoms of Remdesivir and five amino acid residues of ACE2. Remdesivir and prothrombin had an interaction with six hydrogen bonds involving atoms of the drug and five amino acid residues of the clotting factor. Similar to that, Remdesivir and thromboplastin presented interactions via seven hydrogen bonds involving five atoms of the drug and four residues of the clotting factor. While Remdesivir and Factor V established a complex with seven hydrogen bonds between six antiviral atoms and six amino acid residues from the factor, and Factor VII connected with the drug by four hydrogen bonds, which involved three atoms of the drug and three residues of amino acids of the factor. The complex between Remdesivir and Factor IX formed an interaction via 11 hydrophilic bonds with seven atoms of the drug and seven residues of the clotting factor, plus one electrostatic bond and three hydrophobic interactions. Factor X and Remdesivir had an affinity energy of -9.6 kcal/moL, and the complex presented 10 hydrogen bonds and 14 different hydrophobic interactions which involved nine atoms of the drug and 16 amino acid residues of the clotting factor. The interaction between Remdesivir and Factor XI formed five hydrogen bonds involving five amino acid residues of the clotting factor and five of the antiviral atoms.
CONCLUSION Because of the in silico significant affinity, Remdesivir possibly could act in the severe acute respiratory syndrome coronavirus 2 infection blockade by interacting with ACE2 and concomitantly act in the modulation of the coagulation cascade preventing the hypercoagulable state.
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Affiliation(s)
| | | | | | | | - Gabrielle Caroline Peiter
- Programa Multicêntrico de Pós-graduação em Bioquímica e Biologia Molecular - Setor Palotina, Universidade Federal do Paraná, Palotina 85.950-000, Paraná, Brazil
| | | | | | - Fabrício Freire de Melo
- Instituto Multidisciplinar em Saúde - Campus Anísio Teixeira, Universidade Federal da Bahia, Vitória da Conquista 45.029-094, Bahia, Brazil
| | - Kádima Nayara Teixeira
- Campus Toledo, Universidade Federal do Paraná, Toledo 85.919-899, Paraná, Brazil
- Programa Multicêntrico de Pós-graduação em Bioquímica e Biologia Molecular - Setor Palotina, Universidade Federal do Paraná, Palotina 85.950-000, Paraná, Brazil
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Ceja-Gálvez HR, Renteria-Flores FI, Nicoletti F, Hernández-Bello J, Macedo-Ojeda G, Muñoz-Valle JF. Severe COVID-19: Drugs and Clinical Trials. J Clin Med 2023; 12:jcm12082893. [PMID: 37109231 PMCID: PMC10142549 DOI: 10.3390/jcm12082893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/08/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
By January of 2023, the COVID-19 pandemic had led to a reported total of 6,700,883 deaths and 662,631,114 cases worldwide. To date, there have been no effective therapies or standardized treatment schemes for this disease; therefore, the search for effective prophylactic and therapeutic strategies is a primary goal that must be addressed. This review aims to provide an analysis of the most efficient and promising therapies and drugs for the prevention and treatment of severe COVID-19, comparing their degree of success, scope, and limitations, with the aim of providing support to health professionals in choosing the best pharmacological approach. An investigation of the most promising and effective treatments against COVID-19 that are currently available was carried out by employing search terms including "Convalescent plasma therapy in COVID-19" or "Viral polymerase inhibitors" and "COVID-19" in the Clinicaltrials.gov and PubMed databases. From the current perspective and with the information available from the various clinical trials assessing the efficacy of different therapeutic options, we conclude that it is necessary to standardize certain variables-such as the viral clearance time, biomarkers associated with severity, hospital stay, requirement of invasive mechanical ventilation, and mortality rate-in order to facilitate verification of the efficacy of such treatments and to better assess the repeatability of the most effective and promising results.
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Affiliation(s)
- Hazael Ramiro Ceja-Gálvez
- Institute of Research in Biomedical Sciences, University Center of Health Sciences (CUCS), University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Francisco Israel Renteria-Flores
- Institute of Research in Biomedical Sciences, University Center of Health Sciences (CUCS), University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Ferdinando Nicoletti
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Jorge Hernández-Bello
- Institute of Research in Biomedical Sciences, University Center of Health Sciences (CUCS), University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Gabriela Macedo-Ojeda
- Institute of Research in Biomedical Sciences, University Center of Health Sciences (CUCS), University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - José Francisco Muñoz-Valle
- Institute of Research in Biomedical Sciences, University Center of Health Sciences (CUCS), University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
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14
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Paramythiotis D, Karlafti E, Veroplidou K, Fafouti M, Kaiafa G, Netta S, Michalopoulos A, Savopoulos C. Drug-Induced Acute Pancreatitis in Hospitalized COVID-19 Patients. Diagnostics (Basel) 2023; 13:diagnostics13081398. [PMID: 37189499 DOI: 10.3390/diagnostics13081398] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/28/2023] [Accepted: 03/29/2023] [Indexed: 05/17/2023] Open
Abstract
Coronavirus disease-19 (COVID-19), caused by SARS-CoV-2, is a systemic disease that affects not only the respiratory system, but also other systems, including gastrointestinal. A great number of different drugs have been used on hospitalized patients for the management of COVID-19, and acute pancreatitis (AP) has been reported as a complication or side effect of these drugs. The development of drug-induced acute pancreatitis (DIAP) follows a complex of pathophysiological mechanisms, and particular risk factors play a key role. Diagnosis of DIAP depends on specific criteria, and based on these, a drug may be characterized as having a definite, probable or possible connection with AP. The aim of this review is to present the medications that are used for COVID-19 management and are associated with AP in hospitalized patients. The list of these drugs mainly includes corticosteroids, glucocorticoids, non-steroidal anti-inflammatory drugs (NSAIDs), antiviral agents, antibiotics, monoclonal antibodies, estrogens and anesthetic agents. Moreover, the prevention of the development of DIAP is vital, especially for critically ill patients who may receive multiple drugs. DIAP management is mainly non-invasive and the first step concerns the exception of the suspicious drug from patients therapy.
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Affiliation(s)
- Daniel Paramythiotis
- First Propaedeutic Department of Surgery, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Eleni Karlafti
- Emergency Department, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
- First Propaedeutic Department of Internal Medicine, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Kalliopi Veroplidou
- First Propaedeutic Department of Surgery, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Maria Fafouti
- First Propaedeutic Department of Surgery, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Georgia Kaiafa
- First Propaedeutic Department of Internal Medicine, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Smaro Netta
- First Propaedeutic Department of Surgery, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Antonios Michalopoulos
- First Propaedeutic Department of Surgery, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Christos Savopoulos
- First Propaedeutic Department of Internal Medicine, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
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Al Kharusi M, Al Sheikh N, Alhajri M, Al Mandhri SA, Khafagy ES, Moglad EH, Alotaibi HF, Hegazy WAH. A Prospective Cohort Study of COVID-19: Evaluation of the Early Role of IL-1 and IL-6 Antagonists in Improving the Outcome of the Illness and Reduction in the Risk of Death. Healthcare (Basel) 2023; 11:healthcare11071025. [PMID: 37046952 PMCID: PMC10094110 DOI: 10.3390/healthcare11071025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 03/29/2023] [Accepted: 03/30/2023] [Indexed: 04/14/2023] Open
Abstract
The COVID-19 pandemic had a profound impact on global health, economies, and social systems. The crucial factor that determines the success of COVID-19 treatments is preventing the need for mechanical ventilation and intensive care admission. In the context of COVID-19, several treatments have been found to play a role in the disease's progression and severity. Interleukins (ILs) have been identified as key mediators of the cytokine storm that can occur in severe cases of COVID-19, leading to respiratory failure and other complications. For instance, IL-1 antagonist (anakinra) and IL-6 antagonist (tocilizumab) are supposed to be promising treatments as well as cortisones for COVID-19. This prospective study aims to evaluate the effectiveness of anakinra or tocilizumab in addition to cortisone in preventing the progression of mild to moderate COVID-19 cases to severe intensive care admission. Biochemical and hematological parameters, such as D-dimer, ferritin, LDH, CRP, and white blood cells (WBCs), were measured after treatment with either anakinra or tocilizumab in addition to cortisone or cortisone alone. The study also recorded the number of deaths and patients admitted to intensive care. The results indicate that anakinra significantly improved outcomes and decreased the number of intensive care admissions compared to tocilizumab or cortisone alone. Therefore, anakinra may play a vital role in controlling the progression of COVID-19, and its use in mild to moderate cases may prevent the worsening of the disease to severe stages.
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Affiliation(s)
| | | | - Maiya Alhajri
- Pharmacy Department, Field Hospital, Muscat 111, Oman
| | | | - El-Sayed Khafagy
- Department of Pharmaceutics, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-kharj 11942, Saudi Arabia
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Suez Canal University, Ismailia 41522, Egypt
| | - Ehssan H Moglad
- Department of Pharmaceutics, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-kharj 11942, Saudi Arabia
- Department of Microbiology and Parasitology, Medicinal and Aromatic Plants Research Institute, National Center for Research, Khartoum 2404, Sudan
| | - Hadil Faris Alotaibi
- Department of Pharmaceutical Sciences, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - Wael A H Hegazy
- Department of Microbiology and Immunology, Faculty of Pharmacy, Zagazig University, Zagazig 44519, Egypt
- Pharmacy Program, Department of Pharmaceutical Sciences, Oman College of Health Sciences, Muscat 113, Oman
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Al-Akioui-Sanz K, Pascual-Miguel B, Díaz-Almirón M, Mestre-Durán C, Navarro-Zapata A, Clares-Villa L, Martín-Cortázar C, Vicario JL, Moreno MÁ, Balas A, De Paz R, Minguillón J, Pérez-Martínez A, Ferreras C. Donor selection for adoptive cell therapy with CD45RA - memory T cells for patients with coronavirus disease 2019, and dexamethasone and interleukin-15 effects on the phenotype, proliferation and interferon gamma release. Cytotherapy 2023; 25:330-340. [PMID: 36585293 PMCID: PMC9742221 DOI: 10.1016/j.jcyt.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 12/02/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND AIMS We have previously demonstrated the safety and feasibility of adoptive cell therapy with CD45RA- memory T cells containing severe acute respiratory syndrome coronavirus 2-specific T cells for patients with coronavirus disease 2019 from an unvaccinated donor who was chosen based on human leukocyte antigen compatibility and cellular response. In this study, we examined the durability of cellular and humoral immunity within CD45RA- memory T cells and the effect of dexamethasone, the current standard of care treatment, and interleukin-15, a cytokine critically involved in T-cell maintenance and survival. METHODS We performed a longitudinal analysis from previously severe acute respiratory syndrome coronavirus 2-infected and infection-naïve individuals covering 21 months from infection and 10 months after full vaccination with the BNT162b2 Pfizer/BioNTech vaccine. RESULTS We observed that cellular responses are maintained over time. Humoral responses increased after vaccination but were gradually lost. In addition, dexamethasone did not alter cell functionality or proliferation of CD45RA- T cells, and interleukin-15 increased the memory T-cell activation state, regulatory T cell expression, and interferon gamma release. CONCLUSIONS Our results suggest that the best donors for adoptive cell therapy would be recovered individuals and 2 months after vaccination, although further studies with larger cohorts would be needed to confirm this finding. Dexamethasone did not affect the characteristics of the memory T cells at a concentration used in the clinical practice and IL-15 showed a positive effect on SARS-CoV-2-specific CD45RA- T cells.
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Affiliation(s)
- Karima Al-Akioui-Sanz
- IdiPAZ, Hospital La Paz Institute for Health Research, La Paz University Hospital, Madrid, Spain
| | - Bárbara Pascual-Miguel
- IdiPAZ, Hospital La Paz Institute for Health Research, La Paz University Hospital, Madrid, Spain
| | | | - Carmen Mestre-Durán
- IdiPAZ, Hospital La Paz Institute for Health Research, La Paz University Hospital, Madrid, Spain
| | - Alfonso Navarro-Zapata
- IdiPAZ, Hospital La Paz Institute for Health Research, La Paz University Hospital, Madrid, Spain
| | - Laura Clares-Villa
- IdiPAZ, Hospital La Paz Institute for Health Research, La Paz University Hospital, Madrid, Spain
| | - Carla Martín-Cortázar
- IdiPAZ, Hospital La Paz Institute for Health Research, La Paz University Hospital, Madrid, Spain
| | - José Luis Vicario
- Histocompatibility Unit, Transfusion Center of Madrid, Madrid, Spain
| | | | - Antonio Balas
- Histocompatibility Unit, Transfusion Center of Madrid, Madrid, Spain
| | - Raquel De Paz
- Cell Therapy Unit, Hematology Department, La Paz University Hospital, Madrid, Spain
| | - Jordi Minguillón
- IdiPAZ, Hospital La Paz Institute for Health Research, La Paz University Hospital, Madrid, Spain
| | - Antonio Pérez-Martínez
- IdiPAZ, Hospital La Paz Institute for Health Research, La Paz University Hospital, Madrid, Spain; Pediatric Hemato-oncology Department, La Paz University Hospital, Madrid, Spain; Faculty of Medicine Autonomous, University of Madrid, Madrid, Spain
| | - Cristina Ferreras
- IdiPAZ, Hospital La Paz Institute for Health Research, La Paz University Hospital, Madrid, Spain.
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Mavragani A, Roberts J, Moore MA, Gandrakota N. Clinical Outcomes After Use of Inhaled Corticosteroids or Oral Steroids in a COVID-19 Telemedicine Clinic Cohort: Retrospective Chart Review. JMIR Form Res 2023; 7:e36023. [PMID: 36480687 PMCID: PMC9953981 DOI: 10.2196/36023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 10/28/2022] [Accepted: 12/01/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND COVID-19 concerns remain among health care providers, as there are few outpatient treatment options. In the early days of the pandemic, treatment options for nonhospitalized patients were limited, and symptomatic treatment and home-grown guidelines that used recommendations from the Global Initiative for Asthma Management and Treatment were used. OBJECTIVE The possibility that inhaled corticosteroids (ICS) might reduce the risk of respiratory symptoms and promote recovery was the impetus for this review, as it has already been shown that in the nonhospitalized patient population, oral corticosteroids (OCS) in the acute phase could have an adverse effect on recovery. We investigated if (1) patients treated with ICS were less likely to require referral to a post-COVID-19 clinic or pulmonary specialist than patients without ICS treatment or with OCS therapy, and (2) if OCS use was associated with worse health outcomes. METHODS In a retrospective chart review, we identified all patients with acute illness due to COVID-19 that were followed and managed by a telemedicine clinic team between June and December 2020. The data were electronically pulled from electronic medical records through April 2021 and reviewed to determine which patients eventually required referral to a post-COVID-19 clinic or pulmonary specialist due to persistent respiratory symptoms of COVID-19. The data were then analyzed to compare outcomes between patients prescribed OCS and those prescribed ICS. We specifically looked at patients treated acutely with ICS or OCS that then required referral to a pulmonary specialist or post-COVID-19 clinic. We excluded any patients with a history of chronic OCS or ICS use for any reason. RESULTS Prescribing ICS during the acute phase did not reduce the possibility of developing persistent symptoms. There was no difference in the referral rate to a pulmonary specialist or post-COVID-19 clinic between patients treated with OCS versus ICS. However, our data may not be generalizable to other populations, as it represents a patient population enrolled in a telemedicine program at a single center. CONCLUSIONS We found that ICS, as compared to OCS, did not reduce the risk of developing persistent respiratory symptoms. This finding adds to the body of knowledge that ICS and OCS medications remain potent treatments in patients with acute and postacute COVID-19 seen in an outpatient setting.
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Affiliation(s)
| | - Jodi Roberts
- General Internal Medicine, Emory Healthcare, Atlanta, GA, United States
| | - Miranda A Moore
- Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, GA, United States.,Family Medicine Residency Program, School of Medicine, Emory University, Atlanta, GA, United States.,Department of Medicine, School of Medicine, Emory University, Atlanta, GA, United States
| | - Nikhila Gandrakota
- Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, GA, United States.,Family Medicine Residency Program, School of Medicine, Emory University, Atlanta, GA, United States
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18
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Arrieta A, Galvis AE, Osborne S, Morphew T, Imfeld K, Enriquez C, Hoang J, Swearingen M, Nieves DJ, Ashouri N, Singh J, Nugent D. Use of COVID-19 Convalescent Plasma for Treatment of Symptomatic SARS-CoV-2 Infection at a Children's Hospital: A Contribution to a Still Inadequate Body of Evidence. Children (Basel) 2023; 10:children10020350. [PMID: 36832478 PMCID: PMC9955755 DOI: 10.3390/children10020350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/13/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023]
Abstract
Data on COVID-19 convalescent plasma (CCP) safety and efficacy in children and young adults are limited. This single-center prospective, open-label trial evaluates CCP safety, neutralizing antibody kinetics, and outcomes in children and young adults with moderate/severe COVID-19 (April 2020-March 2021). A total of 46 subjects received CCP; 43 were included in the safety analysis (SAS); 7.0% < 2 years old, 2.3% 2-<6, 27.9% 6-<12, 39.5% 12-<19, and 23.3% > 19 years old; 28 were included in the antibody kinetic analysis (AbKS); 10.7% < 2 years old, 10.7% 6-<12, 53.8% 12-<19, and 25.0% > 19 years old. No adverse events occurred. The median COVID-19 severity score improved (5.0 pre-CCP to 1.0 by day 7; p < 0.001). A rapid increase in the median percentage of inhibition was observed in AbKS (22.5% (13.0%, 41.5%) pre-infusion to 52% (23.7%, 72%) 24 h post-infusion); a similar increase was observed in nine immune-competent subjects (28% (23%, 35%) to 63% (53%, 72%)). The inhibition percentage increased until day 7 and persisted at 21 and 90 days. CCP is well tolerated in children and young adults, providing rapid and robust increased antibodies. CCP should remain a therapeutic option for this population for whom vaccines are not fully available and given that the safety and efficacy of existing monoclonal antibodies and antiviral agents have not been established.
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Affiliation(s)
- Antonio Arrieta
- Pediatrics Infectious Diseases, CHOC Children’s Hospital, Orange, CA 92868, USA
- Department of Pediatrics, University of California Irvine School of Medicine, Irvine, CA 92697, USA
| | - Alvaro E. Galvis
- Pediatrics Infectious Diseases, CHOC Children’s Hospital, Orange, CA 92868, USA
- Department of Pediatrics, University of California Irvine School of Medicine, Irvine, CA 92697, USA
| | - Stephanie Osborne
- Research Administration, CHOC Children’s Hospital, Orange, CA 92868, USA
| | - Tricia Morphew
- Morphew Consulting, LLC, CHOC Research Institute, CHOC Children’s Hospital, Orange, CA 92868, USA
| | - Karen Imfeld
- Hematology Advanced Diagnostics Laboratory, CHOC Children’s Hospital, Orange, CA 92868, USA
| | - Claudia Enriquez
- Research Administration, CHOC Children’s Hospital, Orange, CA 92868, USA
| | - Janet Hoang
- Hematology Advanced Diagnostics Laboratory, CHOC Children’s Hospital, Orange, CA 92868, USA
| | - Marcia Swearingen
- Hematology Advanced Diagnostics Laboratory, CHOC Children’s Hospital, Orange, CA 92868, USA
| | - Delma J. Nieves
- Pediatrics Infectious Diseases, CHOC Children’s Hospital, Orange, CA 92868, USA
- Department of Pediatrics, University of California Irvine School of Medicine, Irvine, CA 92697, USA
- Correspondence: ; Tel.: +714-509-8403; Fax: +714-509-3303
| | - Negar Ashouri
- Pediatrics Infectious Diseases, CHOC Children’s Hospital, Orange, CA 92868, USA
- Department of Pediatrics, University of California Irvine School of Medicine, Irvine, CA 92697, USA
| | - Jasjit Singh
- Pediatrics Infectious Diseases, CHOC Children’s Hospital, Orange, CA 92868, USA
- Department of Pediatrics, University of California Irvine School of Medicine, Irvine, CA 92697, USA
| | - Diane Nugent
- Department of Pediatrics, University of California Irvine School of Medicine, Irvine, CA 92697, USA
- Pediatric Hematology, CHOC Children’s Hospital, Orange, CA 92868, USA
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19
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Cao M, Qiao M, Sohail M, Zhang X. Non-anticoagulant heparin derivatives for COVID-19 treatment. Int J Biol Macromol 2023; 226:974-981. [PMID: 36528145 PMCID: PMC9749384 DOI: 10.1016/j.ijbiomac.2022.12.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 11/26/2022] [Accepted: 12/09/2022] [Indexed: 12/15/2022]
Abstract
The ongoing pandemic of COVID-19, caused by the infection of SARS-CoV-2, has generated significant harm to the world economy and taken numerous lives. This syndrome is characterized by an acute inflammatory response, mainly in the lungs and kidneys. Accumulated evidence suggests that exogenous heparin might contribute to the alleviation of COVID-19 severity through anticoagulant and various non-anticoagulant mechanisms, including heparanase inhibition, chemokine and cytokine neutralization, leukocyte trafficking interference, viral cellular-entry obstruction, and extracellular cytotoxic histone neutralization. However, the side effects of heparin and potential drawbacks of administering heparin therapy need to be considered. Here, the current heparin therapy drawbacks were covered in great detail: structure-activity relationship (SAR) mystery, potential contamination, and anticoagulant activity. Considering these unfavorable effects, specific non-anticoagulant heparin derivatives with antiviral activity could be promising candidates to treat COVID-19. Furthermore, a structurally diverse library of non-anticoagulant heparin derivatives, constructed by chemical modification and enzymatic depolymerization, would contribute to a deeper understanding of SAR mystery. In short, targeting non-anticoagulant mechanisms may produce better therapeutic effects, overcoming the side effects in patients suffering from COVID-19 and other inflammatory disorders.
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Affiliation(s)
- Min Cao
- School of Food Science and Pharmaceutical Engineering, Nanjing Normal University, Wenyuan Road 1, Nanjing 210023, China
| | - Meng Qiao
- School of Food Science and Pharmaceutical Engineering, Nanjing Normal University, Wenyuan Road 1, Nanjing 210023, China
| | - Muhammad Sohail
- School of Food Science and Pharmaceutical Engineering, Nanjing Normal University, Wenyuan Road 1, Nanjing 210023, China.
| | - Xing Zhang
- School of Food Science and Pharmaceutical Engineering, Nanjing Normal University, Wenyuan Road 1, Nanjing 210023, China.
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20
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Cuadrado-Payán E, Rodríguez-Espinosa D, Broseta JJ, Guillén-Olmos E, Maduell F. Safety profile and clinical results of Remdesivir in Hemodialysis patients infected with SARS-CoV-2. A single-center Spanish cohort study. J Nephrol 2023; 36:171-172. [PMID: 35716242 PMCID: PMC9206136 DOI: 10.1007/s40620-022-01364-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 05/23/2022] [Indexed: 02/07/2023]
Affiliation(s)
- Elena Cuadrado-Payán
- Department of Nephrology and Renal Transplantation, Hospital Clínic of Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - Diana Rodríguez-Espinosa
- Department of Nephrology and Renal Transplantation, Hospital Clínic of Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - José Jesús Broseta
- Department of Nephrology and Renal Transplantation, Hospital Clínic of Barcelona, Villarroel 170, 08036, Barcelona, Spain.
| | - Elena Guillén-Olmos
- Department of Nephrology and Renal Transplantation, Hospital Clínic of Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - Francisco Maduell
- Department of Nephrology and Renal Transplantation, Hospital Clínic of Barcelona, Villarroel 170, 08036, Barcelona, Spain
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21
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Prakash S, Sahu A, Routray SS, Maiti R, Mitra JK, Mukherjee S. Efficacy of therapeutic plasma exchange in severe COVID-19 disease: A meta-analysis. Vox Sang 2023; 118:49-58. [PMID: 36254849 PMCID: PMC9874931 DOI: 10.1111/vox.13367] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 07/30/2022] [Accepted: 09/27/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND AND OBJECTIVES Therapeutic plasma exchange (TPE) has been used in severe COVID-19 disease to eliminate the cytokine storm. This meta-analysis aims to assess the effectiveness of TPE in reducing mortality in severe COVID-19 disease compared to standard treatment. MATERIALS AND METHODS A comprehensive literature search was performed in PubMed, the Cochrane database and the International Clinical Trial Registry Platform (ICTRP). The random-effect model was used to calculate the risk ratio and standardized mean difference (SMD) as pooled effect size for the difference in mortality and length of the intensive care unit (ICU) stay. The risk of bias and publication bias were assessed in R version 4.1.0. The certainty of the evidence was calculated using the GradePro tool. RESULTS The database identified 382 participants from six studies, including one randomized control trial. Egger's test did not detect any publication bias (p = 0.178). The random model analysis for mortality evaluated a risk ratio of 0.38 (95% CI: 0.28-0.52) with a significant reduction in the TPE group. The certainty of the evidence was moderate, with a risk ratio of 0.34 (95% CI: 0.24-0.49). Length of ICU stays between TPE versus standard care showed an SMD of 0.08 (95% CI: -0.38, 0.55) and was not significant. CONCLUSION The length of ICU stay in the TPE group was not different from standard care. However, this meta-analysis revealed a significant benefit of TPE in reducing mortality in severe COVID-19 disease compared to standard treatment.
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Affiliation(s)
- Satya Prakash
- Department of Transfusion MedicineAll India Institute of Medical SciencesBhubaneswarIndia
| | - Ansuman Sahu
- Department of Transfusion MedicineAll India Institute of Medical SciencesBhubaneswarIndia
| | - Suman Sudha Routray
- Department of Transfusion MedicineAll India Institute of Medical SciencesBhubaneswarIndia
| | - Rituparna Maiti
- Department of PharmacologyAll India Institute of Medical SciencesBhubaneswarIndia
| | - Jayanta Kumar Mitra
- Department of AnaesthesiologyAll India Institute of Medical SciencesBhubaneswarIndia
| | - Somnath Mukherjee
- Department of Transfusion MedicineAll India Institute of Medical SciencesBhubaneswarIndia
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22
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Bello SO, Yunusa A, Adamu AA, Imam MU, Bello MB, Shuaibu A, Igumbor EU, Habib ZG, Popoola MA, Ochu CL, Bello AY, Deeni YY, Okoye I. Innovative, rapid, high-throughput method for drug repurposing in a pandemic-A case study of SARS-CoV-2 and COVID-19. Front Pharmacol 2023; 14:1130828. [PMID: 36937851 PMCID: PMC10014809 DOI: 10.3389/fphar.2023.1130828] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 02/20/2023] [Indexed: 03/05/2023] Open
Abstract
Several efforts to repurpose drugs for COVID-19 treatment have largely either failed to identify a suitable agent or agents identified did not translate to clinical use. Reasons that have been suggested to explain the failures include use of inappropriate doses, that are not clinically achievable, in the screening experiments, and the use of inappropriate pre-clinical laboratory surrogates to predict efficacy. In this study, we used an innovative algorithm, that incorporates dissemination and implementation considerations, to identify potential drugs for COVID-19 using iterative computational and wet laboratory methods. The drugs were screened at doses that are known to be achievable in humans. Furthermore, inhibition of viral induced cytopathic effect (CPE) was used as the laboratory surrogate to predict efficacy. Erythromycin, pyridoxine, folic acid and retapamulin were found to inhibit SARS-CoV-2 induced CPE in Vero cells at concentrations that are clinically achievable. Additional studies may be required to further characterize the inhibitions of CPE and the possible mechanisms.
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Affiliation(s)
- Shaibu Oricha Bello
- Department of Pharmacology and Therapeutics, Faculty of Basic Clinical Sciences, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria
- Nigerian COVID-19 Research Coalition, Nigerian Institute of Medical Research Institute, Abuja, Nigeria
- Centre for Advanced Medical Research and Training, Usmanu Danfodiyo University, Sokoto, Nigeria
- *Correspondence: Shaibu Oricha Bello,
| | - Abdulmajeed Yunusa
- Department of Pharmacology and Therapeutics, Faculty of Basic Clinical Sciences, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria
- Centre for Advanced Medical Research and Training, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Adamu Ahmed Adamu
- Department of Pharmacology and Therapeutics, Faculty of Basic Clinical Sciences, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria
- Centre for Advanced Medical Research and Training, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Mustapha Umar Imam
- Centre for Advanced Medical Research and Training, Usmanu Danfodiyo University, Sokoto, Nigeria
- Department of Medical Biochemistry, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Muhammad Bashir Bello
- Centre for Advanced Medical Research and Training, Usmanu Danfodiyo University, Sokoto, Nigeria
- Department of veterinary Microbiology, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Abdulmalik Shuaibu
- Centre for Advanced Medical Research and Training, Usmanu Danfodiyo University, Sokoto, Nigeria
- Department of veterinary Microbiology, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Ehimario Uche Igumbor
- Nigerian COVID-19 Research Coalition, Nigerian Institute of Medical Research Institute, Abuja, Nigeria
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - Zaiyad Garba Habib
- Nigerian COVID-19 Research Coalition, Nigerian Institute of Medical Research Institute, Abuja, Nigeria
- Department of Medicine, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
| | - Mustapha Ayodele Popoola
- Nigerian COVID-19 Research Coalition, Nigerian Institute of Medical Research Institute, Abuja, Nigeria
| | - Chinwe Lucia Ochu
- Nigerian COVID-19 Research Coalition, Nigerian Institute of Medical Research Institute, Abuja, Nigeria
- Nigerian Centre for Disease Control and Prevention, Abuja, Nigeria
| | - Aishatu Yahaya Bello
- Department of Clinical pharmacy and Pharmacy Practice, Faculty of Pharmaceutical sciences, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Yusuf Yahaya Deeni
- Nigerian COVID-19 Research Coalition, Nigerian Institute of Medical Research Institute, Abuja, Nigeria
- Department of Microbiology and Biotechnology, Federal University of Dutse, Dutse, Nigeria
- Centre for Environmental and Public Health Research and Development, Kano, Nigeria
| | - Ifeoma Okoye
- University of Nigeria Centre for Clinical Trials, University of Nigeria Teaching Hospital, Enugu, Ituku Ozalla, Nigeria
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23
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Karlafti E, Paramythiotis D, Pantazi K, Georgakopoulou VE, Kaiafa G, Papalexis P, Protopapas AA, Ztriva E, Fyntanidou V, Savopoulos C. Drug-Induced Liver Injury in Hospitalized Patients during SARS-CoV-2 Infection. Medicina (B Aires) 2022; 58:medicina58121848. [PMID: 36557050 PMCID: PMC9782075 DOI: 10.3390/medicina58121848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/08/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
In the last few years, the world has had to face the SARS-CoV-2 infection and its multiple effects. Even though COVID-19 was first considered to be a respiratory disease, it has an extended clinical spectrum with symptoms occurring in many tissues, and it is now identified as a systematic disease. Therefore, various drugs are used during the therapy of hospitalized COVID-19 patients. Studies have shown that many of these drugs could have adverse side-effects, including drug-induced liver injury-also known as DILI-which is the focus of our review. Despite the consistent findings, the pathophysiological mechanism behind DILI in COVID-19 disease is still complex, and there are a few risk factors related to it. However, when it comes to the diagnosis, there are specific algorithms (including the RUCAM algorithm) and biomarkers that can assist in identifying DILI and which we will analyze in our review. As indicated by the title, a variety of drugs are associated with this COVID-19-related complication, including systemic corticosteroids, drugs used for the therapy of uncontrolled cytokine storm, as well as antiviral, anti-inflammatory, and anticoagulant drugs. Bearing in mind that hepatotoxicity is very likely to occur during COVID-19, especially in patients treated with multiple medications, we will also refer to the use of other drugs used for DILI therapy in an effort to control and prevent a severe and long-term outcome.
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Affiliation(s)
- Eleni Karlafti
- Emergency Department, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
- First Propaedeutic Department of Internal Medicine, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
- Correspondence: ; Tel.: +231-330-3110
| | - Daniel Paramythiotis
- First Propaedeutic Department of Surgery, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Konstantina Pantazi
- First Propaedeutic Department of Internal Medicine, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | | | - Georgia Kaiafa
- First Propaedeutic Department of Internal Medicine, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Petros Papalexis
- Unit of Endocrinology, First Department of Internal Medicine, Laiko General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Department of Biomedical Sciences, University of West Attica, 12243 Athens, Greece
| | - Adonis A. Protopapas
- First Propaedeutic Department of Internal Medicine, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Eleftheria Ztriva
- First Propaedeutic Department of Internal Medicine, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Varvara Fyntanidou
- Emergency Department, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Christos Savopoulos
- First Propaedeutic Department of Internal Medicine, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
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Olejnik A, Panek R, Madej J, Franus W, Goscianska J. Low-cost zeolitic carriers for delivery of hydroxychloroquine immunomodulatory agent with antiviral activity. Microporous Mesoporous Mater 2022; 346:112315. [PMID: 36407858 PMCID: PMC9644156 DOI: 10.1016/j.micromeso.2022.112315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/01/2022] [Accepted: 10/23/2022] [Indexed: 06/16/2023]
Abstract
The coronavirus pandemic prompted scientists to look for active pharmaceutical ingredients that could be effective in treating COVID-19. One of them was hydroxychloroquine, an antimalarial and immunomodulatory agent exhibiting antiviral activity. The anchoring of this drug on porous carriers enables control of its delivery to a specific place in the body, and thus increases bioavailability. In this work, we developed low-cost zeolitic platforms for hydroxychloroquine. The waste solution generated during zeolite production from fly ashes was used in the synthesis of Na-A and Na-X carriers at laboratory and technical scale. The materials were characterized by high purity and single mineral phase composition. The surface charge of zeolites varied from negative at pH 5.8, and 7.2, to positive at pH 1.2. All samples indicated good sorption ability towards hydroxychloroquine. The mechanism of drug adsorption was based on electrostatic interactions and followed the Freundlich model. Zeolitic carriers modified the hydroxychloroquine release profiles at conditions mimicking the pH of body fluids. The mode of drug liberation was affected by particle size distributions, morphological forms, and chemical compositions of zeolites. The most hydroxychloroquine controlled release at pH 5.8 for the Na-X material was noted, which indicates that it can enhance the drug therapeutic efficacy.
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Affiliation(s)
- Anna Olejnik
- Adam Mickiewicz University in Poznań, Faculty of Chemistry, Department of Chemical Technology, Uniwersytetu Poznańskiego 8, 61-614, Poznań, Poland
| | - Rafał Panek
- Lublin University of Technology, Civil Engineering and Architecture Faculty, Department of Geotechnical Engineering, Nadbystrzycka 40, 20-618, Lublin, Poland
| | - Jarosław Madej
- Lublin University of Technology, Civil Engineering and Architecture Faculty, Department of Geotechnical Engineering, Nadbystrzycka 40, 20-618, Lublin, Poland
| | - Wojciech Franus
- Lublin University of Technology, Civil Engineering and Architecture Faculty, Department of Geotechnical Engineering, Nadbystrzycka 40, 20-618, Lublin, Poland
| | - Joanna Goscianska
- Adam Mickiewicz University in Poznań, Faculty of Chemistry, Department of Chemical Technology, Uniwersytetu Poznańskiego 8, 61-614, Poznań, Poland
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25
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De Vito A, Poliseno M, Colpani A, Zauli B, Puci MV, Santantonio T, Meloni MC, Fois M, Fanelli C, Saderi L, Fois A, Fiore V, Sotgiu G, Babudieri S, Lo Caputo S, Madeddu G. Reduced risk of death in people with SARS-CoV-2 infection treated with remdesivir: a nested case-control study. Curr Med Res Opin 2022; 38:2029-2033. [PMID: 36170020 DOI: 10.1080/03007995.2022.2129801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Since the start of the SARS-CoV-2 pandemic, several treatment options have been proposed (e.g. steroids, heparin, antivirals and monoclonal antibodies). Remdesivir was the first antiviral approved for the treatment of COVID-19, even though controversial evidence exists concerning the efficacy. Therefore, we aimed to conduct a study to evaluate whether the use of remdesivir was associated with lower mortality in patients with COVID-19. METHODS We conducted a nested case-control study of a retrospective cohort collecting medical records of people with SARS-CoV-2 infection admitted in the infectious Disease Unit of Sassari University Hospital (S.C. Clinica di Malattie Infettive, AOU di Sassari, Italy), or in the Infectious Disease Unit of Foggia (AOU "Ospedali Riuniti" Foggia), between 1 July 2020 and 10 November 2021. The outcome considered was death; thus, we matched death (cases) to survivors (controls) by sex and age (1:1). RESULTS We included in the study 342 patients, with 171 deaths (cases) and 171 survivors (controls). Remdesivir was administered to 60 people in the control group and to 18 people in the case group (35.1% vs. 10.5%, p < .0001). In the multivariate analysis, treatment with remdesivir and heparin was associated with lower mortality (OR: 0.19 [95% CI :0.10-0.38], p <.0001; OR: 0.39 [95% CI: 0.21-0.74] p = .004, respectively). On the contrary, diabetes, oxygen therapy and CPAP/NIV were associated with higher mortality. CONCLUSION Our study showed lower mortality in people with SARS-CoV-2 infection treated with remdesivir.
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Affiliation(s)
- Andrea De Vito
- Unit of Infectious Diseases, Department of Clinical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Mariacristina Poliseno
- S.C. Malattie Infettive, Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Foggia, Foggia, Italy
| | - Agnese Colpani
- Unit of Infectious Diseases, Department of Clinical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Beatrice Zauli
- Unit of Infectious Diseases, Department of Clinical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Mariangela Valentina Puci
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Teresa Santantonio
- S.C. Malattie Infettive, Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Foggia, Foggia, Italy
| | - Maria Chiara Meloni
- Unit of Infectious Diseases, Department of Clinical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Marco Fois
- Unit of Infectious Diseases, Department of Clinical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Chiara Fanelli
- Unit of Infectious Diseases, Department of Clinical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Laura Saderi
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Alessandro Fois
- Unit of Respiratory Diseases, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Vito Fiore
- Unit of Infectious Diseases, Department of Clinical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Sergio Babudieri
- Unit of Infectious Diseases, Department of Clinical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Sergio Lo Caputo
- S.C. Malattie Infettive, Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Foggia, Foggia, Italy
| | - Giordano Madeddu
- Unit of Infectious Diseases, Department of Clinical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
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De Vito A, Colpani A, Bitti A, Zauli B, Meloni MC, Fois M, Denti L, Bacciu S, Marcia C, Maida I, Babudieri S, Madeddu G. Safety and efficacy of molnupiravir in SARS-CoV-2-infected patients: A real-life experience. J Med Virol 2022; 94:5582-5588. [PMID: 35855627 PMCID: PMC9349683 DOI: 10.1002/jmv.28011] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 06/28/2022] [Accepted: 07/15/2022] [Indexed: 01/06/2023]
Abstract
Since the start of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic, several treatments have been proposed to cure coronavirus disease 2019 (COVID-19) and prevent it. Molnupiravir is a ribonucleoside prodrug of N-hydroxycytidine with an in vitro and in vivo activity against SARS-CoV-2. We conducted a retrospective cohort study that included all people treated with molnupiravir between January 10, 2022, and March 31, 2022, at the University Hospital of Sassari. Molnupiravir was prescribed, according to the Italian Agency of Drug indications, to patients with recent symptom onset (≤5 days), no need for oxygen supplementation, and with a high risk of disease progression for the presence of chronic diseases. We included 192 people with a mean age of 70.4 ± 15.4 years, with 144 (75%) patients over 60 years. During the follow-up, 20 (10.4%) patients showed a disease progression. At the multivariate analysis, older age, having neurological disease, having dyspnea at the onset of the symptoms, and acquiring SARS-CoV-2 infection during hospital admission were associated with an increased risk of progression. In contrast, an early start of treatment was associated with a reduced risk of disease progression. Molnupiravir was also extremely safe since 13 (6.8%) adverse events were reported, with only one interruption. Our study shows that monlupiravir confirmed its efficacy and safety in a real-life cohort that included a high percentage of elderly people with a high comorbidity burden.
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Affiliation(s)
- Andrea De Vito
- Unit of Infectious Diseases, Department of Medicine, Surgery and PharmacyUniversity of SassariSassariItaly
| | - Agnese Colpani
- Unit of Infectious Diseases, Department of Medicine, Surgery and PharmacyUniversity of SassariSassariItaly
| | - Alessandra Bitti
- Unit of Infectious Diseases, Department of Medicine, Surgery and PharmacyUniversity of SassariSassariItaly
| | - Beatrice Zauli
- Unit of Infectious Diseases, Department of Medicine, Surgery and PharmacyUniversity of SassariSassariItaly
| | - Maria Chiara Meloni
- Unit of Infectious Diseases, Department of Medicine, Surgery and PharmacyUniversity of SassariSassariItaly
| | - Marco Fois
- Unit of Infectious Diseases, Department of Medicine, Surgery and PharmacyUniversity of SassariSassariItaly
| | - Lucia Denti
- Unit of Infectious Diseases, Department of Medicine, Surgery and PharmacyUniversity of SassariSassariItaly
| | - Sara Bacciu
- Unit of Infectious Diseases, Department of Medicine, Surgery and PharmacyUniversity of SassariSassariItaly
| | - Claudia Marcia
- Unit of Infectious Diseases, Department of Medicine, Surgery and PharmacyUniversity of SassariSassariItaly
| | - Ivana Maida
- Unit of Infectious Diseases, Department of Medicine, Surgery and PharmacyUniversity of SassariSassariItaly
| | - Sergio Babudieri
- Unit of Infectious Diseases, Department of Medicine, Surgery and PharmacyUniversity of SassariSassariItaly
| | - Giordano Madeddu
- Unit of Infectious Diseases, Department of Medicine, Surgery and PharmacyUniversity of SassariSassariItaly
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Fernandes RS, Netto MRT, Carvalho FB, Rigatto K. Alamandine: A promising treatment for fibrosis. Peptides 2022; 157:170848. [PMID: 35931236 DOI: 10.1016/j.peptides.2022.170848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 07/27/2022] [Accepted: 08/01/2022] [Indexed: 01/18/2023]
Abstract
Angiotensin (Ang) II, the main active member of the renin angiotensin system (RAS), is essential for the maintenance of cardiovascular homeostasis. However, hyperactivation of the RAS causes fibrotic diseases. Ang II has pro-inflammatory actions, and moreover activates interstitial fibroblasts and/or dysregulates extracellular matrix degradation. The discovery of new RAS pathways has revealed the complexity of this system. Among the RAS peptides, alamandine (ALA, Ala1 Ang 1-7) has been identified in humans, rats, and mice, with protective actions in different pathological conditions. ALA has similar effects to its well-known congener, Ang-(1-7), as a vasodilator, anti-inflammatory, and antifibrotic. Its protective role against cardiovascular diseases is well-reviewed in the literature. However, the protective actions of ALA in fibrotic conditions have been little explored. Therefore, in this article, we review the ability of ALA to modulate the inflammatory process and collagen deposition, to serve as an antioxidant, and to mediate protection against functional disorders. In this scenario, we also explore ALA as a promising therapy for pulmonary fibrosis after COVID-19 infection.
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Affiliation(s)
- Renata Streck Fernandes
- Laboratório de Fisiologia Translacional, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Brazil; Programa de Pós-graduação em Ciências da Saúde, UFCSPA, Brazil
| | | | | | - Katya Rigatto
- Laboratório de Fisiologia Translacional, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Brazil; Programa de Pós-graduação em Ciências da Saúde, UFCSPA, Brazil.
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Ntaji M, Okoye OC, Aigbe F, Ohaju-Obodo J. Knowledge and perception of COVID-19 and its treatment. A community-based survey in South Nigeria. J Public Health Afr 2022; 13:2036. [PMID: 36277942 PMCID: PMC9585596 DOI: 10.4081/jphia.2022.2036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 05/15/2022] [Indexed: 11/22/2022] Open
Abstract
Background Media channels increased COVID-19 pandemic uncertainty and disputes, hindering dissemination and acceptance of evidence-based health information. Socioeconomic, cultural, and developmental factors affect a community's access to credible health information. This community-based study aims to assess semi-urban residents' understanding of COVID-19. Methods This was a cross-sectional study of 384 multistage-sampled residents of the study site. Sociodemographic, psychographic, and COVID-19 and treatment knowledge were obtained using a semistructured questionnaire. Six questions were used to measure knowledge, which was deemed adequate (three or more correct answers) or inadequate (fewer than three correct responses). Results 54 out of 364 responders (14.8%) knew COVID-19. 68.9% of respondents stated citrus fruits or spices, 46.1% mentioned infection safety, and 13.3% mentioned chloroquine for prevention. Regarding treatment, 55.5% of responders reported chloroquine and 20.9% hydroxychloroquine. 17% chose "none of the above." Class I workers were four times more likely to have adequate knowledge than class V workers (p=0.019), while class III workers were 79% less likely (p=0.046). Males had 68%less knowledge than females (p=0.008). Conclusions: In this study, adequate knowledge of COVID-19 was low and associated with higher socioeconomic class.
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Affiliation(s)
- Maureen Ntaji
- Department of Community Medicine, College of Health Sciences, Delta State University, Abraka, Nigeria
- Department of Community Medicine, Delta State University Teaching Hospital, Oghara, Nigeria
| | - Ogochukwu C. Okoye
- Department of Internal Medicine, College of Health Sciences. Delta State University, Abraka, Nigeria
- Nephrology Unit, Department of Internal Medicine, Delta State University Teaching Hospital, Oghara, Nigeria
| | - Fredrick Aigbe
- Department of Internal Medicine, College of Health Sciences. Delta State University, Abraka, Nigeria
- Cardiology Unit, Department of Internal Medicine, Delta State University Teaching Hospital, Oghara, Nigeria
| | - John Ohaju-Obodo
- Department of Internal Medicine, College of Health Sciences. Delta State University, Abraka, Nigeria
- Clinical Pharmacology Unit, Department of Internal Medicine, Delta State University Teaching Hospital, Oghara, Nigeria
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Abdul-Lateef Mousa H. Prevention and treatment of COVID-19 infection by earthing. Biomed J 2022; 46:60-69. [PMID: 35987499 PMCID: PMC9381424 DOI: 10.1016/j.bj.2022.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/25/2022] [Accepted: 08/08/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Earthing is a body contact with earth without insulator. In previous studies, grounding revealed anti-inflammatory effect, immunity enhancement, anticoagulation, and rising blood oxygenation. AIM To investigate the role of earthing in treatment and prevention of COVID-19 infection. METHODS An observational and interventional study included 71 cases with COVID-19 infection. Earthing was applied as preventive and treatment measures. All participants conducted earthing through direct contact with the earth or connecting apparatus for about 15 min to 6 h/day. RESULTS Sixty-nine patients were fully improved within 2 h-11 days after commencement of earthing (mean: 2.9 days, SD ± 2, median: 2 days), while the mean illness duration was 8.9 days (SD ± 4.6) and the median was 9 days. Two patients with many risk factors died where earthing was carried out insufficiently and too late. Nine people contracted mild or short-lived illness (mean: 6.3 days, SD ± 5.5) as a consequence of performing prophylactic earthing. There was a spectacular response in a critically ill patient who was unable to speak due to severe dyspnea with blood oxygen level 38% on continuous oxygen supply. On the second day, after two sessions of 3 h daily earthing, his oxygen level raised to 95% with oxygen supply and 77% without oxygen supply. The following symptoms were improved after implementing earthing: fever, dyspnea, cough, weakness, headache, chest pain, taste and smell sensation loss, anorexia, and body pain. CONCLUSIONS Earthing revealed significant curing and preventive effects with a shorter illness duration.
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Mohiuddin Chowdhury ATM, Kamal A, Abbas MKU, Karim MR, Ali MA, Talukder S, Hamidullah Mehedi HM, Hassan H, Shahin AH, Li Y, He S. Role of H 2 receptor blocker famotidine over the clinical recovery of COVID-19 patients: A randomized controlled trial. World J Clin Cases 2022; 10:8170-8185. [PMID: 36159508 PMCID: PMC9403664 DOI: 10.12998/wjcc.v10.i23.8170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 03/30/2022] [Accepted: 07/06/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) is a global pandemic putting the population at a high risk of infection-related health hazards, mortality and a potential failure of proper medical therapies. Therefore, it is necessary to evaluate the potential use of the existing drugs that could be used as options for the medical management of COVID-19 patients.
AIM To evaluate the role of the H2 receptor blocker “famotidine” in COVID-19 illness.
METHODS This study was done on seriously ill COVID-19 patients admitted to the intensive care unit (ICU) from different institutes in Bangladesh. Patients were divided into famotidine treatment group “A” (famotidine 40 mg to 60 mg oral formulation every 8 h with other treatment as given), and control group “B” (treatment as given). National early warning score (NEWS)-2, and sequential organ failure assessment day-1 score was calculated to evaluate the outcome. Outcomes were evaluated by the time required for clinical improvement, characterized as duration required from enrollment to the achievement of NEWS-2 of ≤ 2 maintained for 24 h; time to symptomatic recovery, defined as the duration in days (from randomization) required for the recovery of the COVID-19 symptoms; mortality rate; duration of ICU and hospital stay; total period of hospitalization; the rate of supplementary oxygen requirement; the computed tomography (CT) chest recovery (%), the time required for the viral clearance and “NEWS-2” on discharge.
RESULTS A total of 208 patients were enrolled in this study with 104 patients in each group. The famotidine treatment group had comparatively better recovery of 75% and a low mortality of 25% than the control with a recovery of 70% and a mortality of 30%. Duration of clinical improvement (group A 9.53 d, group B 14.21 d); hospitalization period among the recovered patients (group A 13.04 d, group B 16.31 d), pulmonary improvement in chest CT (group A 21.7%, group B 13.2%), and the time for viral clearance (group A 20.7 d, group B 23.8 d) were found to be statistically significant P ≤ 0.05. However, the Kaplan Meier survival test was not significant among the two study groups, P = 0.989.
CONCLUSION According to our study, treatment with famotidine achieved a better clinical outcome compared to the control group in severe COVID-19 illness, although no significant survival benefit was found.
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Affiliation(s)
- Abu Taiub Mohammed Mohiuddin Chowdhury
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China
- Ministry of Health and Family Welfare (OSD-DGHS), Dhaka 1212, Bangladesh
| | - Aktar Kamal
- Critical Care Unit, M Abdur Rahim Medical College Hospital, Dinajpur 5200, Bangladesh
| | - Md Kafil Uddin Abbas
- Critical Care Unit, Cox's Bazar 250 Bed District Sadar Hospital, Cox's Bazar 4700, Bangladesh
| | - Md Rezaul Karim
- Department of Neurology, University Hospital Limerick, Limerick V94 T9PX, Ireland
| | - Md Ahsan Ali
- Department of Histology, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China
| | - Shubhashis Talukder
- Intensive Care Unit, 250 Bed Chattogram General Hospital, Chittagong 4000, Bangladesh
| | - H M Hamidullah Mehedi
- Department of Medicine, 250 Bed Chattogram General Hospital, Chittagong 4000, Bangladesh
| | - Hamid Hassan
- Department of Emergency, Chattogram Medical College Hospital, Chittagong 4000, Bangladesh
| | - Abul Hossain Shahin
- Department of Cardiology, 250 Bed Chattogram General Hospital, Chittagong 4000, Bangladesh
| | - Yarui Li
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China
| | - Shuixiang He
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China
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Fazio S, Cosentino M, Marino F, Pandolfi S, Zanolin E, Bellavite P. The Problem of Home Therapy during COVID-19 Pandemic in Italy: Government Guidelines versus Freedom of Cure? J Pharm Pharmacol Res 2022; 6:100-114. [PMID: 37168835 PMCID: PMC10167757 DOI: 10.26502/fjppr.055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
After starting in late 2019, COVID-19 spread worldwide, and Italy was one of the first Western nations to be seriously affected. At that time, both the virus and the disease were little known and there were no Evidence-Based Medicine indications for treatment. The Italian Health Ministry guidelines claimed that, unless oxygen saturation fell to <92%, no pharmacological treatment was necessary during the first 72 hours, other than on a purely symptomatic basis, preferably with paracetamol. As later confirmed, that delay in therapeutic intervention may have been responsible for numerous hospital admissions and a very high lethality (3.5 %). To try to remedy this situation, several volunteer groups were formed, managing to promptlycure thousands of patients at home with non-steroidal anti-inflammatory drugs and a variety of re-purposed drugs (principally hydroxychloroquine, ivermectin) and supplements (such as antioxidants, polyphenols and vitamin D). Although not documented by any randomized controlled studies, these approaches were nonetheless based on the best available evidence, were aimed at addressing otherwise unmet major needs and produced a significant reduction of hospitalizations, of symptom duration, and a complete recovery from the disease compared with late treatment, according to some retrospective observational studies and the clinical experience of many physicians. A prompt discussion, with a clear and open exchange between healthcare Institutions and the said groups of voluntary physicians, could clarify the most effective approaches to reduce the number of hospitalizations and the lethality of this disease.
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Affiliation(s)
- Serafino Fazio
- Medical School University Federico II, Naples (retired professor), Italy
| | - Marco Cosentino
- Center of Research in Medical Pharmacology, University of Insubria, Varese, Italy
| | - Franca Marino
- Center of Research in Medical Pharmacology, University of Insubria, Varese, Italy
| | - Sergio Pandolfi
- High School Master of Oxygen-Ozone Therapy, University of Pavia, Italy
| | - Elisabetta Zanolin
- Department of Diagnostics and Public Health, University of Verona, Italy
| | - Paolo Bellavite
- Medical School University of Verona, Verona (retired professor), Italy
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Ventura-López C, Cervantes-Luevano K, Aguirre-Sánchez JS, Flores-Caballero JC, Alvarez-Delgado C, Bernaldez-Sarabia J, Sánchez-Campos N, Lugo-Sánchez LA, Rodríguez-Vázquez IC, Sander-Padilla JG, Romero-Antonio Y, Arguedas-Núñez MM, González-Canudas J, Licea-Navarro AF. Treatment with metformin glycinate reduces SARS-CoV-2 viral load: An in vitro model and randomized, double-blind, Phase IIb clinical trial. Biomed Pharmacother 2022; 152:113223. [PMID: 35709650 PMCID: PMC9159967 DOI: 10.1016/j.biopha.2022.113223] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 05/25/2022] [Accepted: 05/30/2022] [Indexed: 11/24/2022] Open
Abstract
The health crisis caused by the new coronavirus SARS-CoV-2 highlights the need to identify new treatment strategies for this viral infection. During the past year, over 400 coronavirus disease (COVID-19) treatment patents have been registered; nevertheless, the presence of new virus variants has triggered more severe disease presentations and reduced treatment effectiveness, highlighting the need for new treatment options for the COVID-19. This study evaluates the Metformin Glycinate (MG) effect on the SARS-CoV-2 in vitro and in vivo viral load. The in vitro study was conducted in a model of Vero E6 cells, while the in vivo study was an adaptive, two-armed, randomized, prospective, longitudinal, double-blind, multicentric, and phase IIb clinical trial. Our in vitro results revealed that MG effectively inhibits viral replication after 48 h of exposure to the drug, with no cytotoxic effect in doses up to 100 µM. The effect of the MG was also tested against three variants of interest (alpha, delta, and epsilon), showing increased survival rates in cells treated with MG. These results are aligned with our clinical data, which indicates that MG treatment reduces SARS-CoV2-infected patients´ viral load in just 3.3 days and supplementary oxygen requirements compared with the control group. We expect our results can guide efforts to position MG as a therapeutic option for COVID-19 patients.
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Affiliation(s)
- Claudia Ventura-López
- Departamento de Innovación Biomédica, CICESE, Carretera Ensenada-Tijuana 3918, Zona Playitas, Ensenada, BC 22860, Mexico.
| | - Karla Cervantes-Luevano
- Departamento de Innovación Biomédica, CICESE, Carretera Ensenada-Tijuana 3918, Zona Playitas, Ensenada, BC 22860, Mexico.
| | | | | | - Carolina Alvarez-Delgado
- Departamento de Innovación Biomédica, CICESE, Carretera Ensenada-Tijuana 3918, Zona Playitas, Ensenada, BC 22860, Mexico.
| | - Johanna Bernaldez-Sarabia
- Departamento de Innovación Biomédica, CICESE, Carretera Ensenada-Tijuana 3918, Zona Playitas, Ensenada, BC 22860, Mexico.
| | - Noemí Sánchez-Campos
- Departamento de Innovación Biomédica, CICESE, Carretera Ensenada-Tijuana 3918, Zona Playitas, Ensenada, BC 22860, Mexico.
| | | | | | | | | | | | | | - Alexei F Licea-Navarro
- Departamento de Innovación Biomédica, CICESE, Carretera Ensenada-Tijuana 3918, Zona Playitas, Ensenada, BC 22860, Mexico.
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Wyler E, Adler JM, Eschke K, Teixeira Alves G, Peidli S, Pott F, Kazmierski J, Michalick L, Kershaw O, Bushe J, Andreotti S, Pennitz P, Abdelgawad A, Postmus D, Goffinet C, Kreye J, Reincke SM, Prüss H, Blüthgen N, Gruber AD, Kuebler WM, Witzenrath M, Landthaler M, Nouailles G, Trimpert J. Key benefits of dexamethasone and antibody treatment in COVID-19 hamster models revealed by single-cell transcriptomics. Mol Ther 2022; 30:1952-1965. [PMID: 35339689 PMCID: PMC8942568 DOI: 10.1016/j.ymthe.2022.03.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/17/2022] [Accepted: 03/22/2022] [Indexed: 12/15/2022] Open
Abstract
For coronavirus disease 2019 (COVID-19), effective and well-understood treatment options are still scarce. Since vaccine efficacy is challenged by novel variants, short-lasting immunity, and vaccine hesitancy, understanding and optimizing therapeutic options remains essential. We aimed at better understanding the effects of two standard-of-care drugs, dexamethasone and anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies, on infection and host responses. By using two COVID-19 hamster models, pulmonary immune responses were analyzed to characterize effects of single or combinatorial treatments. Pulmonary viral burden was reduced by anti-SARS-CoV-2 antibody treatment and unaltered or increased by dexamethasone alone. Dexamethasone exhibited strong anti-inflammatory effects and prevented fulminant disease in a severe disease model. Combination therapy showed additive benefits with both anti-viral and anti-inflammatory potency. Bulk and single-cell transcriptomic analyses confirmed dampened inflammatory cell recruitment into lungs upon dexamethasone treatment and identified a specifically responsive subpopulation of neutrophils, thereby indicating a potential mechanism of action. Our analyses confirm the anti-inflammatory properties of dexamethasone and suggest possible mechanisms, validate anti-viral effects of anti-SARS-CoV-2 antibody treatment, and reveal synergistic effects of a combination therapy, thus informing more effective COVID-19 therapies.
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Affiliation(s)
- Emanuel Wyler
- Berlin Institute for Medical Systems Biology (BIMSB), Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany.
| | - Julia M Adler
- Institute of Virology, Freie Universität Berlin, Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Division of Pulmonary Inflammation, Berlin, Germany
| | - Kathrin Eschke
- Institute of Virology, Freie Universität Berlin, Berlin, Germany
| | - G Teixeira Alves
- Berlin Institute for Medical Systems Biology (BIMSB), Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Stefan Peidli
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Pathology, Berlin, Germany; IRI Life Sciences, Institute for Biology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Fabian Pott
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Virology, Berlin, Germany; Berlin Institute of Health (BIH), Berlin, Germany
| | - Julia Kazmierski
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Virology, Berlin, Germany; Berlin Institute of Health (BIH), Berlin, Germany
| | - Laura Michalick
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Physiology, Berlin, Germany
| | - Olivia Kershaw
- Institute of Veterinary Pathology, Freie Universität Berlin, Berlin, Germany
| | - Judith Bushe
- Institute of Veterinary Pathology, Freie Universität Berlin, Berlin, Germany
| | - Sandro Andreotti
- Bioinformatics Solution Center, Freie Universität Berlin, Berlin, Germany
| | - Peter Pennitz
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Division of Pulmonary Inflammation, Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases and Respiratory Medicine, Berlin, Germany
| | - Azza Abdelgawad
- Institute of Virology, Freie Universität Berlin, Berlin, Germany
| | - Dylan Postmus
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Virology, Berlin, Germany; Berlin Institute of Health (BIH), Berlin, Germany
| | - Christine Goffinet
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Virology, Berlin, Germany; Berlin Institute of Health (BIH), Berlin, Germany
| | - Jakob Kreye
- German Center for Neurodegenerative Diseases (DZNE) Berlin, Helmholtz Innovation Lab BaoBab (Brain Antibody-Omics and B-Cell Lab), Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Neurology and Experimental Neurology, Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Pediatric Neurology, Berlin, Germany
| | - S Momsen Reincke
- German Center for Neurodegenerative Diseases (DZNE) Berlin, Helmholtz Innovation Lab BaoBab (Brain Antibody-Omics and B-Cell Lab), Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Neurology and Experimental Neurology, Berlin, Germany
| | - Harald Prüss
- German Center for Neurodegenerative Diseases (DZNE) Berlin, Helmholtz Innovation Lab BaoBab (Brain Antibody-Omics and B-Cell Lab), Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Neurology and Experimental Neurology, Berlin, Germany
| | - Nils Blüthgen
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Pathology, Berlin, Germany; IRI Life Sciences, Institute for Biology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Achim D Gruber
- Institute of Veterinary Pathology, Freie Universität Berlin, Berlin, Germany
| | - Wolfgang M Kuebler
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Physiology, Berlin, Germany
| | - Martin Witzenrath
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Division of Pulmonary Inflammation, Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases and Respiratory Medicine, Berlin, Germany
| | - Markus Landthaler
- Berlin Institute for Medical Systems Biology (BIMSB), Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany; IRI Life Sciences, Institute for Biology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Geraldine Nouailles
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Division of Pulmonary Inflammation, Berlin, Germany.
| | - Jakob Trimpert
- Institute of Virology, Freie Universität Berlin, Berlin, Germany.
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Sberna G, Biagi M, Marafini G, Nardacci R, Biava M, Colavita F, Piselli P, Miraldi E, D'Offizi G, Capobianchi MR, Amendola A. In vitro Evaluation of Antiviral Efficacy of a Standardized Hydroalcoholic Extract of Poplar Type Propolis Against SARS-CoV-2. Front Microbiol 2022; 13:799546. [PMID: 35350622 PMCID: PMC8958028 DOI: 10.3389/fmicb.2022.799546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 01/27/2022] [Indexed: 12/23/2022] Open
Abstract
Except for specific vaccines and monoclonal antibodies, effective prophylactic or post-exposure therapeutic treatments are currently limited for COVID-19. Propolis, a honeybee’s product, has been suggested as a potential candidate for treatment of COVID-19 for its immunomodulatory properties and for its powerful activity against various types of viruses, including common coronaviruses. However, direct evidence regarding the antiviral activities of this product still remains poorly documented. VERO E6 and CALU3 cell lines were infected with SARS-CoV-2 and cultured in the presence of 12.5 or 25 μg/ml of a standardized Hydroalcoholic Extract acronym (sHEP) of Eurasian poplar type propolis and analyzed for viral RNA transcription, for cell damage by optical and electron microscopy, and for virus infectivity by viral titration at 2, 24, 48, and 72 h post-infection. The three main components of sHEP, caffeic acid phenethyl ester, galangin, and pinocembrin, were tested for the antiviral power, either alone or in combination. On both cell lines, sHEP showed significant effects mainly on CALU3 up to 48 h, i.e., some protection from cytopathic effects and consistent reduction of infected cell number, fewer viral particles inside cellular vesicles, reduction of viral titration in supernatants, dramatic drop of N gene negative sense RNA synthesis, and lower concentration of E gene RNA in cell extracts. Interestingly, pre-treatment of cells with sHEP before virus inoculation induced these same effects described previously and was not able to block virus entry. When used in combination, the three main constituents of sHEP showed antiviral activity at the same levels of sHEP. sHEP has a remarkable ability to hinder the replication of SARS-CoV-2, to limit new cycles of infection, and to protect host cells against the cytopathic effect, albeit with rather variable results. However, sHEP do not block the virus entry into the cells. The antiviral activity observed with the three main components of sHEP used in combination highlights that the mechanism underlying the antiviral activity of sHEP is probably the result of a synergistic effect. These data add further emphasis on the possible therapeutic role of this special honeybee’s product as an adjuvant to official treatments of COVID-19 patients for its direct antiviral activity.
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Affiliation(s)
- Giuseppe Sberna
- Laboratory of Virology, National Institute for Infectious Diseases INMI, "Lazzaro Spallanzani" Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Marco Biagi
- Department of Physical Sciences, Earth and Environment, University of Siena, Siena, Italy
| | - Giovanni Marafini
- Laboratory of Virology, National Institute for Infectious Diseases INMI, "Lazzaro Spallanzani" Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Roberta Nardacci
- Laboratory of Virology, National Institute for Infectious Diseases INMI, "Lazzaro Spallanzani" Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.,Clinical Department, National Institute for Infectious Diseases INMI, "Lazzaro Spallanzani" Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Mirella Biava
- Laboratory of Virology, National Institute for Infectious Diseases INMI, "Lazzaro Spallanzani" Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Francesca Colavita
- Laboratory of Virology, National Institute for Infectious Diseases INMI, "Lazzaro Spallanzani" Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Pierluca Piselli
- Epidemiology Department, National Institute for Infectious Diseases INMI, "Lazzaro Spallanzani" Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Elisabetta Miraldi
- Department of Physical Sciences, Earth and Environment, University of Siena, Siena, Italy
| | - Gianpiero D'Offizi
- Clinical Department, National Institute for Infectious Diseases INMI, "Lazzaro Spallanzani" Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.,Saint Camillus International University of Health Sciences, Rome, Italy
| | - Maria Rosaria Capobianchi
- Laboratory of Virology, National Institute for Infectious Diseases INMI, "Lazzaro Spallanzani" Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.,Saint Camillus International University of Health Sciences, Rome, Italy
| | - Alessandra Amendola
- Laboratory of Virology, National Institute for Infectious Diseases INMI, "Lazzaro Spallanzani" Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
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Rommasi F, Nasiri MJ, Mirsaeidi M. Immunomodulatory agents for COVID-19 treatment: possible mechanism of action and immunopathology features. Mol Cell Biochem 2022; 477:711-726. [PMID: 35013850 PMCID: PMC8747854 DOI: 10.1007/s11010-021-04325-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 12/01/2021] [Indexed: 02/06/2023]
Abstract
The novel coronavirus pandemic has emerged as one of the significant medical-health challenges of the current century. The World Health Organization has named this new virus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since the first detection of SARS-CoV-2 in November 2019 in Wuhan, China, physicians, researchers, and others have made it their top priority to find drugs and cures that can effectively treat patients and reduce mortality rates. The symptoms of Coronavirus Disease 2019 (COVID-19) include fever, dry cough, body aches, and anosmia. Various therapeutic compounds have been investigated and applied to mitigate the symptoms in COVID-19 patients and cure the disease. Degenerative virus analyses of the infection incidence and COVID-19 have demonstrated that SARS-CoV-2 penetrates the pulmonary alveoli's endothelial cells through Angiotensin-Converting Enzyme 2 (ACE2) receptors on the membrane, stimulates various signaling pathways and causes excessive secretion of cytokines. The continuous triggering of the innate and acquired immune system, as well as the overproduction of pro-inflammatory factors, cause a severe condition in the COVID-19 patients, which is called "cytokine storm". It can lead to acute respiratory distress syndrome (ARDS) in critical patients. Severe and critical COVID-19 cases demand oxygen therapy and mechanical ventilator support. Various drugs, including immunomodulatory and immunosuppressive agents (e.g., monoclonal antibodies (mAbs) and interleukin antagonists) have been utilized in clinical trials. However, the studies and clinical trials have documented diverging findings, which seem to be due to the differences in these drugs' possible mechanisms of action. These drugs' mechanism of action generally includes suppressing or modulating the immune system, preventing the development of cytokine storm via various signaling pathways, and enhancing the blood vessels' diameter in the lungs. In this review article, multiple medications from different drug families are discussed, and their possible mechanisms of action are also described.
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Affiliation(s)
- Foad Rommasi
- Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran.
| | - Mohammad Javad Nasiri
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Mirsaeidi
- Department of Pulmonary and Critical Care, Miller School of Medicine, University of Miami, Miami, FL, USA
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Daria S, Islam MR. Indiscriminate Use of Antibiotics for COVID-19 Treatment in South Asian Countries is a Threat for Future Pandemics Due to Antibiotic Resistance. Clin Med Insights Pathol 2022; 15:2632010X221099889. [PMID: 35601922 PMCID: PMC9121502 DOI: 10.1177/2632010x221099889] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 04/24/2022] [Indexed: 12/18/2022] Open
Abstract
The COVID-19 pandemic has put enormous strain on the global public health
and healthcare systems. Here we aimed to assess the prevalence and
impact of indiscriminate use of antibiotics for COVID-19 treatment in
south Asian countries. We observed the indiscriminate use of
antibiotics in south Asian countries and other similar parts of the
world. Along with vaccines, people in poor and developing countries
have been taking antibiotics and some other medications without proper
jurisdiction during the waves of the COVID-19 pandemic. We all know
that COVID-19 is a viral disease, and only a few patients might have
bacterial co-infections. Therefore, the role of antibiotics is
ambiguous in most COVID-19 cases. Consequently, the overuse of
antibiotics would cause antimicrobial resistance that has the
potential to become a 2-edged sword after the COVID-19 pandemic era.
Our findings emphasize the judicious use of antibiotics in COVID-19
therapy, especially in poor and developing countries across the
globe.
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Affiliation(s)
- Sohel Daria
- Department of Pharmacy, University of Asia Pacific, Farmgate, Dhaka, Bangladesh
| | - Md Rabiul Islam
- Department of Pharmacy, University of Asia Pacific, Farmgate, Dhaka, Bangladesh
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Pourkarim F, Pourtaghi‐Anvarian S, Rezaee H. Molnupiravir: A new candidate for COVID-19 treatment. Pharmacol Res Perspect 2021; 10:e00909. [PMID: 34968008 PMCID: PMC8929331 DOI: 10.1002/prp2.909] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 12/05/2021] [Accepted: 12/15/2021] [Indexed: 12/15/2022] Open
Abstract
The novel coronavirus disease 2019 (COVID‐19) emerged in late December 2019 in china and has rapidly spread to many countries around the world. The effective pharmacotherapy can reduce the mortality of COVID‐19. Antiviral medications are the candidate therapies for the management of COVID‐19. Molnupiravir is an antiviral drug with anti‐RNA polymerase activity and currently is under investigation for the treatment of patients with COVID‐19. This review focuses on summarizing published literature for the mechanism of action, safety, efficacy, and clinical trials of molnupiravir in the treatment of COVID‐19 patients.
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Affiliation(s)
- Fariba Pourkarim
- Student Research CommitteeFaculty of PharmacyTabriz University of Medical SciencesTabrizIran
- Department of Clinical PharmacyFaculty of PharmacyTabriz University of Medical SciencesTabrizIran
| | - Samira Pourtaghi‐Anvarian
- Student Research CommitteeFaculty of PharmacyTabriz University of Medical SciencesTabrizIran
- Department of Clinical PharmacyFaculty of PharmacyTabriz University of Medical SciencesTabrizIran
| | - Haleh Rezaee
- Department of Clinical PharmacyFaculty of PharmacyTabriz University of Medical SciencesTabrizIran
- Infectious Diseases and Tropical Medicine Research CenterTabriz University of Medical SciencesTabrizIran
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Law MF, Ho R, Law KWT, Cheung CKM. Gastrointestinal and hepatic side effects of potential treatment for COVID-19 and vaccination in patients with chronic liver diseases. World J Hepatol 2021; 13:1850-1874. [PMID: 35069994 PMCID: PMC8727202 DOI: 10.4254/wjh.v13.i12.1850] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/20/2021] [Accepted: 11/15/2021] [Indexed: 02/06/2023] Open
Abstract
The outbreak of coronavirus disease 2019 (COVID-19) is a global pandemic. Many clinical trials have been performed to investigate potential treatments or vaccines for this disease to reduce the high morbidity and mortality. The drugs of higher interest include umifenovir, bromhexine, remdesivir, lopinavir/ritonavir, steroid, tocilizumab, interferon alpha or beta, ribavirin, fivapiravir, nitazoxanide, ivermectin, molnupiravir, hydroxychloroquine/chloroquine alone or in combination with azithromycin, and baricitinib. Gastrointestinal (GI) symptoms and liver dysfunction are frequently seen in patients with COVID-19, which can make it difficult to differentiate disease manifestations from treatment adverse effects. GI symptoms of COVID-19 include anorexia, dyspepsia, nausea, vomiting, diarrhea and abdominal pain. Liver injury can be a result of systemic inflammation or cytokine storm, or due to the adverse drug effects in patients who have been receiving different treatments. Regular monitoring of liver function should be performed. COVID-19 vaccines have been rapidly developed with different technologies including mRNA, viral vectors, inactivated viruses, recombinant DNA, protein subunits and live attenuated viruses. Patients with chronic liver disease or inflammatory bowel disease and liver transplant recipients are encouraged to receive vaccination as the benefits outweigh the risks. Vaccination against COVID-19 is also recommended to family members and healthcare professionals caring for these patients to reduce exposure to the severe acute respiratory syndrome coronavirus 2 virus.
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Affiliation(s)
- Man Fai Law
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
| | - Rita Ho
- Department of Medicine, North District Hospital, Hong Kong, China
| | | | - Carmen Ka Man Cheung
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
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Kumar V, Kumar R, Kumar M, Wander GS, Gupta V, Sahani A. Recent advances in low-cost, portable automated resuscitator systems to fight COVID-19. Health Technol (Berl) 2021;:1-11. [PMID: 34873565 DOI: 10.1007/s12553-021-00629-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 11/27/2021] [Indexed: 01/08/2023]
Abstract
World is fighting one of its greatest battle against COVID-19 (a highly infectious disease), leading to death of hundreds of thousands of people around the world, with severe patients requiring artificial breathing. To overcome the shortage of ventilators in medical infrastructure, various low-cost, easy to assemble, portable ventilators have been proposed to fight the ongoing pandemic. These mechanical ventilators are made from components that are generally readily available worldwide. Such components are already associated with day-to-day gadgets or items and which do not require specialized manufacturing processes. Various designs have been proposed, focussing on meeting basic requirements for artificial ventilation to fight the ongoing pandemic. But some people are against the usage of these mechanical ventilators in real-life situations, owing to poor reliability and inability of these designs to meet certain clinical requirements. Each design has its own merits and demerits, which need to be addressed for proper designing. Therefore, this article aims to provide readers an overview of various design parameters that needs to be considered while designing portable ventilators, by systematic analysis from available pool of proposed designs. By going through existing literature, we have recognized multiple factors influencing device performance and how these factors need to be considered for efficient device operation.
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Tsiatis AA, Davidian M, Holloway ST. Estimation of the odds ratio in a proportional odds model with censored time-lagged outcome in a randomized clinical trial. Biometrics 2021. [PMID: 34825704 DOI: 10.1111/biom.13603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 11/05/2021] [Accepted: 11/18/2021] [Indexed: 12/01/2022]
Abstract
In many randomized clinical trials of therapeutics for COVID-19, the primary outcome is an ordinal categorical variable, and interest focuses on the odds ratio (OR; active agent vs control) under the assumption of a proportional odds model. Although at the final analysis the outcome will be determined for all subjects, at an interim analysis, the status of some participants may not yet be determined, for example, because ascertainment of the outcome may not be possible until some prespecified follow-up time. Accordingly, the outcome from these subjects can be viewed as censored. A valid interim analysis can be based on data only from those subjects with full follow-up; however, this approach is inefficient, as it does not exploit additional information that may be available on those for whom the outcome is not yet available at the time of the interim analysis. Appealing to the theory of semiparametrics, we propose an estimator for the OR in a proportional odds model with censored, time-lagged categorical outcome that incorporates additional baseline and time-dependent covariate information and demonstrate that it can result in considerable gains in efficiency relative to simpler approaches. A byproduct of the approach is a covariate-adjusted estimator for the OR based on the full data that would be available at a final analysis.
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Affiliation(s)
- Anastasios A Tsiatis
- Department of Statistics, North Carolina State University, Raleigh, North Carolina
| | - Marie Davidian
- Department of Statistics, North Carolina State University, Raleigh, North Carolina
| | - Shannon T Holloway
- Department of Statistics, North Carolina State University, Raleigh, North Carolina
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Lucaciu O, Aghiorghiesei O, Petrescu NB, Mirica IC, Benea HRC, Apostu D. In quest of a new therapeutic approach in COVID-19: the endocannabinoid system. Drug Metab Rev 2021; 53:478-490. [PMID: 33683968 PMCID: PMC7989954 DOI: 10.1080/03602532.2021.1895204] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 02/21/2021] [Indexed: 01/08/2023]
Abstract
The SARS-Cov-2 virus caused a high morbidity and mortality rate disease, that is the COVID-19 pandemic. Despite the unprecedented research interest in this field, the lack of specific treatments leads to severe complications in a high number of cases. Current treatment includes antivirals, corticosteroids, immunoglobulins, antimalarials, interleukin-6 inhibitors, anti-GM-CSF, convalescent plasma, immunotherapy, antibiotics, circulation support, oxygen therapy, and circulation support. Due to the limited results, until specific treatments are available, other therapeutic approaches need to be considered. The endocannabinoid system is found in multiple systems within the human body, including the immune system. Its activation can lead to beneficial results such as decreased viral entry, decreased viral replication, and a decrease in pro-inflammatory cytokines such as IL-2, IL-4, IL-6, IL-12, TNF-α, or IFN-γ. Moreover, endocannabinoid system activation can lead to an increase in anti-inflammatory cytokines, mainly represented by IL-10. Overall, the cannabinoid system can potentially reduce pulmonary inflammation, increase the immunomodulatory effect, decrease PMN infiltration, reduce fibrosis, and decrease viral replication, as well as decrease the 'cytokine storm'. Although the cannabinoid system has many mechanisms to provide certain benefits in the treatment of SARS-CoV-2 infected patients, research in this field is needed for a better understanding of the cannabinoid impact in this situation.
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Affiliation(s)
- Ondine Lucaciu
- Department of Oral Rehabilitation, University of Medicine and Pharmacy ‘Iuliu Hatieganu’, Cluj-Napoca, Romania
| | - Ovidiu Aghiorghiesei
- Department of Oral Rehabilitation, University of Medicine and Pharmacy ‘Iuliu Hatieganu’, Cluj-Napoca, Romania
| | - Nausica Bianca Petrescu
- Department of Oral Rehabilitation, University of Medicine and Pharmacy ‘Iuliu Hatieganu’, Cluj-Napoca, Romania
| | - Ioana Codruta Mirica
- Department of Oral Rehabilitation, University of Medicine and Pharmacy ‘Iuliu Hatieganu’, Cluj-Napoca, Romania
| | - Horea Rareș Ciprian Benea
- Department of Orthopedics-Traumatology and Pediatric Orthopedics, University of Medicine and Pharmacy ‘Iuliu Hatieganu’, Cluj-Napoca, Romania
| | - Dragoș Apostu
- Department of Orthopedics-Traumatology and Pediatric Orthopedics, University of Medicine and Pharmacy ‘Iuliu Hatieganu’, Cluj-Napoca, Romania
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Straus MR, Bidon MK, Tang T, Jaimes JA, Whittaker GR, Daniel S. Inhibitors of L-Type Calcium Channels Show Therapeutic Potential for Treating SARS-CoV-2 Infections by Preventing Virus Entry and Spread. ACS Infect Dis 2021; 7:2807-2815. [PMID: 34498840 PMCID: PMC8442615 DOI: 10.1021/acsinfecdis.1c00023] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Indexed: 01/06/2023]
Abstract
COVID-19 is caused by a novel coronavirus, the severe acute respiratory syndrome coronavirus (CoV)-2 (SARS-CoV-2). The virus is responsible for an ongoing pandemic and concomitant public health crisis around the world. While vaccine development is proving to be highly successful, parallel drug development approaches are also critical in the response to SARS-CoV-2 and other emerging viruses. Coronaviruses require Ca2+ ions for host cell entry, and we have previously shown that Ca2+ modulates the interaction of the viral fusion peptide with host cell membranes. In an attempt to accelerate drug repurposing, we tested a panel of L-type calcium channel blocker (CCB) drugs currently developed for other conditions to determine whether they would inhibit SARS-CoV-2 infection in cell culture. All the CCBs tested showed varying degrees of inhibition, with felodipine and nifedipine strongly limiting SARS-CoV-2 entry and infection in epithelial lung cells at concentrations where cell toxicity was minimal. Further studies with pseudotyped particles displaying the SARS-CoV-2 spike protein suggested that inhibition occurs at the level of virus entry. Overall, our data suggest that certain CCBs have the potential to treat SARS-CoV-2 infections and are worthy of further examination for possible treatment of COVID-19.
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Affiliation(s)
- Marco R. Straus
- Department of Microbiology & Immunology, College
of Veterinary Medicine, Cornell University, Ithaca, New York
14853, United States
| | - Miya K. Bidon
- Robert Frederick Smith School of Chemical &
Biomolecular Engineering, Cornell University, Ithaca, New York
14853, United States
| | - Tiffany Tang
- Robert Frederick Smith School of Chemical &
Biomolecular Engineering, Cornell University, Ithaca, New York
14853, United States
| | - Javier A. Jaimes
- Department of Microbiology & Immunology, College
of Veterinary Medicine, Cornell University, Ithaca, New York
14853, United States
| | - Gary R. Whittaker
- Department of Microbiology & Immunology, College
of Veterinary Medicine, Cornell University, Ithaca, New York
14853, United States
- Master of Public Health Program, Cornell
University, Ithaca, New York 14853, United States
| | - Susan Daniel
- Robert Frederick Smith School of Chemical &
Biomolecular Engineering, Cornell University, Ithaca, New York
14853, United States
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Arora R, Goel R, Khanam S, Kumar S, Shah S, Singh S, Chhabra M, Meher R, Khurana N, Sagar T, Kumar S, Garg S, Kumar J, Saxena S, Pant R. Rhino-Orbito-Cerebral-Mucormycosis During the COVID-19 Second Wave in 2021 - A Preliminary Report from a Single Hospital. Clin Ophthalmol 2021; 15:3505-3514. [PMID: 34429582 PMCID: PMC8380130 DOI: 10.2147/opth.s324977] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 08/05/2021] [Indexed: 02/01/2023] Open
Abstract
PURPOSE To list the clinico-epidemiological profile and possible risk factors of COVID-19 associated rhino-orbital-cerebral mucormycosis (CA-ROCM) patients presenting to a COVID dedicated hospital during the second wave of COVID-19 in India. PATIENTS AND METHODS A cross-sectional, single-center study was done on 60 cases of probable CA-ROCM based on clinical features and supportive diagnostic nasal endoscopic findings and/or radiologic findings. Patients with recent or active COVID-19 were included. The demographic profile, clinical features, possible risk factors and diagnostic workup (microbiological, pathological and radiological) were analysed to identify the triggering factors for CA-ROCM. RESULTS The age of patients ranged from 29 to 75 years and male-female ratio was 3:1. The duration between the first positive COVID report and onset of CA-ROCM was 0 to 47 days. Forty-nine (81.66%) patients had a recent COVID infection and 11 (18.33%) had active COVID infection at presentation. Thirty-five patients (58%) had ocular/orbital involvement at presentation. In the affected eye, 10 had no perception of light and in the rest visual acuity ranged from log MAR 0 to +1.5. Ocular manifestations were ptosis (29), ophthalmoplegia (23), periocular tenderness and edema (33), proptosis (14), black discoloration of eyelids (3), facial palsy (3), endophthalmitis (4), retinal artery occlusion (8), disc edema (4) and disc pallor (5). Twenty-two (25%) patients had neither received steroids nor oxygen. Thirty patients (50%) were managed with oxygen while 38 patients (63.3%) with systemic steroids. The most common risk factor was diabetes in 59 patients. The average glycosylated hemoglobin (HbA1c) was 10.31 ± 2.59%. Systemic Amphotericin B was started in all the patients. Radical surgical debridement was performed in 12 patients and the remaining were planned. CONCLUSION SARS-CoV-2 variant with accompanying glycaemic dysregulation was found to be the triggering factor for the epidemic of CA-ROCM.
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Affiliation(s)
- Ritu Arora
- Department of Ophthalmology, Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, India
| | - Ruchi Goel
- Department of Ophthalmology, Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, India
| | - Samreen Khanam
- Department of Ophthalmology, Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, India
| | - Sumit Kumar
- Department of Ophthalmology, Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, India
| | - Shalin Shah
- Department of Ophthalmology, Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, India
| | - Sonam Singh
- Department of Ophthalmology, Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, India
| | - Mohit Chhabra
- Department of Ophthalmology, Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, India
| | - Ravi Meher
- Department of Otorhinolaryngology, Maulana Azad Medical College, New Delhi, India
| | - Nita Khurana
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Tanu Sagar
- Department of Microbiology, Maulana Azad Medical College, New Delhi, India
| | - Suresh Kumar
- Department of Medicine, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
| | - Sandeep Garg
- Department of Medicine, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
| | - Jyoti Kumar
- Department of Radiodiagnosis, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
| | - Sonal Saxena
- Department of Microbiology, Maulana Azad Medical College, New Delhi, India
| | - Rashmi Pant
- Society for Health Education and Allied Research, New Delhi, India
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Badhe RV, Nipate SS. The use of negative oxygen ion clusters [O 2-(H 2O) n] and bicarbonate ions [HCO 3-] as the supportive treatment of COVID-19 infections: A possibility. Med Hypotheses 2021; 154:110658. [PMID: 34390895 PMCID: PMC8339564 DOI: 10.1016/j.mehy.2021.110658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 06/23/2021] [Accepted: 06/24/2021] [Indexed: 11/28/2022]
Abstract
The COVID-19 or novel coronavirus SARS-CoV-2 pandemic is challenging worldwide healthcare system and severely affecting global economy. Furious efforts to end the pandemic including prevention of spread of SARS-CoV-2, use of antiviral drugs, symptomatic treatments and vaccination are underway. But there are no effective treatments available to save the dying patient in stage 2 (pulmonary) and stage 3 (hyperinflammation) of the infection. The detailed genetic and phenotypical analysis of SARS-CoV-2 revealed that the spike protein (S1) has increased positive charges (compared to SARS-CoV) on them and are responsible for attachment to human angiotensin-converting enzyme 2 (ACE2) receptor and infection by the virus. In addition, it was also reported that the inflammation in the tissue rendered the lung environment more acidic supporting the fusion of SARS-CoV-2 with the cells. We hypothesize that the intermittent use of the oxygen ionizer generating negative oxygen ion clusters [O2-(H2O)n] and sodium bicarbonate nebulizer (generating HCO3-); when connected to ventilator inlet or oxygen concentrator will neutralize the spike protein of the virus in respiratory tract and lungs and change the lung environment to neutral/alkaline condition respectively facilitating improved oxygen pressure in blood. These physical changes can effectively reduce the viral burden and help the patient recover from the infection faster.
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Affiliation(s)
| | - Sonali S Nipate
- SidIra Laboratories, Moshi, Pune, Maharashtra, India; Pharmacology Department, Modern College of Pharmacy, Nigdi, Pune, Maharashtra, India
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Kasiukiewicz A, Wojszel ZB. Assessment of Referrals and Hospitalizations in the Hospital Transformed into COVID-19 Facility in Poland during the "Spring Wave" of the Epidemic in 2020-A Cross-Sectional Study. Int J Environ Res Public Health 2021; 18:7143. [PMID: 34281079 PMCID: PMC8295743 DOI: 10.3390/ijerph18137143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/25/2021] [Accepted: 06/29/2021] [Indexed: 01/08/2023]
Abstract
The study aimed to evaluate hospitalizations in a COVID-dedicated facility during the "spring wave" of the epidemic in 2020 in Poland and analyze changes in access to hospital treatment in the country in the early phase of the pandemic. We investigated all referrals and admissions to the Ministry of Interior and Administration hospital in Białystok from 14 April to 14 August 2020. A total of 238 patients were referred to the hospital (with a median age of 64.5 years; IQR, 44-78), most commonly with fever (n = 151; 63.5%). Only 135 (56.7%) were admitted (5.5% of the number hospitalized in the same period in 2019). SARS-CoV-2 was confirmed in 42 (17.7%) cases. Older people with concomitant diseases and disabilities dominated. Seventeen patients (12.6%) required ICU treatment, and 19 (14%) died. Based on the National Health Fund data, we also examined changes in the rate of hospitalizations in Poland and in selected Polish COVID/ and non-COVID hospitals between February and August 2019 and 2020. The number of hospitalizations in Poland decreased dramatically in comparison to 2019. A very low hospitalization rate, significantly lower than in structurally similar non-COVID hospitals, was observed in transformed hospitals. Better use of hospital resources was observed when the hospital was semi-transformed and had the flexibility to adapt to epidemiological needs. The study seems to confirm that the system of transformed COVID hospitals resulted in unused healthcare resources and limited patient access to medical services in the early period of the epidemic. As a consequence, systemic modifications allowing the maximization and adequate use of the Polish healthcare system's limited resources have been implemented.
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Affiliation(s)
- Agnieszka Kasiukiewicz
- Department of Geriatrics, Hospital of the Ministry of Interior in Bialystok, 15-471 Bialystok, Poland;
- Department of Geriatrics, Medical University of Bialystok, 15-471 Bialystok, Poland
| | - Zyta Beata Wojszel
- Department of Geriatrics, Hospital of the Ministry of Interior in Bialystok, 15-471 Bialystok, Poland;
- Department of Geriatrics, Medical University of Bialystok, 15-471 Bialystok, Poland
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Omokhua-Uyi AG, Van Staden J. Natural product remedies for COVID-19: A focus on safety. S Afr J Bot 2021; 139:386-398. [PMID: 33753960 PMCID: PMC7970016 DOI: 10.1016/j.sajb.2021.03.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 01/23/2021] [Accepted: 03/03/2021] [Indexed: 05/07/2023]
Abstract
Infection by the novel coronavirus SARS-CoV-2 causing the coronavirus disease (COVID-19), is currently a global pandemic with more than two million deaths to date. Though a number of vaccines have recently been approved against the virus, availability remains a big challenge, and also acceptance by most people has become a big debate. This review discusses possible/proposed natural product remedies and some major conventional treatment options used to manage the infection and, safety concerns on the use of unproven or unapproved health products against COVID-19. An extensive literature review indicated that the influx of unproven and unapproved health products in the global market are on the rise, leading to various forms of self- medication. To this effect, there have been warnings by the United States Food and Drug Administration and the World Health Organisation against the use of such products. Conventional drugs such as remdesivir, chloroquine/hydroxychloroquine and dexamethasone are the major proposed drugs that are currently undergoing clinical trials for the management of this disease. Efforts are being made globally in the search for possible therapeutics which may be the best way to eradicating this disease. Some countries have approved the use of natural products in the management of COVID-19, despite little or no clinical evidence on their efficacy and safety. Natural products may hold a great potential in the fight against COVID-19 but without detailed clinical trials, their potency against the virus and their safe use cannot be established. To attain this goal, extensive research followed by clinical studies are needed. Collaborative efforts between researchers, clinicians, governments and traditional medicinal practitioners in the search and development of safe and effective therapeutics from natural products for the treatment of COVID-19 could be a potential option.
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Affiliation(s)
- Aitebiremen Gift Omokhua-Uyi
- Research Centre for Plant Growth and Development, School of Life Sciences, University of KwaZulu-Natal Pietermaritzburg, Private Bag X01, Scottsville 3201, South Africa
| | - Johannes Van Staden
- Research Centre for Plant Growth and Development, School of Life Sciences, University of KwaZulu-Natal Pietermaritzburg, Private Bag X01, Scottsville 3201, South Africa
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Lay-Ekuakille A, Chiffi C, Celesti A, Rahman MZU, Singh SP. Infrared Monitoring of Oxygenation Process Generated by Robotic Verticalization in Bedridden People. IEEE Sens J 2021; 21:14426-14433. [PMID: 35790096 PMCID: PMC8768999 DOI: 10.1109/jsen.2021.3068670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/19/2021] [Accepted: 03/22/2021] [Indexed: 05/03/2023]
Abstract
Bedridden people, especially at home, suffer from diverse pathologies beyond the main one that brings them to a specific position. Long-term cares are suitable at home to avoid congestions within hospital facilities. There are different technologies available to improve such people's conditions in their daily life. The standing posture is the key solution to enhance people's wellness amid the psychological burden due to the almost impossibility to be completely healed. The paper proposes the use of a polyfunctional and robotic bed capable of displaying many positions namely vertical, tilting, anti-trendelenburg with necessary graduation. A three-year monitoring of a patient, using a polyfunctional and robotic bed, suffering from amyotrophic lateral sclerosis (ALS), has been investigated. Different physiological parameters have been measured and, particularly, the variation of temperature has been measured in presence of body position connected to the robotic bed rotation that provokes biomechanical effort. It is demonstrated that certain body positions correspond to major and minor physical effort, hence major and minor oxygenation. An infrared camera has been used. As a positive result, the variation of posture has been delaying the increase of the pathological signs, because of better conditions.
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Affiliation(s)
- Aime Lay-Ekuakille
- Department of Innovation EngineeringUniversity of Salento 73100 Lecce Italy
| | | | - Antonio Celesti
- Department of EngineeringUniversity of Messina 98166 Messina Italy
| | - Md Zia Ur Rahman
- Department of Electronics and Communication EngineeringKoneru Lakshmanih Education Foundation, K L University Guntur 522052 India
| | - Satya P Singh
- School of Electrical and Electronic EngineeringNanyang Technological University Singapore 639798
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Perwitasari DA, Faridah IN, Dania H, Lolita L, Irham LM, Alim MDM, Shoaliha M, Heriyanto MJ. The knowledge of COVID-19 treatments, behaviors, and attitudes of providing the information on COVID-19 treatments: Perspectives of pharmacy students. J Educ Health Promot 2021; 10:235. [PMID: 34395672 PMCID: PMC8318149 DOI: 10.4103/jehp.jehp_1416_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 12/14/2020] [Indexed: 06/13/2023]
Abstract
BACKGROUND Increasing community awareness about the transmission and treatment of COVID-19 will stop the spread of the virus. Pharmacy students are the potential facilitator to give community education about COVID-19 treatment. The objective of this study is to evaluate the pharmacy students' knowledge of COVID-19 treatment, behavior, and attitude of providing the information about COVID-19 treatment. MATERIALS AND METHODS We conducted cross-sectional study, recruiting 429 pharmacy students from three schools of pharmacy in Indonesia. The questionnaire about the knowledge of COVID-19 treatment, behavior, and attitude of providing the information on COVID-19 treatment met the validity and reliability criteria. We defined the proportion of knowledge, behavior, and attitude of the students using SPSS® version 22. RESULTS Most of the students are in the earlier years (46.63%), female (84.15%), find the information about COVID-19 from many sources of media (85.08%) including scientific articles and know information about COVID-19 transmission around their life area (76.46%). The students' knowledge about antiviral and plasma convalescent is good (>70%), the positive behaviors are related to the COVID-19 treatment information regarding to the antiviral and the provision of Vitamin C (>50%), and the positive attitude are related to giving information about the use of avigan®, plasma convalescent, chloroquine, hydroxychloroquine, and immunomodulator (>50%). CONCLUSIONS As a future pharmacist, the knowledge of pharmacy students about COVID-19 treatment needs to be improved since earlier years. Furthermore, using the good knowledge about COVID-19 treatment, the positive behavior and attitude of providing information of the students, the community behavior and attitude will be improved. The high year students have a tendency for the good knowledge and positive behavior and attitude of providing the information.
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Affiliation(s)
- Dyah Aryani Perwitasari
- Department of Pharmacology, Clinical Pharmacy and Community, Faculty of Pharmacy, Universitas Ahmad Dahlan, Yogyakarta, Indonesia
| | - Imaniar Noor Faridah
- Department of Pharmacology, Clinical Pharmacy and Community, Faculty of Pharmacy, Universitas Ahmad Dahlan, Yogyakarta, Indonesia
| | - Haafizah Dania
- Department of Pharmacology, Clinical Pharmacy and Community, Faculty of Pharmacy, Universitas Ahmad Dahlan, Yogyakarta, Indonesia
| | - Lolita Lolita
- Department of Pharmacology, Clinical Pharmacy and Community, Faculty of Pharmacy, Universitas Ahmad Dahlan, Yogyakarta, Indonesia
| | - Lalu Muhammad Irham
- Department of Pharmacology, Clinical Pharmacy and Community, Faculty of Pharmacy, Universitas Ahmad Dahlan, Yogyakarta, Indonesia
| | | | - Maratun Shoaliha
- Department of Pharmacy,School of Health Science Bani Saleh, Bekasi, Indonesia
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Torrente-López A, Hermosilla J, Navas N, Cuadros-Rodríguez L, Cabeza J, Salmerón-García A. The Relevance of Monoclonal Antibodies in the Treatment of COVID-19. Vaccines (Basel) 2021; 9:557. [PMID: 34073559 PMCID: PMC8229508 DOI: 10.3390/vaccines9060557] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/18/2021] [Accepted: 05/22/2021] [Indexed: 12/14/2022] Open
Abstract
Major efforts have been made in the search for effective treatments since the outbreak of the COVID-19 infection in December 2019. Extensive research has been conducted on drugs that are already available and new treatments are also under development. Within this context, therapeutic monoclonal antibodies (mAbs) have been the subject of widespread investigation focusing on two target-based groups, i.e., non-SARS-CoV-2 specific mAbs, that target immune system responses, and SARS-CoV-2 specific mAbs, designed to neutralize the virus protein structure. Here we review the latest literature about the use of mAbs in order to describe the state of the art of the clinical trials and the benefits of using these biotherapeutics in the treatment of COVID-19. The clinical trials considered in the present review include both observational and randomized studies. We begin by presenting the studies conducted using non-SARS-CoV-2 specific mAbs for treating different immune disorders that were already on the market. Within this group of mAbs, we focus particularly on anti-IL-6/IL-6R. This is followed by a discussion of the studies on SARS-CoV-2 specific mAbs. Our findings indicate that SARS-CoV-2 specific mAbs are significantly more effective than non-specific ones.
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Affiliation(s)
- Anabel Torrente-López
- Department of Analytical Chemistry, Science Faculty, Biohealth Research Institute (ibs.GRANADA), University of Granada, E-18071 Granada, Spain; (A.T.-L.); (J.H.); (L.C.-R.)
| | - Jesús Hermosilla
- Department of Analytical Chemistry, Science Faculty, Biohealth Research Institute (ibs.GRANADA), University of Granada, E-18071 Granada, Spain; (A.T.-L.); (J.H.); (L.C.-R.)
| | - Natalia Navas
- Department of Analytical Chemistry, Science Faculty, Biohealth Research Institute (ibs.GRANADA), University of Granada, E-18071 Granada, Spain; (A.T.-L.); (J.H.); (L.C.-R.)
| | - Luis Cuadros-Rodríguez
- Department of Analytical Chemistry, Science Faculty, Biohealth Research Institute (ibs.GRANADA), University of Granada, E-18071 Granada, Spain; (A.T.-L.); (J.H.); (L.C.-R.)
| | - José Cabeza
- Department of Clinical Pharmacy, Biohealth Research Institute (ibs.GRANADA), San Cecilio University Hospital, E-18012 Granada, Spain; (J.C.); (A.S.-G.)
| | - Antonio Salmerón-García
- Department of Clinical Pharmacy, Biohealth Research Institute (ibs.GRANADA), San Cecilio University Hospital, E-18012 Granada, Spain; (J.C.); (A.S.-G.)
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50
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Silva-Ayarza I, Bachelet VC. What we know and dont know on SARS-CoV-2 and COVID-19. Medwave 2021; 21:e8198. [PMID: 34213514 DOI: 10.5867/medwave.2021.04.8198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 05/18/2021] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19), caused by the SARS-CoV-2 virus discovered in December 2019 in Wuhan, China, has had an enormous impact on public health worldwide due to its rapid spread and pandemic behavior, challenges in its control and mitigation, and few therapeutic alternatives. In this review, we summarize the pathophysiological mechanisms, clinical presentation, and diagnostic techniques. In addition, the main lineages and the different strategies for disease prevention are reviewed, with emphasis on the development of vaccines and their different platforms. Finally, some of the currently available therapeutic strategies are summarized. Throughout the article, we point out the current knowns and unknowns at the time of writing this article.
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Affiliation(s)
- Ignacio Silva-Ayarza
- Escuela de Medicina, Universidad de Santiago de Chile (USACH), Santiago, Chile; Departamento de Infectología, Hospital Barros Luco, Santiago, Chile. Adress: Escuela de Medicina, Universidad de Santiago de Chile, Avenida Libertador Bernardo O'Higgins 3363, Estación Central, Santiago, Chile. . ORCID: 0000-0002-6996-3695
| | - Vivienne C Bachelet
- Escuela de Medicina, Universidad de Santiago de Chile (USACH), Santiago, Chile. ORCID: 0000-0002-5715-9755
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