ABSTRACT
Introduction: Owing to the similarity between SARS-CoV-2 and hepatitis C virus (both SARS-CoV-2 Mpro protease and HCV NS3/4A protease are double B-barrel folded with similar orientation), and based on molecular docking models, many researchers suggested using hepatitis C direct acting antiviral drugs (DAAs) for the treatment of SARS-CoV-2 infection. Aims & Methods: This study aimed to estimate the prevalence of SARSCoV- 2 infection among chronic hepatitis C patients receiving treatment with sofosbuvir plus daclatasvir in comparison to chronic hepatitis C patients who finished treatment course one year before COVID-19 pandemic (control group). A retrospective case-control study was designed including 500 chronic hepatitis C patients receiving treatment with sofosbuvir plus daclatasvir (study group) during COVID-19 pandemic (March to September 2020) in comparison to matched 500 individuals who finished treatment course for hepatitis C one year (March to September 2019) before COVID-19 pan demic (control group). Both groups were followed up for 6 months starting from March 2020 up to September 2020. Baseline demographic data, comorbidities, history of confirmed diagnosis of with SARS-CoV-2 infection, residence in an area endemic with SARS-CoV-2 infection or close contact with confirmed or suspected cases were compared in both groups. Results: Our study included 1000 participants (500 in each group), mean age (± standard deviation) was 48.45 (± 7.68) in the study group and 47.67 (± 10.56) in the control group (p value=0.18). Most of participants in the study were males, 400 (80%) in the study group and 380 (76%) in the control group. No significant differences were present in baseline characteristics including area of residence (rural versus urban), level of education, work in medical field, smoking, presence of liver cirrhosis or other comorbidities (Diabetes mellitus, Hypertension, Chest diseases, Cardiac disease, Autoimmune disease or Obesity). In the study group 22 (4.4%) patients had contact with SARS-CoV-2 infected patient while in the control group 24 (4.8%) individuals had contact with SARS-CoV-2 infected patient (p value= 0.88). Patient receiving chronic hepatitis C treatment with sofosbuvir plus daclatasvir had a lower rate of SARS-CoV-2 infection (2.2%, 11 SARSCoV- 2 infections) than individuals in the control group (6%, 30 SARS-CoV-2 infections). Conclusion: Chronic hepatitis C treatment (sofosbuvir plus daclatasvir) can protect against SARS-CoV-2 infection. Larger randomized controlled studies are urgently required to explore the efficacy of sofosbuvir plus daclatasvir combination as a potential therapy for SARS-CoV-2 infection.
ABSTRACT
Aims An outbreak of coronavirus disease 19 (COVID-19) has altered the dynamic of endoscopic practices. Many guidelines, questionnaires have been published addressing service resumption during the pandemic. Curious about the situation indifferent endoscopic units across the globe, the study was designed to evaluate different aspects of practice resumptionworldwide and their adherence to guidelines. Methods An online questionnaire was created and distributed by national/regional representatives and societies. Redcapplatform was used as the interface;afterwards, Microsoft Excel 2016 and Prism 5 were utilized for data analysis. Results From a total of 307 responses from 47 countries/regions was collected, 290 valid answers were analyzed. Almosthalf (47 %) were in post-peak period by August, 2020. Many units were not designated to be COVID-oriented facility. About15.5 % of centers remained unrecovered, mainly in North and South America;those were recovered, training was still withheld significantly. Nevertheless, opened centers kept safety measurements strictly. Patient load was decreased by 37 %,but waiting list was increased 0-25 %. Among many surveillance methods, body temperature, PCR and chest CT were themost common. 74.8 % increased post-procedural disinfection time and 68.2 % increase in per-case inspection were noted.PPE usage was implemented highly and shortage of these posed as one of the resumption barriers. Post-procedural patientsurveillance was not reinforced. Conclusions The study represented real-time global endoscopic service's adaptation to COVID-19 pandemic. Previouslypublished barriers upon practice resumption remained. Despite Delphi consensus' emphasis on post-procedural surveillance, application was not widely reinforced, raising concerns in disease control.