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2019 19
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2021 2273
2022 13
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Page 1
. 2021 Oct 7;165:D6173.

[SARS-CoV-2 neutralizing monoclonal antibodies: a potential breakthrough in the early treatment of Covid-19 in high-risk patients]

[Article in Dutch]
Affiliations
  • PMID: 34854645

[SARS-CoV-2 neutralizing monoclonal antibodies: a potential breakthrough in the early treatment of Covid-19 in high-risk patients]

[Article in Dutch]
Godelieve J de Bree et al. Ned Tijdschr Geneeskd. .

Abstract

Despite vaccination, a substantial proportion of immunocompromised patients have an increased risk for severe Covid-19. Treatment with SARS-CoV-2 neutralizing monoclonal antibodies has been shown to be safe and can prevent Covid-19 associated hospitalization and death. Monoclonal antibodies neutralize the virus and promote the immune response against SARS-CoV-2. Treatment with monoclonal antibodies is a potential breakthrough for the treatment of patients who are at high risk for severe disease when given early after infection. The first encouraging clinical trial data and the imminent availability of combination antibody therapy create a "momentum" to address several essential questions that are necessary to address for the structural use of this treatment in routine clinical care. These concern the real-world effect and sustainability of treatment of vulnerable patients, the optimal logistics and the cost-effectiveness of these novel compounds.

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Review
. 2021 Dec 2;143899.
doi: 10.13075/mp.5893.01207. Online ahead of print.

Potential therapeutic application of mesenchymal stem cells in COVID-19 complications

Affiliations
Review

Potential therapeutic application of mesenchymal stem cells in COVID-19 complications

Emanuel Kolanko et al. Med Pr. .

Abstract

Mesenchymal stem cells (MSCs) have remarkable immunomodulatory properties, low immunogenicity, and paracrine properties as well as the ability to differentiate into multiple cell lines. These properties make them potential candidates for clinical applications in the treatment of neurodegenerative, cardiovascular, and lung diseases, which may be occupational diseases. Preclinical studies using experimental animal models have demonstrated regenerative properties of MSCs in diseases such as silicosis and occupational asthma. Currently, treatment of the novel disease COVID-19 could be enhanced by using MSC therapies. This disease affects many professional groups with great intensity and its consequences might be considered as an occupational disease. It is a significant public health problem and a therapeutic challenge. Despite the development of vaccines against COVID-19, there is growing concern about the emergence of new mutations of the SARS-CoV-2 virus in addition to the known alpha, beta, gamma, and delta variants. There is still no effective COVID-19 treatment and the existing ones only play a supporting role. MSCs offer treatment possibilities as an alternative or complementary therapy. The clinical trials to date using MSCs in patients with COVID-19 give hope for the safe and effective use of this stem cell population. Med Pr. 2021;72(6).

Keywords: COVID-19; SARS-CoV-2 mutations; cell therapy; complementary therapy; mesenchymal stem cells; occupational diseases.

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. 2021 Dec 1;4(1):1347.
doi: 10.1038/s42003-021-02866-9.

Amantadine has potential for the treatment of COVID-19 because it inhibits known and novel ion channels encoded by SARS-CoV-2

Affiliations

Amantadine has potential for the treatment of COVID-19 because it inhibits known and novel ion channels encoded by SARS-CoV-2

Trine Lisberg Toft-Bertelsen et al. Commun Biol. .

Abstract

The dire need for COVID-19 treatments has inspired strategies of repurposing approved drugs. Amantadine has been suggested as a candidate, and cellular as well as clinical studies have indicated beneficial effects of this drug. We demonstrate that amantadine and hexamethylene-amiloride (HMA), but not rimantadine, block the ion channel activity of Protein E from SARS-CoV-2, a conserved viroporin among coronaviruses. These findings agree with their binding to Protein E as evaluated by solution NMR and molecular dynamics simulations. Moreover, we identify two novel viroporins of SARS-CoV-2; ORF7b and ORF10, by showing ion channel activity in a X. laevis oocyte expression system. Notably, amantadine also blocks the ion channel activity of ORF10, thereby providing two ion channel targets in SARS-CoV-2 for amantadine treatment in COVID-19 patients. A screen of known viroporin inhibitors on Protein E, ORF7b, ORF10 and Protein 3a from SARS-CoV-2 revealed inhibition of Protein E and ORF7b by emodin and xanthene, the latter also blocking Protein 3a. This illustrates a general potential of well-known ion channel blockers against SARS-CoV-2 and specifically a dual molecular basis for the promising effects of amantadine in COVID-19 treatment. We therefore propose amantadine as a novel, cheap, readily available and effective way to treat COVID-19.

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. 2021 Dec 1;1-9.
doi: 10.1007/s40265-021-01636-5. Online ahead of print.

Fluvoxamine for the Early Treatment of SARS-CoV-2 Infection: A Review of Current Evidence

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Fluvoxamine for the Early Treatment of SARS-CoV-2 Infection: A Review of Current Evidence

Shelley N Facente et al. Drugs. .

Abstract

SARS-CoV-2 infection causes COVID-19, which frequently leads to clinical deterioration and/or long-lasting morbidity. Academic and governmental experts throughout the USA met in 2021 to discuss the potential for use of fluvoxamine as early treatment of SARS-CoV-2 infection. Fluvoxamine is a selective serotonin reuptake inhibitor (SSRI) that is a strong sigma-1 receptor agonist, and this may effectively reduce cytokine production, preventing clinical deterioration. This repurposed psychiatric medication has a well-known safety record, is inexpensive, easy to use, and widely available, all of which are advantages during this global COVID-19 pandemic. At the meeting, experts reviewed the existing published literature on the use of fluvoxamine as experimental COVID-19 treatment, as well as prior research on the potential mechanisms for anti-inflammatory effects of fluvoxamine, including for other conditions including sepsis. Investigators shared current trials underway and existing gaps in knowledge. Two randomized controlled trials and one observational study examining the effect of fluvoxamine in COVID-19 treatment have found high efficacy. Four larger randomized clinical trials are currently underway, including three in the USA and Canada. More data are needed on dosing and mechanisms of effect; however, fluvoxamine appears to have substantial potential as a safe and widely available medication that could be repurposed to ameliorate serious COVID-19-related morbidity and mortality. As of April 2021, fluvoxamine was mentioned in the NIH COVID-19 treatment guidelines, although no recommendation is made for or against use. Available data may warrant clinician discussion of fluvoxamine as a treatment option for COVID-19, using shared decision making. Video Abstract.

Conflict of interest statement

Dr. Reiersen and Dr. Lenze are listed on a patent application related to methods of treating COVID-19, that was filed by Washington University in St. Louis. No other authors report any conflicts of interest.

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. 2021 Nov;37(11):1035-1041.
doi: 10.1051/medsci/2021142. Epub 2021 Dec 1.

[Citation misuse and its effects on public health]

[Article in French]
Affiliations

[Citation misuse and its effects on public health]

[Article in French]
Estelle Dumas-Mallet et al. Med Sci (Paris). 2021 Nov.

Abstract

In order to effectively contribute to scientific knowledge, biomedical observations have to be validated and debated by scientists in the relevant field. Along this debate that mainly takes place in the scientific literature, citation of previous studies plays a major role. However, only a few academic studies have quantitatively evaluated the suitability and accuracy of scientific citations. Here we review these academic studies. Two types of misuse have been pointed out: Citation bias and citation distortion. First, scientific citations favor positive results and those supporting authors' conclusion. Second, many statements linked to a reference actually misrepresent the referenced findings. About 10% of all citations in biomedicine are strongly inaccurate and misleading for the reader. Finally, we give two examples illustrating how some citation misuses do affect public health: The opioid crisis in the USA and the unjustified fostering of hydroxychloroquine for Covid-19 treatment in France.

Title: Le mésusage des citations et ses conséquences en médecine.

Abstract: Les observations biomédicales ne deviennent une source de connaissance qu’après un débat entre chercheurs. Au cours de ce débat, la citation des études antérieures tient un rôle majeur, mais les travaux académiques qui en évaluent l’usage sont rares. Ils ont cependant pu révéler deux types de problèmes : les biais de citation et les écarts de sens entre l’étude antérieure citée et ce qu’en dit l’article citant. Dans cette revue, nous synthétisons ces travaux et en dégageons les principales caractéristiques : les études favorables à la conclusion des auteurs citants sont plus souvent citées que celles qui les questionnent ; des écarts de sens majeurs affectent environ 10 % des citations. Nous illustrons par deux exemples les conséquences de ce mésusage des citations.

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. 2021 Nov 25;dkab432.
doi: 10.1093/jac/dkab432. Online ahead of print.

Retrospective modelling of hospital bed capacities associated with the administration of remdesivir during the first wave of COVID-19 in a German metropolitan city

Affiliations

Retrospective modelling of hospital bed capacities associated with the administration of remdesivir during the first wave of COVID-19 in a German metropolitan city

Julia Jeck et al. J Antimicrob Chemother. .

Abstract

Objectives: Internationally, healthcare systems are confronted by an ever-increasing scarcity of medical resources due to the ongoing novel coronavirus disease 2019 (COVID-19) pandemic. The aim of this study was to investigate the impact of remdesivir on the demand of hospital bed capacities for hospitalized COVID-19 patients and to evaluate the potentially created capacities for treating additional COVID-19 patients or elective treatments at the hospital.

Methods: An epidemiological model was developed that utilized the population of Cologne (Germany) during the first COVID-19 wave (first hospitalized patient-30 September 2020) to compare two scenarios: no administration of remdesivir (A) and the administration of remdesivir according to the EMA label (B). The results of the Adaptive COVID-19 Treatment Trial were used to evaluate the potential impact of remdesivir on hospital capacity.

Results: With the first recorded patient on 2 March 2020, a total of 576 COVID-19 hospitalized patients were detected during the first wave in Cologne. Comparing both scenarios (A versus B) of the model, the administration of remdesivir increased the number of discharges from 259 to 293 (+5.8%) and fewer patients needed ICU admission [214 versus 178 (-6.3%)]. In addition, the model estimated 20 fewer deaths (scenario B). Based on a reduced length of stay, 31.4 hospital beds (57.0 versus 25.6) could have been freed by administering remdesivir to eligible patients. This would have allowed either the treatment of an additional 730 COVID-19 patients or 660 elective treatments.

Conclusions: In our model, remdesivir administration profoundly contributed to free hospital capacities in the metropolitan city Cologne in Germany.

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. 2021 Nov 25;100382.
doi: 10.1016/j.ijans.2021.100382. Online ahead of print.

Perspectives of Nurses on Preparedness for Combating Covid-19 Crisis in Ghana: A Qualitative Inquiry

Affiliations
Free PMC article

Perspectives of Nurses on Preparedness for Combating Covid-19 Crisis in Ghana: A Qualitative Inquiry

Merri Iddrisu et al. Int J Afr Nurs Sci. .
Free PMC article

Abstract

COVID-19 has impacted negatively on people physically, psychologically, spiritually, and socioeconomically worldwide. Nurses' ability to prepare towards case management is imperative because the potential of one coming across the virus at the hospital is inevitable. This study intended to explore and describe nurses' perspectives on preparation towards fighting COVID 19 in Ghana. Methods: A qualitative exploratory descriptive design was adopted. Nine major health facilities designated for COVID-19 treatment centres in four regions in Ghana were involved in the study. A semi structured interview guide was used to interview twenty-nine nurses via telephone based on data saturation. Ethics approval was obtained from the Ethics Review Committee of the Nursing and Midwifery Council of Ghana. Result: data yielded two major themes and four subthemes. The two main themes were 1. Health facilities' preparation of nurses towards COVID-19, with its subthemes; targeted training, and selection of experienced staff. 2. Nurses' individual preparedness towards COVID-19 with the subthemes; information sourcing and sharing. Nurses in Ghana prepared for combating COVID-19 by going through training on infection prevention and control, and case management using demonstrations and simulations. Experienced nurses in Ghana volunteered to be at the frontline managing cases. Continuous updates on the virus and its management through information tracking sharing played a key role. Conclusion: Nurses in Ghana need to have more specialty training targeted at diseases of public health importance. Key words: Nurse; preparedness; covid-19.

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Review
. 2021 Nov 23;14:8557-8571.
doi: 10.2147/IJGM.S332458. eCollection 2021.

Effectiveness of Remdesivir, Lopinavir/Ritonavir, and Favipiravir for COVID-19 Treatment: A Systematic Review

Affiliations
Free PMC article
Review

Effectiveness of Remdesivir, Lopinavir/Ritonavir, and Favipiravir for COVID-19 Treatment: A Systematic Review

Windi Fresha Qomara et al. Int J Gen Med. .
Free PMC article

Abstract

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel strain that causes acute respiratory illnesses known as coronavirus disease 2019 (COVID-19). Currently, there is limited information regarding the therapeutic management for this disease. Several studies have stated that antivirals drugs such as remdesivir, favipiravir, and lopinavir/ritonavir may potentially inhibit the virus from spreading to the host.

Objective: The aim of this systematic review was to summarize the clinical effectiveness and safety of remdesivir, favipiravir, and lopinavir/ritonavir on COVID-19.

Methods: The PubMed and Cochrane Library databases were searched up to July 2021 to identify eligible experimental randomized controlled trials on remdesivir, favipiravir, and lopinavir/ritonavir for COVID-19 patients. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline.

Results: From 158 references, 15 studies were included in the review. The results showed that remdesivir has some potential benefits for hospitalized COVID-19 patients, as seen from clinical improvements such as faster recovery time, less duration of hospitalization, and fewer respiratory side effects among COVID-19 patients. However, the impact of remdesivir in reducing mortality remains uncertain. Treatment with favipiravir has shown promising improvement in the clinical status of COVID-19 patients, although the results suggested no significant differences in some clinical parameters such as length of hospitalizations and clinical recovery. A combination of favipiravir with other supportive therapy showed more favorable outcomes for COVID-19 patients. Furthermore, the use of lopinavir/ritonavir in COVID-19 patients reported no significant clinical improvement compared to standard care with notable adverse effect reactions.

Conclusion: This study provides an overview of the evidence-based role of remdesivir, favipiravir, and lopinavir/ritonavir in the management of COVID-19. A thorough assessment of the benefit-risk profile in COVID-19 patients is urgently needed. The current review was based on very limited available data; therefore, further well-designed clinical trials are required.

Keywords: COVID-19; SARS-CoV-2; antiviral drugs; favipiravir; lopinavir/ritonavir; remdesivir.

Conflict of interest statement

The authors report no conflicts of interest in this work.

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. 2021 Nov 30;11(1):23179.
doi: 10.1038/s41598-021-02353-5.

Drug repurposing for COVID-19 using graph neural network and harmonizing multiple evidence

Affiliations

Drug repurposing for COVID-19 using graph neural network and harmonizing multiple evidence

Kanglin Hsieh et al. Sci Rep. .

Abstract

Since the 2019 novel coronavirus disease (COVID-19) outbreak in 2019 and the pandemic continues for more than one year, a vast amount of drug research has been conducted and few of them got FDA approval. Our objective is to prioritize repurposable drugs using a pipeline that systematically integrates the interaction between COVID-19 and drugs, deep graph neural networks, and in vitro/population-based validations. We first collected all available drugs (n = 3635) related to COVID-19 patient treatment through CTDbase. We built a COVID-19 knowledge graph based on the interactions among virus baits, host genes, pathways, drugs, and phenotypes. A deep graph neural network approach was used to derive the candidate drug's representation based on the biological interactions. We prioritized the candidate drugs using clinical trial history, and then validated them with their genetic profiles, in vitro experimental efficacy, and population-based treatment effect. We highlight the top 22 drugs including Azithromycin, Atorvastatin, Aspirin, Acetaminophen, and Albuterol. We further pinpointed drug combinations that may synergistically target COVID-19. In summary, we demonstrated that the integration of extensive interactions, deep neural networks, and multiple evidence can facilitate the rapid identification of candidate drugs for COVID-19 treatment.

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. 2021 Nov 30.
doi: 10.1080/14787210.2022.2012155. Online ahead of print.

Evaluation of favipiravir in the treatment of COVID-19 based on the real-world

Affiliations

Evaluation of favipiravir in the treatment of COVID-19 based on the real-world

Weishang Deng et al. Expert Rev Anti Infect Ther. .

Abstract

Background: The role of favipiravir (FVP) as a COVID-19 treatment is recognized but not fully elucidated. We aimed to evaluate whether FVP has definite clinical efficacy and safety in the treatment of COVID-19.

Methods: International and Chinese databases were searched for randomized controlled clinical trials evaluating FVP for the treatment of COVID-19. A meta-analysis was performed and published literature was synthesized to evaluate the corresponding therapeutic effects.

Results: We included 13 studies (1430 patients in total). Meta-analysis showed that patients with mild-to-moderate disease treated with FVP had a significantly higher viral clearance rate than those in the control group 10 and 14 days after initiation of treatment [RR: 1.13 (95% CI: 1.00, 1.28), P=0.04; I2 =39% for day 10 and RR: 1.16 (95% CI: 1.04, 1.30), P=0.008; I2 =38% for day 14] and a significantly shorter hospital stay [MD: -1.52 (95% CI: -2.82, -0.23), P=0.02; I2=0%].

Conclusions: FVP significantly promotes viral clearance and reduces the hospitalization duration in mild-to-moderate COVID-19 patients, which can reduce the risk of severe disease outcomes in patients. However, more importantly, the results showed no benefit of FVP in severe patients, and caution should be taken regarding the treatment options of FVP in severe patients.The urgent need to identify effective interventions to treat novel coronavirus infections is a major challenge. The role of favipiravir (FVP) as a COVID-19 treatment is recognized but not fully elucidated. Our study showed a significant correlation between viral clearance and the promotion of clinical improvement with FVP in mild-to-moderate patients, which is significant for reducing the length of hospital stay of patients, reducing the risk of patients progressing to severe disease, thereby reducing mortality. However, the results showed no benefit of FVP in severe patients and the conclusion of this study still needs to be further verified by clinical trials with large samples.

Keywords: Antiviral agents; COVID-19; Favipiravir; Meta-analysis; Viral clearance.

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Case Reports
. 2021 Nov 26;15(1):572.
doi: 10.1186/s13256-021-03159-9.

Symptomatic severe acute respiratory syndrome coronavirus 2 reinfection in a lupus patient treated with hydroxychloroquine: a case report

Affiliations
Free PMC article
Case Reports

Symptomatic severe acute respiratory syndrome coronavirus 2 reinfection in a lupus patient treated with hydroxychloroquine: a case report

Astrid Muyldermans et al. J Med Case Rep. .
Free PMC article

Abstract

Background: Hydroxychloroquine and chloroquine have been used for hospitalized coronavirus disease 2019 patients because of their antiviral and anti-inflammatory function. However, little research has been published on the impact of the immunomodulatory effect of (hydroxy)chloroquine on humoral immunity.

Case presentation: We report a case of symptomatic severe acute respiratory syndrome coronavirus 2 reinfection, diagnosed 141 days after the first episode, in a 56-year-old man of Black African origin treated with hydroxychloroquine for lupus erythematosus. No anti-severe acute respiratory syndrome coronavirus 2 IgG antibodies could be detected 127 days after the initial episode of coronavirus disease 2019.

Conclusions: The treatment with hydroxychloroquine probably explains the decreased immune response with negative serology and subsequent reinfection in our patient. As humoral immunity is crucial to fight a severe acute respiratory syndrome coronavirus 2 infection, the use of (hydroxy)chloroquine is likely to have a detrimental effect on the spread of the virus. This case emphasizes that more needs to be learned about the role of antibodies in protecting against severe acute respiratory syndrome coronavirus 2 (re)infection and the role of (hydroxy)chloroquine on humoral immunity.

Keywords: COVID-19; Case report; Hydroxychloroquine; Lupus; Reinfection; SARS-CoV-2.

Conflict of interest statement

The authors declare that they have no competing interests.

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. 2021 Nov 12;13(11):4047.
doi: 10.3390/nu13114047.

Rapid and Effective Vitamin D Supplementation May Present Better Clinical Outcomes in COVID-19 (SARS-CoV-2) Patients by Altering Serum INOS1, IL1B, IFNg, Cathelicidin-LL37, and ICAM1

Affiliations
Free PMC article

Rapid and Effective Vitamin D Supplementation May Present Better Clinical Outcomes in COVID-19 (SARS-CoV-2) Patients by Altering Serum INOS1, IL1B, IFNg, Cathelicidin-LL37, and ICAM1

Mustafa Sait Gönen et al. Nutrients. .
Free PMC article

Abstract

Background: We aimed to establish an acute treatment protocol to increase serum vitamin D, evaluate the effectiveness of vitamin D3 supplementation, and reveal the potential mechanisms in COVID-19.

Methods: We retrospectively analyzed the data of 867 COVID-19 cases. Then, a prospective study was conducted, including 23 healthy individuals and 210 cases. A total of 163 cases had vitamin D supplementation, and 95 were followed for 14 days. Clinical outcomes, routine blood biomarkers, serum levels of vitamin D metabolism, and action mechanism-related parameters were evaluated.

Results: Our treatment protocol increased the serum 25OHD levels significantly to above 30 ng/mL within two weeks. COVID-19 cases (no comorbidities, no vitamin D treatment, 25OHD <30 ng/mL) had 1.9-fold increased risk of having hospitalization longer than 8 days compared with the cases with comorbidities and vitamin D treatment. Having vitamin D treatment decreased the mortality rate by 2.14 times. The correlation analysis of specific serum biomarkers with 25OHD indicated that the vitamin D action in COVID-19 might involve regulation of INOS1, IL1B, IFNg, cathelicidin-LL37, and ICAM1.

Conclusions: Vitamin D treatment shortened hospital stay and decreased mortality in COVID-19 cases, even in the existence of comorbidities. Vitamin D supplementation is effective on various target parameters; therefore, it is essential for COVID-19 treatment.

Keywords: COVID-19; SARS-CoV-2; acute respiratory failure; cathelicidin-LL37; cytokine; vitamin D.

Conflict of interest statement

All authors declare that they have no conflict of interest.

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. 2021 Oct 21;13(11):1759.
doi: 10.3390/pharmaceutics13111759.

A Comprehensive Review about the Molecular Structure of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): Insights into Natural Products against COVID-19

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Free PMC article
Review

A Comprehensive Review about the Molecular Structure of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): Insights into Natural Products against COVID-19

Essa M Saied et al. Pharmaceutics. .
Free PMC article

Abstract

In 2019, the world suffered from the emergence of COVID-19 infection, one of the most difficult pandemics in recent history. Millions of confirmed deaths from this pandemic have been reported worldwide. This disaster was caused by SARS-CoV-2, which is the last discovered member of the family of Coronaviridae. Various studies have shown that natural compounds have effective antiviral properties against coronaviruses by inhibiting multiple viral targets, including spike proteins and viral enzymes. This review presents the classification and a detailed explanation of the SARS-CoV-2 molecular characteristics and structure-function relationships. We present all currently available crystal structures of different SARS-CoV-2 proteins and emphasized on the crystal structure of different virus proteins and the binding modes of their ligands. This review also discusses the various therapeutic approaches for COVID-19 treatment and available vaccinations. In addition, we highlight and compare the existing data about natural compounds extracted from algae, fungi, plants, and scorpion venom that were used as antiviral agents against SARS-CoV-2 infection. Moreover, we discuss the repurposing of select approved therapeutic agents that have been used in the treatment of other viruses.

Keywords: COVID-19; SARS-CoV-2; antioxidants; antivirals; coronavirus; molecular structure; natural products; therapeutic approach; vaccines; virus detection; virus lifecycle.

Conflict of interest statement

The authors declare no conflict of interest.

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Review
. 2021 Nov 17;22(22):12385.
doi: 10.3390/ijms222212385.

Molecular Mechanisms of Possible Action of Phenolic Compounds in COVID-19 Protection and Prevention

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Free PMC article
Review

Molecular Mechanisms of Possible Action of Phenolic Compounds in COVID-19 Protection and Prevention

Nikola Gligorijevic et al. Int J Mol Sci. .
Free PMC article

Abstract

The worldwide outbreak of COVID-19 was caused by a pathogenic virus called Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Therapies against SARS-CoV-2 target the virus or human cells or the immune system. However, therapies based on specific antibodies, such as vaccines and monoclonal antibodies, may become inefficient enough when the virus changes its antigenicity due to mutations. Polyphenols are the major class of bioactive compounds in nature, exerting diverse health effects based on their direct antioxidant activity and their effects in the modulation of intracellular signaling. There are currently numerous clinical trials investigating the effects of polyphenols in prophylaxis and the treatment of COVID-19, from symptomatic, via moderate and severe COVID-19 treatment, to anti-fibrotic treatment in discharged COVID-19 patients. Antiviral activities of polyphenols and their impact on immune system modulation could serve as a solid basis for developing polyphenol-based natural approaches for preventing and treating COVID-19.

Keywords: SARS-CoV-2; antiviral effects; antiviral targets; polyphenols.

Conflict of interest statement

The authors declare no conflict of interest.

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Case Reports
. 2021 Nov 5;11(11):2050.
doi: 10.3390/diagnostics11112050.

Maxillary Mucormycosis Osteomyelitis in Post COVID-19 Patients: A Series of Fourteen Cases

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Free PMC article
Case Reports

Maxillary Mucormycosis Osteomyelitis in Post COVID-19 Patients: A Series of Fourteen Cases

Wael M Said Ahmed et al. Diagnostics (Basel). .
Free PMC article

Abstract

During the current pandemic of COVID-19, numerous manifestations and complications have developed. Patients with COVID-19 are at high risk of fungal infections, such as mucormycosis, that may result directly from COVID-19 infection and/or as a side effect of the drugs used in COVID-19 treatment protocol, such as dexamethasone, hydroxychloroquine, and antibiotics. In this report, we described a series of 14 cases with maxillary mucormycosis osteomyelitis in immediate post-COVID-19 patients.

Keywords: COVID-19; maxilla; mucormycosis; osteomyelitis.

Conflict of interest statement

The authors declared no conflict of interest.

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. 2021 Oct 27;11(11):1586.
doi: 10.3390/biom11111586.

Glycan Epitopes and Potential Glycoside Antagonists of DC-SIGN Involved in COVID-19: In Silico Study

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Free PMC article

Glycan Epitopes and Potential Glycoside Antagonists of DC-SIGN Involved in COVID-19: In Silico Study

Meina Gao et al. Biomolecules. .
Free PMC article

Abstract

Glycosylation is an important post-translational modification that affects a wide variety of physiological functions. DC-SIGN (Dendritic Cell-Specific Intercellular adhesion molecule-3-Grabbing Non-integrin) is a protein expressed in antigen-presenting cells that recognizes a variety of glycan epitopes. Until now, the binding of DC-SIGN to SARS-CoV-2 Spike glycoprotein has been reported in various articles and is regarded to be a factor in systemic infection and cytokine storm. The mechanism of DC-SIGN recognition offers an alternative method for discovering new medication for COVID-19 treatment. Here, we discovered three potential pockets that hold different glycan epitopes by performing molecular dynamics simulations of previously reported oligosaccharides. The "EPN" motif, "NDD" motif, and Glu354 form the most critical pocket, which is known as the Core site. We proposed that the type of glycan epitopes, rather than the precise amino acid sequence, determines the recognition. Furthermore, we deduced that oligosaccharides could occupy an additional site, which adds to their higher affinity than monosaccharides. Based on our findings and previously described glycoforms on the SARS-CoV-2 Spike, we predicted the potential glycan epitopes for DC-SIGN. It suggested that glycan epitopes could be recognized at multiple sites, not just Asn234, Asn149 and Asn343. Subsequently, we found that Saikosaponin A and Liquiritin, two plant glycosides, were promising DC-SIGN antagonists in silico.

Keywords: COVID-19; DC-SIGN; carbohydrate recognition mechanism; glycan epitopes; molecular dynamics simulations; natural glycoside antagonists.

Conflict of interest statement

The authors declare no conflict of interest.

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. 2021 Dec;69(12):3664-3676.
doi: 10.4103/ijo.IJO_1474_21.

Sight-threatening intraocular infection in patients with COVID-19 in India

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Sight-threatening intraocular infection in patients with COVID-19 in India

Sameera Nayak et al. Indian J Ophthalmol. 2021 Dec.

Abstract

Purpose: Intraocular infection in patients with COVID-19 could be different in the presence of treatment with systemic corticosteroid and immunosuppressive agents. We describe the epidemiology and microbiological profile of intraocular infection in COVID-19 patients after their release from the hospital.

Methods: We analyzed the clinical and microbiological data of laboratory-confirmed COVID-19 patients from April 2020 to January 2021 presenting with features of endogenous endophthalmitis within 12 weeks of their discharge from the hospital in two neighboring states in South India. The data included demography, systemic comorbidities, COVID-19 treatment details, time interval to visual symptoms, the microbiology of systemic and ocular findings, ophthalmic management, and outcomes.

Results: The mean age of 24 patients (33 eyes) was 53.6 ± 13.5 (range: 5-72) years; 17 (70.83%) patients were male. Twenty-two (91.6%) patients had systemic comorbidities, and the median period of hospitalization for COVID-19 treatment was 14.5 ± 0.7 (range: 7-63) days. Infection was bilateral in nine patients. COVID-19 treatment included broad-spectrum systemic antibiotics (all), antiviral drugs (22, 91.66% of patients), systemic corticosteroid (21, 87.5% of patients), supplemental oxygen (18, 75% of patients), low molecular weight heparin (17, 70.8% of patients), admission in intensive care units (16, 66.6% of patients), and interleukin-6 inhibitor (tocilizumab) (14, 58.3% of patients). Five (20.8%) patients died of COVID-19-related complications during treatment for endophthalmitis; one eye progressed to pan ophthalmitis and orbital cellulitis; eight eyes regained vision >20/400. Fourteen of 19 (73.7%) vitreous biopsies were microbiologically positive (culture, PCR, and microscopy), and the majority (11 patients, 78.5%) were fungi.

Conclusion: Intraocular infection in COVID-19 patients is predominantly caused by fungi. We suggest a routine eye examination be included as a standard of care of COVID-19.

Keywords: COVID-19; endogenous endophthalmitis; intraocular infection.

Conflict of interest statement

None

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. 2021 Nov;146(23):1538-1542.
doi: 10.1055/a-1643-4209. Epub 2021 Nov 26.

[Clinical benefit of Tocilizumab and other immunomodulating agents for treatment of COVID-19]

[Article in German]
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[Clinical benefit of Tocilizumab and other immunomodulating agents for treatment of COVID-19]

[Article in German]
Daniel Hornuss et al. Dtsch Med Wochenschr. 2021 Nov.

Abstract

The pathophysiological course of COVID-19 can be distinguished in a phase of viral replication and an inflammatory phase. Hyperinflammatory processes promote the development of severe COVID-19. Therefore, immunomodulating agents came into focus. Dexamethasone has already become standard of care for treatment of severe COVID-19. Two large randomized trials and a meta-analysis of collectively nine randomized trials showed a reduced mortality in patients with severe COVID-19 if Tocilizumab - an IL-6-rezeptor antagonist - was added to standard of care. Treatment with Baricitinib - a JAK 1/2 inhibitor - may also be beneficial for patients without or on low oxygen supplementation. National and international guidelines recommend Tocilizumab for treatment of severe COVID-19. Treatment with JAK inhibitors is an option for hospitalized patients with moderate COVID-19. It should be emphasized that comedication of JAK inhibitors and Tocilizumab is not recommended. Further high quality research is required for the widespread use of immunomodulating agents in COVID-19.

IMMUNOLOGISCHER VERLAUF DER COVID-19-ERKRANKUNG: Der pathogenetische Verlauf der COVID-19-Erkrankung lässt sich in eine replikative und eine hyperinflammatorische Phase unterteilen. Da bei schweren Verläufen die Hyperinflammation von zentraler Bedeutung ist, nehmen Immunmodulatoren aktuell eine immer größere Rolle in der Behandlung von COVID-19 ein. So gehört Dexamethason mittlerweile zur empfohlenen Therapie bei drohendem schwerem Verlauf. Weitere Immunmodulatoren wie Tocilizumab und JAK-Inhibitoren erscheinen ebenfalls vielversprechend in der Behandlung von COVID-19. WIRKUNGSWEISE VON TOCILIZUMAB UND BARICITINIB: Tocilizumab greift als IL-6-Rezeptor-Antagonist in zentrale Schlüsselpositionen der proinflammatorischen Signalkaskade ein und wird seit einigen Jahren erfolgreich bei rheumatologischen Krankheitsbildern eingesetzt. Baricitinib ist ein JAK-1/2-Inhibitor und wird gegenwärtig zur Behandlung der rheumatoiden Arthritis eingesetzt. Neben der immunmodulatorischen Wirkung durch Inhibition der Janus-Kinasen im Bereich der Inflammations-Kaskade werden auch direkte antivirale Effekte diskutiert. BISHERIGE STUDIENLAGE ZU DIREKTEN IMMUNMODULATOREN BEI COVID-19: Mehrere Studien zu Tocilizumab zeigten einen potenziellen positiven Effekt bei schwerer COVID-19-Erkrankung. Daten einer kürzlich veröffentlichten Meta-Analyse über 9 randomisierte kontrollierte Studien konnten kumulativ eine Mortalitätsreduktion durch Tocilizumab nachweisen. Der Einsatz im Rahmen der intensivmedizinischen Behandlung bei schweren Verläufen von COVID-19 wird daher empfohlen. Die Behandlung mit JAK-Inhibitoren scheint bei Patienten mit leichter COVID-19 Erkrankung ebenfalls einen positiven Effekt zu haben. Jedoch ist die Datenlage zu JAK-Inhibitoren und anderen Immunmodulatoren wie Anakinra im Vergleich zu Tocilizumab gegenwärtig noch uneinheitlich und bedarf weiterer Studien. Nach Therapie mit JAK-Inhibitoren wird die Gabe von Tocilizumab bei klinischer Verschlechterung aufgrund der fehlenden Datenlage derzeit nicht empfohlen.

Conflict of interest statement

Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht.

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. 2021 Nov 24;214:108864.
doi: 10.1016/j.exer.2021.108864. Online ahead of print.

Hydroxychloroquine treatment on SARS-CoV-2 receptor ACE2, TMPRSS2 and NRP1 expression in human primary pterygium and conjunctival cells

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Free PMC article

Hydroxychloroquine treatment on SARS-CoV-2 receptor ACE2, TMPRSS2 and NRP1 expression in human primary pterygium and conjunctival cells

Yao Yao et al. Exp Eye Res. .
Free PMC article

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the pathogen for coronavirus disease 2019 (COVID-19) pandemic. Its infection depends on the binding of spike protein to the host cell receptor angiotensin-converting enzyme 2 (ACE2), type II transmembrane serine protease (TMPRSS2) and neuropilin-1 (NRP1). Hydroxychloroquine has been applied as one of the COVID-19 treatment strategies. Here we aimed to evaluate hydroxychloroquine treatment on SARS-CoV-2 receptor expression in human primary pterygium and conjunctival cells and its potential influences. Expression of ACE2, TMPRSS2 and NRP1 proteins were found in the epithelial layer of both primary pterygium and conjunctiva tissues as well as in their isolated fibroblasts. High concentration of hydroxychloroquine treatment significantly reduced the viability of both primary pterygium and conjunctival cells. ACE2 protein expression was significantly decreased in both pterygium and conjunctival cells after hydroxychloroquine treatment. Hydroxychloroquine also reduced NRP1 protein expression in conjunctival cells. In contrast, TMPRSS2 protein expression showed slightly increased in conjunctival cells. Notably, ROS production and SOD2 expression was significantly elevated in both pterygium and conjunctival cells after hydroxychloroquine treatment. In summary, this study revealed the reduction of ACE2 and NRP1 expression by hydroxychloroquine in human primary pterygium and conjunctival fibroblasts; yet with the increase in TMPRSS2 expression and oxidative stress and decrease in cell viability. Implementation of hydroxychloroquine for COVID-19 treatment should be carefully considered with its potential side effects and in combination with TMPRSS2 inhibitor.

Keywords: ACE2; Conjunctiva; Hydroxychloroquine; NRP1; Pterygium; TMPRSS2.

Conflict of interest statement

The authors declare that they have no potential conflict of interest.

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. 2021 Nov 26.
doi: 10.1111/biom.13603. Online ahead of print.

Estimation of the odds ratio in a proportional odds model with censored time-lagged outcome in a randomized clinical trial

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Estimation of the odds ratio in a proportional odds model with censored time-lagged outcome in a randomized clinical trial

Anastasios A Tsiatis et al. Biometrics. .

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 (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, e.g., because ascertainment of the outcome may not be possible until some pre-specified 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 odds ratio 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 odds ratio based on the full data that would be available at a final analysis. This article is protected by copyright. All rights reserved.

Keywords: COVID-19 treatment; augmented inverse probability weighting; censored ordinal categorical outcome; covariate adjustment; estimating function; marked point process.

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Review
. 2021 Nov 9;101524.
doi: 10.1016/j.smim.2021.101524. Online ahead of print.

Myeloid dysregulation and therapeutic intervention in COVID-19

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Free PMC article
Review

Myeloid dysregulation and therapeutic intervention in COVID-19

Runxia Gu et al. Semin Immunol. .
Free PMC article

Abstract

The dysregulation of myeloid cell responses is increasingly demonstrated to be a major mechanism of pathogenesis for COVID-19. The pathological cellular and cytokine signatures associated with this disease point to a critical role of a hyperactivated innate immune response in driving pathology. Unique immunopathological features of COVID-19 include myeloid-cell dominant inflammation and cytokine release syndrome (CRS) alongside lymphopenia and acute respiratory distress syndrome (ARDS), all of which correlate with severe disease. Studies suggest a range of causes mediating myeloid hyperactivation, such as aberrant innate sensing, asynchronized immune cellular responses, as well as direct viral protein/host interactions. These include the recent identification of new myeloid cell receptors that bind SARS-CoV-2, which drive myeloid cell hyperinflammatory responses independently of lung epithelial cell infection via the canonical receptor, angiotensin-converting enzyme 2 (ACE2). The spectrum and nature of myeloid cell dysregulation in COVID-19 also differs from, at least to some extent, what is observed in other infectious diseases involving myeloid cell activation. While much of the therapeutic effort has focused on preventative measures with vaccines or neutralizing antibodies that block viral infection, recent clinical trials have also targeted myeloid cells and the associated cytokines as a means to resolve CRS and severe disease, with promising but thus far modest effects. In this review, we critically examine potential mechanisms driving myeloid cell dysregulation, leading to immunopathology and severe disease, and discuss potential therapeutic strategies targeting myeloid cells as a new paradigm for COVID-19 treatment.

Keywords: COVID-19; Hyperactivation; Immunopathology; Immunotherapy; Myeloid cell; Pathogenesis; SARS-CoV-2.

Conflict of interest statement

J.W. and Q.L. are named inventors on a patent application that describes the anti-SARS-CoV-2 spike nanobodies that block both ACE2 and myeloid cell receptor interactions. J.W. is a consultant for Lilly Asia Ventures and is on the Scientific Advisory Board of Rootpath Genomics, which is not relevant to this work. T.M. is named an inventor on a patent entitled “Compositions and Methods for Treating, Ameliorating, and/or Preventing Viral Infections”. The other authors declare no competing interests exist.

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. 2021 Nov 25;1-6.
doi: 10.1007/s10787-021-00896-7. Online ahead of print.

NSAIDs and Kelleni's protocol as potential early COVID-19 treatment game changer: could it be the final countdown?

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Free PMC article

NSAIDs and Kelleni's protocol as potential early COVID-19 treatment game changer: could it be the final countdown?

Mina T Kelleni. Inflammopharmacology. .
Free PMC article

Abstract

We have previously published several papers illustrating numerous immunomodulatory and anti-inflammatory potential benefits when we repurposed safe, generic non-steroidal anti-inflammatory drugs (NSAIDs)/nitazoxanide/azithromycin (Kelleni's protocol), to early manage our COVID-19 pediatric, adult, and pregnant patients. In this manuscript, we discuss some recently published meta-analysis and clinical studies supporting our practice and discuss a molecular study that might be interpreted as an academic proof that our protocol might also prevent SARS-CoV-2 replication. Moreover, after aspirin has been suggested to be independently associated with reduced risk of mechanical ventilation, ICU admission and in-hospital mortality of COVID-19, we claim that the molecular interpretation of the results that led to this suggestion was not scientifically accurate, and we provide our academic interpretation confirming that low-dose aspirin is least likely to improve COVID-19 mortality through anticoagulation as was suggested. Furthermore, we describe other potential benefits related to aspirin-triggered lipoxins and resolvins while illustrating how NSAIDs interfere with COX-1, COX-2, SARS-CoV-2/ SARS-CoV-2 ORF protein-dependent activation of caspases and their subsequent mitochondrial dysfunction, endoplasmic reticulum stress, apoptosis and necroptosis which were associated with COVID-19 complications. Similarly, NSAIDs are known caspase inhibitors and thus they might independently inhibit other caspase-related COVID-19-associated downstream pathological signaling mechanisms. Finally, we postulated that CARD-14, a caspase recruitment domain-containing protein, polymorphisms might play a role in the development of severe and critical COVID-19 and confirmed our old call to early adopt NSAIDs, as an integral part of Kelleni's protocol, as of choice in its management aiming to end this pandemic.

Keywords: Apoptosis; Aspirin; Azithromycin; COVID-19; Caspases; Endoplasmic reticulum stress; Kelleni’s protocol; NSAIDs; Nitazoxanide; SARS-CoV-2.

Conflict of interest statement

The author has no conflicts of interest to declare.

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. 2021 Jul;67(7):979-984.
doi: 10.1590/1806-9282.20210380.

The impact of hydroxychloroquine and azithromycin on the corrected qt interval in patients with the novel Coronavirus disease 2019

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Free article

The impact of hydroxychloroquine and azithromycin on the corrected qt interval in patients with the novel Coronavirus disease 2019

Bektas Murat et al. Rev Assoc Med Bras (1992). 2021 Jul.
Free article

Abstract

Objective: With the coronavirus disease 2019 (COVID-19) continuing to spread all over the world, although there is no specific treatment until now, hydroxychloroquine and azithromycin have been reported to be effective in recent studies. Although long-term use of hydroxychloroquine and azithromycin has been reported to cause QT prolongation and malign arrhythmia, there is not enough data about the effect of short-term use on arrhythmia. Therefore, this study aims to assess the effect of hydroxychloroquine alone and hydroxychloroquine + azithromycin on corrected QT (QTc).

Methods: A baseline electrocardiogram and on-treatment baseline electrocardiogram were retrospectively collected in COVID-19 patients who received hydroxychloroquine and/or azithromycin. The QTc interval was calculated, and the baseline and peak QTc intervals were compared. In addition, the peak QTc intervals of monotherapy and combination therapy were compared.

Results: Of the 155 patients included, 102 (65.8%) patients were using hydroxychloroquine, and 53 (34.2%) patients were using hydroxychloroquine + azithromycin combination. The use of both hydroxychloroquine alone and hydroxychloroquine + azithromycin combined therapy significantly prolonged the QTc, and the QTc interval was significantly longer in patients receiving combination therapy. QTc prolongation caused early termination in both groups, 5 (4.9%) patients in the monotherapy group and 6 (11.3%) patients in the combination therapy group.

Conclusion: In this study, patients who received hydroxychloroquine for the treatment of COVID-19 were at high risk of QTc prolongation, and concurrent treatment with azithromycin was associated with greater changes in QTc.

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. 2021 Sep;67(9):1299-1304.
doi: 10.1590/1806-9282.20210600.

The effectiveness of dexamethasone on the prognosis of dialysis patients with severe COVID-19

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Free article

The effectiveness of dexamethasone on the prognosis of dialysis patients with severe COVID-19

Aysel Toçoglu et al. Rev Assoc Med Bras (1992). 2021 Sep.
Free article

Abstract

Objective: This study aimed to investigate the effectiveness of dexamethasone in dialysis patients with COVID-19 and whether it predicts mortality.

Methods: This is a comparative cross-sectional study of 113 consecutive patients with COVID-19 with severe pneumonia signs. The patients were divided into two groups according to the use of dexamethasone treatment: group 1 (n=45) included patients who were treated with dexamethasone and group 2 (n=68) who did not receive dexamethasone.

Results: The mean age of both groups was 67.0±10.6 and 67.2±13.0 years, respectively (p=0.947). With respect to demographic and laboratory findings, there were no significant differences between the two groups (p>0.05). The hospitalization time of patients in group 1 was longer than that in group 2 (11 [7-17] days vs. 8 [5.3-14] days, p=0.093]. The 28-day survival rate was 54.2% in the group receiving dexamethasone treatment and 79.5% in the group not receiving dexamethasone treatment (p=0.440).

Conclusion: Dexamethasone did not reduce mortality rates and the requirement for intensive care unit in dialysis patients with COVID-19. Larger prospective randomized clinical trials are required to associate personalized medicine with the corticosteroid treatment to select suitable patients who are more likely to show a benefit.

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Published Erratum
. 2021 Nov 22;1.
doi: 10.1007/s00705-021-05307-4. Online ahead of print.

Retraction Note to: Efficacy of favipiravir in COVID‑19 treatment: a multi‑center randomized study

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Free PMC article
Published Erratum

Retraction Note to: Efficacy of favipiravir in COVID‑19 treatment: a multi‑center randomized study

Hany M Dabbous et al. Arch Virol. .
Free PMC article
No abstract available

Retraction of

  • doi: 10.1007/s00705-021-04956-9

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. 2021 Nov 21.
doi: 10.2174/2772574X12666211122113318. Online ahead of print.

The Potential Use of Cyclosporine Ultrafine Solution Pressurised Metered-Dose Inhaler in the Treatment of COVID-19 Patients

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The Potential Use of Cyclosporine Ultrafine Solution Pressurised Metered-Dose Inhaler in the Treatment of COVID-19 Patients

Touraj Ehtezazi. Recent Adv Drug Deliv Formul. .

Abstract

Introduction: Serious COVID-19 respiratory problems start when the virus reaches the alveolar level, where type II cells get infected and die. Therefore, virus inhibition at the alveolar level would help prevent these respiratory complications.

Method: A literature search was conducted to collect physicochemical properties of small molecule compounds that could be used for the COVID-19 treatment. Compounds with a low melting point were selected along with those soluble in ethanol, hydrogen-bond donors, and acceptors.

Results: There are severe acute respiratory syndrome coronavirus inhibitors with physicochemical properties suitable for the formulation as an ultrafine pressurised metered-dose inhaler (pMDI). Mycophenolic acid, Debio 025, and cyclosporine A are prime candidates among these compounds. Cyclosporine A (hereafter cyclosporine) is a potent SARS-CoV-2 inhibitor, and it has been used for the treatment of COVID-19 patients, demonstrating an improved survival rate. Also, inhalation therapy of nebulised cyclosporine was tolerated, which was used for patients with lung transplants. Finally, cyclosporine has been formulated as a solution ultrafine pMDI. Although vaccine therapy has been started in most countries, inhalation therapies with non-immunological activities could minimise the spread of the disease and be used in vaccine-hesitant individuals.

Conclusion: Ultrafine pMDI formulation of cyclosporine or Debio 025 should be investigated for the inhalation therapy of COVID-19.

Keywords: COVID-19; approved drugs; cyclosporine A; inhalation; pressurised metered-dose inhaler; regulatory tests.

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Observational Study
. 2021 Aug 2;45(5):253-257.

Experience in the use of remdesivir in patients with SARS-CoV-2 pneumonia

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  • PMID: 34806585
Free article
Observational Study

Experience in the use of remdesivir in patients with SARS-CoV-2 pneumonia

Anna Murgadella-Sancho et al. Farm Hosp. .
Free article

Abstract

Objective: To describe the effectiveness and safety of remdesivir in patients with SARS-CoV-2 pneumonia in real-world clinical practice conditions.

Method: Retrospective observational study that included all adults with SARS-CoV-2 pneumonia admitted at the Moisès Broggi Hospital and treated with remdesivir between July 1st and November 7th, 2020. Efficacy outcomes were time to recovery, 28-day mortality, length of hospital stay, and the need of mechanical ventilation after treatment. The main safetyrelated endpoint was elevation of transaminases after treatment.

Results: A total of 111 patients were included of whom 97 (87.4%) were receiving low-flow oxygen therapy. Median time to recovery was 9 days [6-14]. Seven patients (6.3%) died at 28 days' follow-up. Median length of hospital stay was 12 days [9-22] and 15 patients (13.5%) needed mechanical ventilation after treatment with remdesivir. Severe hypertransaminasemia was observed in 4 patients (4%).

Conclusions: Clinical outcomes of patients with SARS-CoV-2 pneumonia on low-flow oxygen therapy treated with remdesivir were similar to those published in clinical trials, both in terms of time to recovery and 28-day mortality.

Objetivo: Describir la efectividad y seguridad de remdesivir en pacientes con neumonía por SARS-CoV-2 en condiciones de práctica clínica real.Método: Estudio observacional retrospectivo que incluyó a todos los pacientes tratados con remdesivir en el Hospital Moisès Broggi entre el 1 de julio y el 7 de noviembre de 2020. Como variables de efectividad se registraron el tiempo hasta la recuperación, la mortalidad a los 28 días, la estancia hospitalaria y la proporción de pacientes que requirió ventilación mecánica invasiva tras el tratamiento. Como variable de seguridad se registró la alteración en las transaminasas tras el tratamiento.Resultados: Se incluyeron 111 pacientes, 97 (87,4%) con oxigenoterapia de bajo flujo. El tiempo hasta la recuperación fue de 9 días [6-14] de mediana y 7 pacientes (6,3%) habían fallecido a los 28 días de seguimiento. La estancia hospitalaria fue de 12 días [9-22] de mediana. Un total de 15 pacientes (13,5%) requirió ventilación mecánica invasiva tras el tratamiento y 4 pacientes (4%) presentaron una alteración grave de las transaminasas.Conclusiones: El tratamiento con remdesivir en la práctica clínica habitual presenta resultados similares a los publicados en los ensayos clínicos en el subgrupo de pacientes con oxigenoterapia de bajo flujo, tanto en el tiempo hasta la recuperación como en la mortalidad a los 28 días.

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