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1.
Braz. j. biol ; 84: e253508, 2024. tab, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1360218

ABSTRACT

Present research work represents antiviral and antibacterial value of body fat of Saara hardwickii commonly called as spiny tailed lizard. Oil was extracted from body fats located in the ventral region of this animal using hydrocarbons e.g., n-hexane, methanol, butanol and ethyl acetate as a solvent. The antibacterial activity of lizard oil was tested against standard as well as multi-resistant lines ofEscherichia coli, Styphalococcus aureus, Pseudomonas aeruginosa and Proteus vulgaris alone and with antibiotic ampicillin. For antibacterial potential, Ethyl acetate and Butanol solvent extract showed best zone of inhibition (7mm) with P. aeruginosa and S. aureus respectively. For antiviral potential, Butanol and Methanol extract showed best HA (Hemagglutination) titer of 04 with NDV and IBV viral strain respectively. It is concluded that lizard oil has antimicrobial potential against different pathogens strains (virus, bacteria).


O presente trabalho de pesquisa apresenta a importância antiviral e antibacteriana da gordura corporal de Saara hardwickii, comumente chamado de lagarto de cauda espinhosa. O óleo foi extraído de gorduras corporais localizadas na região ventral desse animal usando hidrocarbonetos, por exemplo, n-hexano, metanol, butanol e acetato de etila, como solvente. A atividade antibacteriana do óleo do lagarto foi testada em linhagens padrão e multirresistentes de Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa e Proteus vulgaris, de forma isolada e com antibiótico ampicilina. Para o potencial antibacteriano, acetato de etila e extrato de butanol apresentaram melhor zona de inibição (7 mm) com P. aeruginosa e S. aureus, respectivamente. Para o potencial antiviral, o extrato de butanol e o extrato de metanol apresentaram melhor título de hemaglutinação de 4 com as cepas virais NDV e IBV, respectivamente. Conclui-se que o óleo do lagarto possui potencial antimicrobiano contra diferentes cepas de patógenos (vírus e bactérias).


Subject(s)
Animals , Antiviral Agents , Adipose Tissue , Lizards , Anti-Bacterial Agents
2.
Braz. j. biol ; 83: e248083, 2023. tab, graf
Article in English | LILACS, VETINDEX | ID: biblio-1278546

ABSTRACT

Abstract Species of the genus Cordia have shown biological activities, such as anti-inflammatory, analgesic, antioxidant, antiviral, and antifungal activities. The species Cordia glabrata (MART) A.DC. Has no information concerning its phytochemical profile and possible biological activities. Thus, this study aimed to evaluate this profile in ethanolic extracts of young, adult and senescent leaves, as well as their antioxidant, photoprotective, antimicrobial, and virucidal potentials. Phytochemical analysis was performed by TLC (thin-layer chromatography) and showed the presence of flavonoids, tannins, and terpenes. The evaluation by UPLC-MS/MS (Ultra performance liquid chromatography - tandem mass spectrometer) evidenced the presence of caffeic (3.89 mgL-1), p-cumaric (6.13 mgL-1), and ferulic (0.58 mgL-1) acids, whilst, in GC/MS (Gas chromatography-mass spectrometry) analysis there was a greater amount of palmitic (51.17%), stearic (20.34%), linoleic (9.62%), and miristic (8.16%) fatty acids. The DPPH (2,2-Diphenyl-1-picrylhydrazyl) and ABTS+ (2′-Azino-bis(3-ethylbenzothiazoline-6-sulfonic acid)) radicals were used to verify the potential antioxidant activity, observing a better activity for the leaf extract in the adult phenological stage: 54.63 ± 1.06 µgmL-1 (DPPH) and 44.21 ± 1.69 mM (ABTS). The potential photoprotective activity of the extracts was determined by spectrophotometry and the in vitro values of SPF (Sun Protection Factor) in young and adult leaves (5.47 and 5.41, respectively) showed values close to the minimum SPF of 6.0 required by ANVISA (Brazilian Health Regulatory Agency). It was not observed an antimicrobial activity for Staphylococcus aureus with a minimum inhibitory concentration of 2000 μgmL-1, however the anti-herpetic assay against the Herpes simplex virus type 2 (HSV-2) showed a potent virucidal activity at the tested concentrations with CV50 value <0.195 μgmL-1 and a Selectivity Index (SI = CC50 / CV50) greater than 448. The results obtained in this study suggest that extracts of leaves of C. glabrata in their adult phenological stage have potential antioxidant, photoprotective and virucidal activity, considering in vitro test results.


Resumo Espécies do gênero Cordia apresentam atividades biológicas, como anti-inflamatória, analgésica, antioxidante, antiviral e antifúngica. Para a espécie Cordia glabrata (MART) A.DC., ainda não existem informações sobre seu perfil fitoquímico e possíveis atividades biológicas, deste modo, o presente estudo teve como objetivo avaliar este perfil em extratos etanólicos de folhas jovens, adultas e senescentes, bem como o potencial antioxidante, fotoprotetor, antimicrobiano e virucida. A análise fitoquímica foi realizada por CCD (Cromatografia em Camada Delgada), mostrando a presença de flavonóides, taninos e terpenos. Na avaliação por CLAE EM/EM (Cromatografia Líquida de Ultra Eficiência acoplada a Espectrometria de Massas) foi evidenciado a presença dos ácidos caféico (3,89 mgL-1), p-cumárico (6,13 mgL-1) e ferúlico (0,58 mgL-1), paralelamente, na CG/EM (Cromatografia Gasosa acoplada a Espectrometria de Massas) verificou-se maior quantidade dos ácidos graxos palmítico (51,17%), esteárico (20,34%), linoléico (9,62%) e mirístico (8,16%). Os radicais DPPH (2,2-Difenil-1-picrilhidrazil) e ABTS+ (2′-Azino-bis (ácido 3-etilbenzotiazolina-6-sulfônico)) foram utilizados para verificar o potencial antioxidante, observando-se uma atividade superior para o extrato da folha em sua fase fenológica adulta: 54,63 ± 1,06 µgmL-1 (DPPH) e 44,21 ± 1,69 mM (ABTS+). A potencial atividade fotoprotetora dos extratos foi determinada espectrofotometricamente e os valores in vitro de FPS (Fator de Proteção Solar) em folhas jovens e adultas (5,47 e 5,41 respectivamente) apresentaram valores próximos ao FPS mínimo de 6,0 exigido pela ANVISA (Agência Nacional de Vigilância Sanitária). Não foi observada atividade antimicrobiana para Staphylococcus aureus sendo a concentração inibitória mínima de 2000 μgmL-1, no entanto o ensaio anti-herpético contra o vírus Herpes simplex tipo 2 (HSV-2) mostrou uma potente atividade virucida nas concentrações testadas com um valor de CV50 <0,195 μgmL-1 e um Índice de Seletividade (IS = CC50 / CV50) maior que 448. Os resultados obtidos neste estudo sugerem que extratos de folhas de C. glabrata em seu estágio fenológico adulto apresentam potencial antioxidante, fotoprotetora e virucida, considerando os resultados de testes in vitro.


Subject(s)
Cordia , Anti-Infective Agents , Antiviral Agents/pharmacology , Brazil , Plant Extracts/pharmacology , Chromatography, Liquid , Plant Leaves , Tandem Mass Spectrometry , Antioxidants/pharmacology
3.
J. Health Biol. Sci. (Online) ; 10(1): 1-12, 01/jan./2022. tab, ilus
Article in English | LILACS | ID: biblio-1378476

ABSTRACT

Objective: Analyze lysosomotropic agents and their action on COVID-19 targets using the molecular docking technique. Methods: Molecular docking analyses of these lysosomotropic agents were performed, namely of fluoxetine, imipramine, chloroquine, verapamil, tamoxifen, amitriptyline, and chlorpromazine against important targets for the pathogenesis of SARS-CoV-2. Results: The results revealed that the inhibitors bind to distinct regions of Mpro COVID-19, with variations in RMSD values from 1.325 to 1.962 Å and binding free energy of -5.2 to -4.3 kcal/mol. Furthermore, the analysis of the second target showed that all inhibitors bonded at the same site as the enzyme, and the interaction resulted in an RMSD variation of 0.735 to 1.562 Å and binding free energy ranging from -6.0 to -8.7 kcal/mol. Conclusion: Therefore, this study allows proposing the use of these lysosomotropic compounds. However, these computer simulations are just an initial step toward conceiving new projects for the development of antiviral molecules.


Objetivo: aAnalisar agentes lisossomotrópicos e sua ação em alvos de COVID-19 usando a técnica de docking molecular. Métodos: Foram realizadas análises de docagem molecular destes agentes lisossomotrópicos, nomeadamente de fluoxetina, imipramina, cloroquina, verapamil, tamoxifeno, amitriptilina e clorpromazina contra alvos importantes para a patogenia do SARS-CoV-2. Resultados: Os resultados revelaram que os inibidores se ligam a regiões distintas do Mpro COVID-19, com variações nos valores de RMSD de 1.325 a 1.962 Å e energia livre de ligação de -5,2 a -4,3 kcal/mol. Além disso, a análise do segundo alvo mostrou que todos os inibidores se ligaram no mesmo sítio da enzima, e a interação resultante em uma variação de RMSD de 0,735 a 1.562 Å e energia livre de ligação variando de -6,0 a -8,7 kcal/mol. Conclusão: Portanto, este estudo permite propor o uso desses compostos lisossomotrópicos. No entanto, essas simulações em computador são apenas um passo inicial para a concepção de novos projetos para o desenvolvimento de moléculas antivirais.


Subject(s)
SARS-CoV-2 , COVID-19 , Antiviral Agents , Chloroquine , Mass Screening , Fluoxetine , Amitriptyline , Imipramine
4.
J. Health Biol. Sci. (Online) ; 10(1): 1-10, 01/jan./2022. tab, ilus
Article in English | LILACS | ID: biblio-1378456

ABSTRACT

Objective: This study aimed to evaluate the interactions of di- and tri-terpenes from Stillingia loranthacea with the enzyme NSP16-NSP10 of SARS-CoV-2, important for viral replication. Methods: The molecular docking technique was used to evaluate this interaction. Results: The analysis showed that the evaluated compounds obtained RMSD values of 0.888 to 1.944 Å and free energy of -6.1 to -9.4 kcal/mol, with the observation of hydrogen bonds, salt bridges, and pi-sulfur, pi-alkyl, and hydrophobic interactions. Conclusion: Thus, the results obtained show the potential of the compounds analyzed against the selected target. Since computer simulations are only an initial step in projects for the development of antiviral drugs, this study provides important data for future research.


Objetivo: avaliar as interações de di- e tri-terpenos de Stillingia loranthacea com a enzima NSP16-NSP10 de SARS-CoV-2, importante para a replicação viral. Métodos: A técnica de docking molecular foi utilizada para avaliar essa interação. Resultados: A análise mostrou que os compostos avaliados obtiveram valores de RMSD de 0,888 a 1,944 Å e energia livre de -6,1 a -9,4 kcal/mol, observando-se ligações de hidrogênio, pontes salinas e pi-enxofre, pi-alquil, e interações hidrofóbicas. Conclusão: Assim, os resultados obtidos mostram o potencial dos compostos analisados frente ao alvo selecionado. Como as simulações computacionais são apenas um passo inicial nos projetos de desenvolvimento de medicamentos antivirais, este estudo fornece dados importantes para pesquisas futuras.


Subject(s)
SARS-CoV-2 , Antiviral Agents , Terpenes , Virus Replication , Enzymes , Molecular Docking Simulation
5.
Geneve; WHO; Sept. 16, 2022. 141 p. ilus, tab, graf. (WHO/2019-nCoV/therapeutics/2022.5).
Non-conventional in English | LILACS, BIGG | ID: biblio-1393164

ABSTRACT

The WHO Therapeutics and COVID-19: living guideline contains the Organization's most up-to-date recommendations for the use of therapeutics in the treatment of COVID-19. The latest version of this living guideline is available in pdf format (via the 'Download' button) and via an online platform, and is updated regularly as new evidence emerges. This twelfth version of the WHO living guideline now contains 19 recommendations. This latest update provides updated recommendations for remdesivir, addresses the use of combination therapy with corticosteroids, interleukin-6 (IL-6) receptor blockers and Janus kinase (JAK) inhibitors in patients with severe or critical COVID-19, and modifies previous recommendations for the neutralizing monoclonal antibodies sotrovimab and casirivimab-imdevimab in patients with non-severe COVID-19.


Subject(s)
Humans , COVID-19/drug therapy , Antiviral Agents/therapeutic use , Plasma/immunology , Ivermectin/therapeutic use , Colchicine/therapeutic use , Immunization, Passive , Fluvoxamine/therapeutic use , Adrenal Cortex Hormones/therapeutic use , Receptors, Interleukin-6/therapeutic use , Lopinavir/therapeutic use , Janus Kinase Inhibitors/therapeutic use , Hydroxychloroquine/therapeutic use
6.
s.l; CONETEC; 3 jun. 2022.
Non-conventional in Spanish | LILACS, BRISA | ID: biblio-1371525

ABSTRACT

INTRODUCCIÓN: El remdesivir fue evaluado originalmente en ensayos clínicos para abordar el brote de virus del ébola en 2014.(13) Con la demostración de que remdesivir poseía una amplia actividad contra otros virus de ARN, incluidos los coronavirus, múltiples grupos evaluaron su actividad antiviral in vitro como in vivo en otras indicaciones. Posteriormente, se confirmó su actividad antiviral contra los coronavirus zoonóticos MERS, así como los coronavirus humanos circulantes HCoV-OC43 y HCoV-229E, agentes causantes del resfriado común.(14) Recientemente, también ha demostrado su actividad in vitro frente al SARS-CoV-2.(15) En un modelo de macaco Rhesus con infección por SARS-CoV-2 donde el tratamiento con remdesivir se inició poco después de la inoculación, los animales tratados con este fármaco presentaron niveles de virus más bajos en los pulmones y menos daño pulmonar respecto a los animales de control. Aunque este modelo animal no representa la enfermedad grave observada en algunos pacientes con COVID-19, se tomaron estos hallazgos como una posibilidad biológica para iniciar estudios clínicos con este fármaco antiviral en pacientes con COVID-19. OBJETIVO: El objetivo del presente informe es evaluar parámetros de eficacia, seguridad, conveniencia y recomendaciones disponibles acerca del empleo de remdesivir para el tratamiento de pacientes con COVID-19 en Argentina. MÉTODOS: Efectos en la Salud: Teniendo en cuenta la velocidad con la que la información relacionada a la pandemia aparece y se modifica, se desarrolló un protocolo sustentado en proyectos que resume activamente la evidencia científica a medida que la misma se hace disponible. Con este fin se utilizó la plataforma L- ove de Epistemonikos https://app.iloveevidence.com/topics para identificar revisiones sistemáticas "vivas". Se seleccionaron aquellas con una calidad metodológica apropiada evaluada a través de la herramienta AMSTAR-2, y que a su vez llevaran un proceso de actualización frecuente. De cada una de las revisiones sistemáticas identificadas se extractaron los efectos de la intervención sobre los desenlaces priorizados como importantes o críticos y la certeza en dichos efectos. Para la priorización de los desenlaces se adoptó una perspectiva desde el paciente considerando sus potenciales preferencias. La selección se realizó por consenso entre los autores y supervisores del informe considerando los resultados de múltiples ejercicios de priorización publicados, realizados en el marco del desarrollo de distintas guías de práctica clínica. Implementación: Este dominio contempla dos subdominios: la existencia de barreras y facilitadores en nuestro contexto para la implementación de la tecnología evaluada no consideradas en los otros dominios analizados, y los costos comparativos en relación con otras intervenciones similares. Con el objetivo de emitir un juicio de valor sobre la magnitud de dichos costos, en pacientes hospitalizados se utilizó como comparador al tratamiento con dexametasona, que ha demostrado ser una intervención accesible y de beneficios importantes en el contexto analizado. Recomendaciones: Para la identificación de recomendaciones sustentadas en evidencia y actualizadas, se utilizó la plataforma COVID recmap. Se seleccionaron aquellas guías con rigor metodológico apropiado según la herramienta AGREE II (> 70%) y se incorporaron sus recomendaciones al informe. RESULTADOS: Se identificaron tres revisiones sistemáticas que cumplieron con los criterios de inclusión del presente informe y reportaron resultados: Las revisiones sistemáticas identificadas incluyeron 12 estudios aleatorizados para remdesivir en COVID19 que aleatorizaron un total de 9869 pacientes. Los resultados de 12 ECCA, incluyendo los resultados finales del ensayo SOLIDARITY, muestran que, en pacientes hospitalizados con COVID-19 y enfermedad de moderada a crítica, el remdesivir probablemente reduce la mortalidad y la necesidad de ventilación mecánica invasiva, y podría mejorar el tiempo de resolución de los síntomas. La certeza de la evidencia fue clasificada como moderada debido a la imprecisión. En pacientes con enfermedad leve de comienzo reciente, el remdesivir podría reducir las hospitalizaciones, pero la certeza de la evidencia es baja también por imprecisión. Adicionalmente, existe información sobre la efectividad in vitro de remdesivir frente a las diferentes variantes de SARS-CoV-2. Esta información se encuentra disponible en OpenData Portal, que condensa lo reportado por conjunto priorizado de publicaciones (preprints y artículos revisados por pares). resultados muestran que remdesivir podría tener una efectividad similar frente a las nuevas variantes del SARS-CoV-2, incluida Omicrón y subvariantes (B.1.1.529; BA.1.1; BA.1; BA.1 [+Q493K]; BA.2; B.1.1.529 [+F694Y] en comparación de las variantes predominantes al momento de realizarse los estudios. CONCLUSIONES: El cuerpo de la evidencia disponible, muestra que en pacientes con enfermedad leve o de reciente comienzo y factores de riesgo para progresión a enfermedad severa, remdesivir podría disminuir las hospitalizaciones y podría aumentar la velocidad para la mejoría clínica y resolución de los sintomas. Sin embargo, la magnitud de la reducción solo resulta importante (mayor a 1%) para pacientes sin esquema de vacunación completo o con riesgo de respuesta inmune inapropriada. En pacientes hospitalizados con enfermedad severa en cambio, el remdesivir probablemente reduce la mortalidad y la necesidad de ventilación mecánica invasiva y podría mejorar el tiempo de resolución de los síntomas, sin aumentar los eventos adversos sérios. A pesar que remdesivir se encuentra autorizado para su comercialización en Argentina, existen algunas situaciones que podrían constituir barreras para el acceso. La vía de administración endovenosa podría no ser aceptada en personas con enfermedad leve. Además, el costo del tratamiento es muy elevado y existe una extensa población objetivo para la aplicación de este tratamiento, que podrían constituir también barreras de acceso. Las guías sugieren el tratamiento con remdesivir condicionado a aquellos pacientes no graves con mayor riesgo de hospitalización. También sugieren en forma condicional utilizar remdesivir en pacientes hospitalizados que requieren oxígeno y recomiendan fuertemente no utilizar en adultos hospitalizados con COVID-19 que requieran ventilación no invasiva o invasiva. En el contexto de América Latina y el Caribe, se sugirió que cada país debe evaluar la decisión de su uso con base en los recursos disponibles, la factibilidad de su implementación, el acceso, los factores específicos del paciente (p. ej., la duración de los síntomas, el funcionamiento renal, las interacciones farmacológicas), la cobertura de vacunación y la forma de administración. También, es importante que se determine la capacidad de los servicios para poder administrar los medicamentos y considerar el tiempo adecuado para su uso.


Subject(s)
Humans , Synthetic Drugs/therapeutic use , SARS-CoV-2/drug effects , COVID-19/drug therapy , Antiviral Agents/therapeutic use , Efficacy , Cost-Benefit Analysis
7.
Säo Paulo med. j ; 140(3): 372-377, May-June 2022. tab, graf
Article in English | LILACS | ID: biblio-1377393

ABSTRACT

ABSTRACT BACKGROUND: Favipiravir is generally used in treating coronavirus disease 2019 (COVID-19) pneumonia in Turkey. OBJECTIVE: To determine the side effects of favipiravir and whether it is a good treatment option. DESIGN AND SETTING: Retrospective study conducted in Atatürk Chest Diseases and Chest Surgery Training and Research Hospital, Ankara, Turkey. METHODS: 357 patients who completed favipiravir treatment at the recommended dose were included. 37 patients with drug side effects and 320 patients without drug side effects were examined in two groups. RESULTS: Side effects were observed in 37 (10.36%) out of 357 patients using favipiravir. The most common side effect was liver dysfunction, in 26 (7.28%) of the patients. The following other side effects were also observed: diarrhea (1.4%), nausea (0.84%), abdominal pain (0.28%) and thrombocytopenia (0.28%). One patient (0.28%) presented both increased transaminases and nausea. CONCLUSION: In this study, it was determined that favipiravir may constitute an alternative for treating COVID-19 pneumonia given that its side effects are generally well tolerated and not serious.


Subject(s)
Drug-Related Side Effects and Adverse Reactions/drug therapy , COVID-19/drug therapy , Antiviral Agents/adverse effects , Pyrazines , Retrospective Studies , Treatment Outcome , Amides , SARS-CoV-2 , Nausea/chemically induced , Nausea/drug therapy
8.
Bol. latinoam. Caribe plantas med. aromát ; 21(2): 176-206, mar. 2022. ilus, tab
Article in English | LILACS | ID: biblio-1393396

ABSTRACT

Currently, the whole world is facing a life-threatening novel coronavirus 2019 (COVID-19) pandemic. Natural products are well-known for their potential role against viral disease, and some anti-viral agents have been developed to combat these diseases. Herein, the authors investigated the possible effects of this Holy plant Nigella sativa L. (NS), against coronavirus, using evidence-based and mechanistic approaches to conclude the immune-boosting and alleviation of respiratory systemeffects of NS. The pharmacological studies established a prominent role in treating various respiratory, immune systems, cardiovascular, skin, and gastrointestinal disorders. Literature supported the significant anti-viral role and showed an inhibitory role for NS against MHV-A59 CoV (mouse-hepatitis virus­A59) infected Hela, i.e., HeLaCEACAM1a (HeLa-epithelial carcinoembryonic antigen-related cell adhesion molecule 1a) cell. NS is a safe herbal product or dietary supplement and could be an effective and affordable community adjuvant treatment for coronavirus in the current scenario.


Actualmente, el mundo entero se enfrenta a una pandemia del nuevo coronavirus 2019 (COVID-19) que amenaza la vida. Los productos naturales son bien conocidos por su papel potencial contra las enfermedades virales, y se han desarrollado algunos agentes antivirales para combatir estas enfermedades. En este documento, los autores investigaron los posibles efectos de esta planta sagrada Nigella sativa L. (NS), contra el coronavirus, utilizando enfoques mecanicistas y basados en la evidencia para concluir el refuerzo inmunológico y el alivio de los efectos del SN en el sistema respiratorio. Los estudios farmacológicos establecieron un papel destacado en el tratamiento de diversos trastornos respiratorios, del sistema inmunológico, cardiovasculares, cutáneos y gastrointestinales. La literatura apoyó el importante papel antivírico y mostró un papel inhibidor de NS contra células Hela infectadas con MHV-A59 CoV (virus de la hepatitis de ratón-A59), es decir, HeLaCEACAM1a (molécula de adhesión celular 1a relacionada con el antígeno carcinoembrionario epitelial de HeLa). NS es un producto a base de hierbas o un suplemento dietético seguro y podría ser un tratamiento adyuvante comunitario eficaz y asequible para el coronavirus en el escenario actual.


Subject(s)
Humans , Antiviral Agents/pharmacology , Plant Extracts/pharmacology , Nigella sativa/chemistry , COVID-19/drug therapy , Antiviral Agents/immunology , Respiratory System/drug effects , Respiratory System/immunology , Plant Extracts/immunology , Anti-Asthmatic Agents , COVID-19/immunology , Immune System/drug effects
9.
Lima; Instituto Nacional de Salud; mar. 2022.
Non-conventional in Spanish | LILACS, BRISA | ID: biblio-1369503

ABSTRACT

ANTECEDENTES: Este informe se efectúa en atención a la solicitud de la Dirección General de Intervenciones Estratégicas de Salud Pública del Ministerio de Salud. El objetivo es sintetizar la evidencia científica publicada respecto a la eficacia y seguridad de Molnupiravir en el tratamiento de pacientes con COVID-19. La UNAGESP elaboró 2 notas técnicas previas, vinculadas a esta solicitud - SNT N° 08-2021: Eficacia y Seguridad de Molnupiravir para el tratamiento de COVID-19 de fecha 6 de setiembre de 2021 - SNT N° 002-2022: Eficacia y Seguridad de Molnupiravir para el tratamiento de COVID-19, actualización al 29 de diciembre de 2021, de fecha enero de 2022. El presente informe actualiza la información previamente señalada. MÉTODOS: Pregunta PICO abordada en este informe: En pacientes adultos con COVID-19 ¿la administración de Molnupiravir es eficaz y seguro en comparación a no administrarlo para el tratamiento de COVID-19? Criterios de elegibilidad: Los criterios de selección de los estudios fueron los siguientes: Revisiones sistemáticas de Ensayos clínicos aleatorizados (ECA) o ECA que reporten resultados para al menos uno de los desenlaces de interés. Idioma: inglés o español. Se excluyeron estudios preclínicos, series de casos, reportes de casos, reportes breves y cartas al editor. Métodos para la búsqueda e identificación de la evidencia: Para la identificación de las revisiones sistemáticas se efectuó una búsqueda manual en la plataforma de COVID-END, recuperándose dos revisiones sistemáticas vivas: a. Revisión sistemática del Consorcio COVID-NMA disponible en https://covidnma.com/living_data/index.php?treatment1=Molnupiravir&submit=Validate#comparisons_div actualizada al 25 de febrero de 2022(2). b. Revisión Rápida de la Organización Panamericana de la Salud (OPS)(3), versión del 22 de febrero de 2022(4), disponible en https://iris.paho.org/handle/10665.2/52719 RESULTADOS: El Molnupiravir es un profármaco con actividad antiviral contra el SARS-CoV-2 cuyo mecanismo de acción es conocido como catástrofe de error viral o mutagénesis letal, ya que produce una acumulación de errores en el genoma viral que conduce a la inhibición de la replicación. Molnupiravir se metaboliza al análogo de nucleósido de la citidina, NHC, que se distribuye en las células donde el NHC se fosforila para formar el ribonucleósido trifosfato farmacológicamente activo (NHC-TP) el cual se incorpora en el ARN del SARS-CoV-2 mediante la ARN polimerasa viral para ejercer el mecanismo de acción. El 23 de diciembre de 2021, la Administración de Alimentos y Medicamentos de los Estados Unidos (FDA, su sigla del inglés Food and Drug Administration), emitió la autorización de uso de emergencia del Molnupiravir para el tratamiento de la enfermedad por COVID-19 de leve a moderada en adultos con resultados positivos en las pruebas virales directas del SARS-CoV-2 y que tienen un alto riesgo de progresión a COVID-19 grave y para quienes las opciones alternativas de tratamiento para la COVID-19 aprobadas o autorizadas por la FDA no son accesibles o clínicamente adecuadas. La dosis autorizada es de 800 mg por vía oral cada 12 horas durante 5 días, que debe iniciarse tan pronto como sea posible luego del diagnóstico y dentro de los 5 días de la aparición de los síntomas. No está autorizado para su uso en pacientes menores de 18 años, para el inicio del tratamiento en pacientes que requieren hospitalización debido a la COVID-19, para usar durante más de 5 días consecutivos y para profilaxis previa o posterior a la exposición para la prevención de COVID-19. En el país, el uso del Molnupiravir cuenta con registro sanitario condicional. CONCLUSIONES: Molnupiravir es un profármaco con actividad antiviral contra el SARS-CoV-2. Ha sido autorizado por la FDA de Estados Unidos para el tratamiento de COVID-19 leve a moderado en adultos con enfermedad de reciente comienzo, quienes tienen un alto riesgo de progresión a COVID-19 grave y para quienes las opciones alternativas de tratamiento aprobadas o autorizadas por la FDA no son accesibles o clínicamente adecuadas. En el país, el uso del Molnupiravir cuenta con registro sanitario condicional. El objetivo del informe fue sintetizar la evidencia científica respecto a la eficacia y seguridad del molnupiravir en el tratamiento de pacientes con COVID-19. La evidencia en pacientes adultos no hospitalizados, no vacunados, con COVID-19 leve a moderado, tiempo de enfermedad ≤ 5 días y con factores de riesgo para progresión a enfermedad severa mostró lo siguiente: - Molnupiravir en comparación a no administrarlo probablemente tiene un efecto pequeño sobre la mortalidad por cualquier causa a los 28 días: 11 muertes menos por cada 1000 pacientes tratados, IC 95%: 13 menos a 6 menos; 3 ensayos clínicos aleatorizados (ECA), 1937 participantes; certeza moderada. - Molnupiravir probablemente reduce las hospitalizaciones o la muerte por cualquier causa a los 28 días en comparación a no administrarlo, aunque el tamaño del efecto podría ser importante o pequeño: 28 pacientes menos por cada 1000 tratados se hospitalizaron o murieron, IC 95%: 46 menos a 2 menos; 2 ECA, 1735 participantes, certeza moderada. - Molnupiravir podría no incrementar la incidencia de eventos adversos serios en comparación con No administrarlo: 23 pacientes menos por cada 1000 tratados, IC 95%: 39 menos a 3 más; 4 ECA, 1955 participantes; certeza baja. En pacientes hospitalizados, con COVID-19 moderado o severo, no vacunados y más de 5 días desde el inicio de síntomas, la administración de Molnupiravir podría incrementar la mortalidad por cualquier causa a los 28 días (certeza baja), no incrementaría la incidencia de eventos adversos y eventos adversos serios (certeza baja) y es incierto si tendría algún impacto en la progresión a ventilación mecánica (certeza muy baja). Hasta la fecha del informe no se identificaron resultados publicados sobre la eficacia o efectividad de Molnupiravir en pacientes con antecedente de vacunación contra COVID-19 o en un contexto de circulación de la variante omicrón. Estudios in vitro mostraron que la actividad antiviral de Molnupiravir se mantuvo frente a la variante Ómicron. En estudios in vivo, redujo la replicación viral en vías respiratorias superiores y en tejido pulmonar en modelos animales que simulaban una infección viral leve o con afectación pulmonar no severa respectivamente.


Subject(s)
Humans , Antiviral Agents/therapeutic use , Prodrugs/therapeutic use , SARS-CoV-2/drug effects , COVID-19/drug therapy , Efficacy , Cost-Benefit Analysis
10.
Vitae (Medellín) ; 29(1): 1-11, 2022-01-09. Ilustraciones
Article in English | LILACS, COLNAL | ID: biblio-1363751

ABSTRACT

Background: Coronavirus infectious disease 2019 (COVID-19) caused by the infection with the new coronavirus SARS-CoV-2 has affected the life and health of more than 222 million people. In the absence of any specific pharmacological treatment, the need to find new therapeutic alternatives is clear. Medicinal plants are widely used worldwide to treat different conditions, including COVID-19; however, in most cases, there are no specific studies to evaluate the efficacy of these treatments. Objective: This article evaluates the antiviral effect of six plant extracts used by indigenous and afro Colombian people against SARS-CoV-2 in vitro. Methods: The antiviral effect of six extracts prepared from plants used in Colombian traditional medicine was evaluated against SARS-CoV-2 through a pre-post treatment strategy on the Vero E6 cell line. Once cytotoxicity was established through an MTT assay, the antiviral effect of the extracts was calculated based on the reduction in the viral titer determined by plaque assay. Results:Gliricidia sepium inhibited SARS-CoV-2 in a 75.6%, 56.8%, 62.5% and 40.0% at 10 mg/mL, 8 mg/mL, 6 mg/mL, and 2 mg/mL, respectively, while Piper tuberculatumtreatment reduced viral titer in 33.3% at 6 mg/mL after 48h. Conclusion:G. sepium and P. tuberculatum extracts exhibit antiviral activity against SARS-CoV-2 in vitro


Introducción: La enfermedad infecciosa causada por el coronavirus 2019 (COVID-19) generada por la infección con el nuevo coronavirus SARS-CoV-2 ha afectado la vida y la salud de mas de 222 millones de personas. En ausencia de algún tratamiento farmacológico específico, la necesidad de encontrar nuevas alternativas terapéuticas es clara. Las plantas medicinales son utilizadas en todo el mundo para tratar diferentes condiciones, incluyendo el COVID-19; sin embargo, en la mayoría de los casos no existen estudios específicos que evalúen la eficacia de estos tratamientos. Objetivo: En este artículo, evaluamos el efecto antiviral de seis extractos de plantas usadas por pueblos indígenas y afrocolombianos contra el SARS-CoV-2 in vitro.Metodología: El efecto antiviral de seis extractos preparados a partir de plantas usadas en medicina tradicional colombiana fue evaluado contra SARS-CoV-2 por medio de una estrategia de pre-post tratamiento en células Vero E6. Una vez se estableció la citotoxicidad por un ensayo de MTT, el efecto antiviral de estos extractos fue calculado basado en la reducción del título viral determinado por ensayo de plaqueo. Resultados:G. sepium inhibió SARS-CoV-2 en un 75.6%, 56.8%, 62.5% y 40.0% a 10 mg/mL, 8 mg/mL, 6 mg/mL, and 2 mg/mL, respectivamente. Mientras el extracto de Piper tuberculatum redujo el título viral en un 33.3% a 6 mg/mL luego de 48h de tratamiento


Subject(s)
Antiviral Agents/pharmacology , Plants, Medicinal/chemistry , Plant Extracts/pharmacology , SARS-CoV-2/drug effects , Colombia
11.
Article in English | WPRIM | ID: wpr-929244

ABSTRACT

Fourteen new geranyl phenyl ethers (1-14) along with three known compounds (15-17) were isolated from Illicium micranthum, and their structures were elucidated by comprehensive spectroscopic methods. Illimicranins A-H (1-8) were characterized as geranyl vanillin ethers, while 9 and 10 were dimethyl acetal derivatives. Illimicranins I and J (11 and 12) were rare geranyl isoeugenol ethers. Illimicranins K and L (13 and 14) represented the first example of geranyl guaiacylacetone ether and geranyl zingerone ether, respectively. Compounds 1, 2 and 15 exhibited anti-HBV (hepatitis B virus) activity against HBsAg (hepatitis B surface antigen) and HBeAg (hepatitis B e antigen) secretion, and HBV DNA replication.


Subject(s)
Antiviral Agents/pharmacology , Hepatitis B Surface Antigens , Hepatitis B e Antigens , Illicium/chemistry , Phenyl Ethers
12.
Article in English | WPRIM | ID: wpr-929022

ABSTRACT

OBJECTIVES@#Hepatitis B virus related acute-on-chronic liver failure (HBV-ACLF) is the most common type of liver failure in China, with a high mortality. Early rapid reduction of HBV-DNA load can improve the survival rate of HBV-ACLF patients. At present, the commonly used drugs are nucleoside (acid) analogues, such as entecavir (ETV), tenofovir, and so on. The newly listed tenofovir alafenamide fumarate (TAF) has attracted great attention of clinicians because of its stronger antiviral effect, higher transaminase normalization rate, better bone and kidney safety, and zero drug resistance. However, there are few clinical research data on the efficacy and safety of TAF in the treatment of Chinese HBV-ACLF patients, and there is a lack of pharmacoeconomic evaluation. This study aims to compare the efficacy, safety, and cost-effectiveness between TAF and ETV in patients with HBV-ACLF.@*METHODS@#The data were collected from 196 HBV-ACLF patients (80 patients in the TAF group and 116 patients in the ETV group) who were hospitalized in Xiangya Hospital, Central South University from May 2020 to March 2021. Biochemistry and virology were detected before and after treatment (at baseline, Week 2, 4, and 12). Clinical features, disease prognosis, and cost-effectiveness were compared between the 2 groups. According to the baseline, HBV-ACLF patients were divided into 4 stages including pre-liver failure stage, early stage, medium stage, and end stage. And the liver transplantation rate and mortality was also compared. Pharmacoeconomic evaluation was taken using cost-effectiveness analysis and cost minimization analysis..@*RESULTS@#After 4 weeks of treatment, there were no significant differences in the efficacy (liver function, viral load) between the 2 groups (all P>0.05). The TAF group showed lower creatinine [(80.35±18.77) μmol/L vs (105.59±82.32) μmol/L, P<0.05] and higher estimated glomerular filtration rate (eGFR) levels [(95.65±23.21) mL/(min·1.73 m2) vs (82.68±26.32) mL/(min·1.73 m2), P<0.05] than the ETV group. After 12 weeks of treatment, the analysis of overall the liver transplantation rate and mortality between the 2 groups showed similar conclusion. However, the TAF group had a lower the liver transplantation rate and mortality than the ETV group in patients with pre-liver failure (0vs13.89%, P<0.05). No evident distinction was found in the liver transplantation rate and mortality during the early, medium, or end stages of liver failure (13.04% vs 17.65%, 37.50% vs 37.04%, and 54.55% vs 68.42%, respectively). Ratio of cost to effectiveness in the ETV group was higher than that in the TAF group.@*CONCLUSIONS@#TAF is not more efficient than ETV group in improving liver function and reducing viral load for HBV-ACLF patients and they also show similar safety. However, TAF has a greater advantage over ETV not only in preserving renal function, but also in reducing the liver transplantation rate and mortality in patients with pre-liver failure. TAF can provide economic benefit to patients with HBV-ACLF.


Subject(s)
Acute-On-Chronic Liver Failure/drug therapy , Alanine/therapeutic use , Antiviral Agents/therapeutic use , Guanine/analogs & derivatives , Hepatitis B virus/genetics , Hepatitis B, Chronic/drug therapy , Humans , Tenofovir/analogs & derivatives , Treatment Outcome
13.
Article in English | WPRIM | ID: wpr-928954

ABSTRACT

OBJECTIVE@#To explore potential natural products against severe acute respiratory syndrome coronavirus (SARS-CoV-2) via the study of structural and non-structural proteins of human coronaviruses.@*METHODS@#In this study, we performed an in-silico survey of 25 potential natural compounds acting against SARS-CoV-2. Molecular docking studies were carried out using compounds against 3-chymotrypsin-like protease (3CLPRO), papain-like protease (PLPRO), RNA-dependent RNA polymerase (RdRp), non-structural protein (nsp), human angiotensin converting enzyme 2 receptor (hACE2R), spike glycoprotein (S protein), abelson murine leukemia viral oncogene homolog 1 (ABL1), calcineurin-nuclear factor of activated T-cells (NFAT) and transmembrane protease serine 2.@*RESULTS@#Among the screened compounds, amentoflavone showed the best binding affinity with the 3CLPRO, RdRp, nsp13, nsp15, hACE2R. ABL1 and calcineurin-NFAT; berbamine with hACE2R and ABL1; cepharanthine with nsp10, nsp14, nsp16, S protein and ABL1; glucogallin with nsp15; and papyriflavonol A with PLPRO protein. Other good interacting compounds were juglanin, betulinic acid, betulonic acid, broussooflavan A, tomentin A, B and E, 7-methoxycryptopleurine, aloe emodin, quercetin, tanshinone I, tylophorine and furruginol, which also showed excellent binding affinity towards a number of target proteins. Most of these compounds showed better binding affinities towards the target proteins than the standard drugs used in this study.@*CONCLUSION@#Natural products or their derivatives may be one of the potential targets to fight against SARS-CoV-2.


Subject(s)
Animals , Antiviral Agents/therapeutic use , Biological Products/pharmacology , COVID-19/drug therapy , Humans , Mice , Molecular Docking Simulation , SARS-CoV-2
14.
Esc. Anna Nery Rev. Enferm ; 26: e20210203, 2022. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1356215

ABSTRACT

RESUMO Objetivo analisar as características individuais, clínicas e os fatores associados à mortalidade de pacientes com COVID-19, em hospital público do estado do Paraná, Brasil. Métodos estudo seccional, retrospectivo, documental (n= 86), com pacientes adultos internados, de março a junho de 2020. Resultados a mortalidade foi de 12,8%, o grupo de maior risco foi de idosos com comorbidades, especialmente, cardiovasculares. A chance de óbito foi 58 vezes maior em idosos, comparada aos adultos, e oito vezes maior naqueles com comorbidades, comparadas aos hígidos. A maioria dos pacientes apresentou sintomatologia respiratória, febre e mialgia. Tratamento à base de antibióticos, anticoagulantes e antivirais, associado ao suporte ventilatório. As principais complicações foram hipóxia, insuficiência renal aguda e infecção secundária. Conclusão e implicações para a prática idosos com comorbidades cardiovasculares que necessitaram de cuidados intensivos apresentaram maior chance de óbito. Os resultados de um dos centros de referência na pandemia possibilitam discutir medidas epidemiológicas adotadas, com ênfase em conceitos restritivos nos primeiros meses.


RESUMEN Objetivo analizar las características individuales, clínicas y los factores asociados a la mortalidad en pacientes con COVID-19 en un hospital público del estado de Paraná. Métodos estudio transversal, retrospectivo, documental (n = 86), con pacientes adultos hospitalizados, de marzo a junio de 2020. Resultados la mortalidad fue del 12,8%, grupo de mayor riesgo para los ancianos con comorbilidades, especialmente enfermedades cardiovasculares. La probabilidad de muerte fue 58 veces mayor en los ancianos en comparación con los adultos y ocho veces mayor en aquellos con comorbilidades en comparación con los sanos. La mayoría de los pacientes presentaban síntomas respiratorios, fiebre y mialgia. Tratamiento a base de antibióticos, anticoagulantes y antivirales, asociado al soporte ventilatorio. Las principales complicaciones fueron hipoxia, insuficiencia renal aguda e infección secundaria. Conclusión e implicaciones para la práctica los ancianos con comorbilidades cardiovasculares que requirieron cuidados intensivos tenían una mayor probabilidad de muerte. Los resultados de uno de los centros de referencia pandémica permiten discutir las medidas epidemiológicas adoptadas, con énfasis en conceptos restrictivos en los primeros meses.


ABSTRACT Objective to analyze the individual and clinical characteristics and the factors associated with mortality in patients with COVID-19, in a public hospital in the state of Paraná, Brazil. Methods a cross-sectional, retrospective, documentary study (n= 86), with adult inpatients, from March to June 2020. Results mortality was 12.8%, the highest risk group was the elderly with comorbidities, especially cardiovascular ones. The chance of death was 58 times higher in the elderly compared to adults, and eight times higher in those with comorbidities compared to the healthy ones. Most patients presented with respiratory symptoms, fever, and myalgia. Treatment was based on antibiotics, anticoagulants and antivirals, associated with ventilatory support. The main complications were hypoxia, acute renal failure, and secondary infection. Conclusion and implications for practice elderly people with cardiovascular comorbidities who required intensive care had a higher chance of death. The results from one of the reference centers in the pandemic make it possible to discuss epidemiological measures adopted, with emphasis on restrictive concepts in the first months.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Health Profile , COVID-19/mortality , Antiviral Agents/therapeutic use , Patients' Rooms , Brazil , Comorbidity , Retrospective Studies , Risk Factors , Azithromycin/therapeutic use , Cough , Dyspnea , Renal Insufficiency/complications , Fever , Interactive Ventilatory Support , Myalgia , COVID-19/therapy , Inpatients/statistics & numerical data , Intensive Care Units , Length of Stay/statistics & numerical data , Hypoxia/complications , Anticoagulants/therapeutic use
15.
Audiol., Commun. res ; 27: e2548, 2022. tab, graf
Article in Portuguese | LILACS | ID: biblio-1374474

ABSTRACT

RESUMO Objetivo Verificar se o tratamento com os antivirais de ação direta para a hepatite C provocam efeitos adversos na audição. Métodos A casuística foi composta por 16 indivíduos portadores do vírus da hepatite C, de ambos os gêneros, com média de idade de 51 anos. Foram excluídos do grupo indivíduos com perda auditiva do tipo condutiva ou mista e que apresentassem fatores de risco para perda auditiva. A avaliação foi realizada em dois momentos: antes do uso dos antivirais de ação direta e após o término do tratamento de três meses. Incluiu os seguintes procedimentos: anamnese, inspeção do meato acústico externo, audiometria tonal liminar, limiar de recepção de fala, índice de reconhecimento de fala, medidas de imitância acústica e emissões otoacústicas evocadas por estímulo transiente e produto de distorção. Resultados: Houve baixa ocorrência de zumbido e vertigem. Não houve diferença estatisticamente significativa entre os resultados da avaliação pré-tratamento e pós-tratamento. Conclusão O tratamento com antivirais de ação direta contra o vírus da hepatite C não provocou efeitos adversos na função auditiva.


ABSTRACT Purpose To verify whether treatment with hepatitis C direct-acting antivirals has adverse effects on hearing. Methods The sample consisted of 16 individuals with hepatitis C virus, of both sexes, with an average age of 51 years. Individuals with conductive or mixed hearing loss who presented risk factors for hearing loss were excluded from the group. The evaluation was carried out in two moments: before the use of direct-acting antivirals and after the three-month treatment. It included the following procedures: anamnesis, external auditory canal inspection, pure tone audiometry, speech reception threshold, speech recognition index, acoustic immittance measures and transient and distortion product otoacoustic emissions. Results There was a low incidence of tinnitus and vertigo. There was no statistically significant difference between the results of the pre- and post-treatment assessment. Conclusion The treatment with direct-acting antivirals against the hepatitis C virus did not cause any adverse effects on hearing function.


Subject(s)
Humans , Male , Female , Middle Aged , Antiviral Agents/adverse effects , Hepatitis C/drug therapy , Risk Adjustment , Hearing Loss , Brazil , Longitudinal Studies , Otoacoustic Emissions, Spontaneous
16.
Evid. actual. práct. ambul ; 25(2): e007014, 2022. ilus, tab
Article in Spanish | LILACS, BINACIS, UNISALUD | ID: biblio-1380221

ABSTRACT

El nuevo tratamiento simplificado con antivirales orales para pacientes con Hepatitis C puede ser abordado desde la atención primaria, lo que facilita el acceso de la población afectada por esta infección crónica. En este artículo se repasan los aspectos claves del diagnóstico, el esquema de tratamiento simplificado y los candidatos a recibirlo. (AU)


The new simplified treatment with oral antivirals for hepatitis C patients can be approached at the primary care level, facilitating access for the population affected by this chronic infection. This article reviews the key aspects of the diagnosis, the simplified treatment scheme, and the eligible candidates for the treatment. (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Antiviral Agents/administration & dosage , Hepatitis C/diagnosis , Hepatitis C/drug therapy , Primary Health Care , Enzyme-Linked Immunosorbent Assay , Hepatitis C/blood , Persistent Infection/diagnosis , Persistent Infection/drug therapy , Persistent Infection/blood , Liver Cirrhosis/diagnosis
17.
J. bras. pneumol ; 48(1): e20210393, 2022. tab, graf
Article in English | LILACS | ID: biblio-1360541

ABSTRACT

ABSTRACT Objective: Studies in the literature regarding the use of remdesivir to treat COVID-19 patients have shown conflicting results. This study sought to answer questions related to the use of remdesivir for the treatment of patients hospitalized with moderate to severe COVID-19. Methods: This was a systematic review and meta-analysis including phase 3 randomized clinical trials (RCTs) and observational cohort studies selected from various databases, comparing patients hospitalized with moderate to severe COVID-19 receiving remdesivir and controls. Results: A total of 207 studies were retrieved, 9 of which met the eligibility criteria and were included in the study. The meta-analysis using RCTs alone showed no statistically significant differences regarding mortality or use of mechanical ventilation/extracorporeal membrane oxygenation between remdesivir and control groups, and the quality of evidence was moderate and low, respectively. The use of remdesivir increased the recovery rate by 6% (95% CI, 3-9); p = 0.004) and the clinical improvement rate by 7% (95% CI, 1-14); p = 0.02). Additionally, no significant differences in mortality were found between remdesivir and control groups when the meta-analysis used observational cohort studies alone (risk difference = −0.01 (95% CI, −0.02 to 0.01; p = 0.32), the quality of evidence being moderate, and the risk of adverse events was 4% ([95% CI, −0.08 to 0.01]; p = 0.09). Conclusions: The use of remdesivir for the treatment of patients with moderate to severe COVID-19 had no significant impact on clinically important outcomes.


RESUMO Objetivo: Estudos na literatura sobre o uso de remdesivir no tratamento de pacientes com COVID-19 têm apresentado resultados divergentes. O objetivo deste estudo foi responder a perguntas a respeito do uso de remdesivir no tratamento de pacientes hospitalizados com COVID-19 moderada a grave. Métodos: Trata-se de uma revisão sistemática e meta-análise de ensaios clínicos controlados randomizados (ECR) de fase 3 e estudos observacionais de coorte recuperados de diversos bancos de dados, comparando pacientes hospitalizados com COVID-19 moderada a grave recebendo remdesivir a controles. Resultados: Foram recuperados 207 estudos, dos quais 9 preencheram os critérios de elegibilidade e foram incluídos no estudo. A meta-análise somente dos ECR não mostrou diferenças estatisticamente significativas entre os grupos remdesivir e controle quanto à mortalidade ou ao uso de ventilação mecânica/oxigenação por membrana extracorpórea, e a qualidade das evidências foi moderada e baixa, respectivamente. O uso de remdesivir aumentou a taxa de recuperação em 6% (IC95%: 3-9; p = 0,004) e a taxa de melhora clínica em 7% (IC95%: 1-14; p = 0,02). Além disso, não foram observadas diferenças significativas entre os grupos remdesivir e controle quanto à mortalidade quando a meta-análise concentrou-se apenas nos estudos observacionais de coorte [diferença de risco = −0,01 (IC95%: −0,02 a 0,01); p = 0,32; qualidade das evidências: moderada], e o risco de eventos adversos foi de 4% (IC95%: −0,08 a 0,01; p = 0,09). Conclusões: O uso de remdesivir no tratamento de pacientes com COVID-19 moderada a grave não teve impacto significativo em desfechos clinicamente importantes.


Subject(s)
Humans , COVID-19/drug therapy , Antiviral Agents/therapeutic use , Adenosine Monophosphate/analogs & derivatives , Treatment Outcome , Alanine/analogs & derivatives , Observational Studies as Topic , SARS-CoV-2
18.
Braz. J. Pharm. Sci. (Online) ; 58: e19517, 2022. tab, graf
Article in English | LILACS | ID: biblio-1383995

ABSTRACT

Nordihydroguaiaretic acid (NDGA) is a natural product obtained by the alkaline extraction of dried plants of Larrea tridentata species. Due to the biological properties presented, such as antioxidant, anti-inflammatory, antiviral and cytotoxic capacity, this compound is being increasingly studied. In this review, it was evaluated the benefits of NDGA against different animal models. Besides that, it was found that this compound has antitumor activity similar to its synthetic derivative terameprocol in prostate tumors. The hypoglycemic effect may be evidenced by the inhibition of sugar uptake by NDGA; in obesity, studies have observed that NDGA presented a positive regulatory effect for Peroxisome proliferator-activated receptors (PPAR-α) involved in the oxidation of hepatic fatty acids and reduced the expression of lipogenic genes. Regarding its antioxidant potential, its mechanism is related to the ability to in vitro scavenging reactive substances. Although there are several studies demonstrating the benefits of using NDGA, there are also reports of its toxicity, mainly of liver damage and nephrotoxicity


Subject(s)
Masoprocol/analysis , Chemical Phenomena , Antiviral Agents/pharmacology , Plants/classification , Biological Products/analysis , In Vitro Techniques/methods , Models, Animal , Toxicity , Hypoglycemic Agents/pharmacology , Neoplasms , Antioxidants/pharmacology
19.
Braz. J. Pharm. Sci. (Online) ; 58: e19925, 2022. tab
Article in English | LILACS | ID: biblio-1394039

ABSTRACT

Abstract This study aimed to evaluate the effectiveness and safety of direct-acting antivirals in a Unified Health System pharmacy of Londrina, Brazil. A descriptive observational study was performed from June 2017 to June 2018. Sociodemographic, clinical, and therapeutic variables of patients were collected from secondary data sources. Effectiveness was evaluated by sustained virologic response (SVR) and safety was evaluated by adverse events (AEs) and drug interactions (DIs). The mean population (N=30) was 56.6±11.3 years old and almost all patients had comorbidities (93.3%) and concomitant drugs (96.7%). Effectiveness evaluation was possible in 17 patients, and all of them (100.0%) achieved SVR. Eighteen patients (60.0%) reported 38 AEs, mostly mild, such as stomach symptoms and headache. No statistical relation was found between AE occurrence and treatment duration, Ribavirin use, number of comorbidities or number of concomitant drugs. A total of 48 DIs were reported, 18 being severe, and were managed by the pharmacist. The study indicates that the treatment was effective and safe.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Antiviral Agents/analysis , Efficacy , Hepatitis C, Chronic/pathology , Insurance/classification , Patients/classification , Pharmacists/classification , Unified Health System , Pharmaceutical Preparations/administration & dosage , Drug Interactions , Drug Therapy/methods
20.
Braz. J. Pharm. Sci. (Online) ; 58: e18637, 2022. tab, graf
Article in English | LILACS | ID: biblio-1364416

ABSTRACT

Abstract The therapeutic drugs to treat Herpes simplex virus (HSV) infections have toxic side effects and there has been an emergence of drug-resistant strains. Therefore, the search for new treatments for HSV infections is mounting. In the present study, semi-solid formulations containing a crude hydroethanolic extract (CHE) from Schinus terebinthifolia were developed. Skin irritation, cutaneous permeation, and in vivo therapeutic efficacy of the formulations were investigated. Treatment with the ointment formulations did not result in any signs of skin irritation while the emulsions increased the thickness of the epidermis in Swiss mice. The cutaneous permeation test indicated that the CHE incorporated in the formulations permeated through the skin layers and was present in the epidermis and dermis even 3 h after topical application. In vivo antiviral activity in BALB/c mice treated with the CHE ointments was better than those treated with the CHE emulsions and did not significantly differ from an acyclovir-treated group. Taken together, this suggests that the incorporation of CHE in the ointment may be a potential candidate for the alternative topical treatment of herpetic lesions.


Subject(s)
Pharmaceutical Preparations/analysis , Simplexvirus/classification , Herpesvirus 1, Human/classification , Anacardiaceae/adverse effects , Antiviral Agents/adverse effects , Acyclovir/antagonists & inhibitors , Efficacy , Emulsions/adverse effects
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