ABSTRACT
Assessment of viral load levels in various biological samples taken from the respiratory tract can be an indicator of an ongoing process of active viral replication and may be used to monitor severe respiratory viral infections. The study of the relationship between SARS-CoV-2 viral load and immunological laboratory parameters is an important step in the search for clinical markers of COVID-19. The aim of this research was to quantify viral load in patients with COVID-19 and to identify the relationship between viral load and changes in the parameters of the cellular component of the immune system. A laboratory examination was carried out on 74 patients diagnosed with COVID-19, they were divided into 3 groups based on the severity of the disease: mild, moderate, severe. Total viral load in clinical samples was determined by the number of SARS-CoV-2 RNA copies per 100 copies of the reference RNaseP gene. A comprehensive assessment of the cellular component of the immune system was performed using flow cytometry and direct monoclonal antibodies, and the IL-6, and C-reactive protein concentrations were determined. We revealed a relationship between the development of serious clinical conditions in the patients with COVID-19, and the levels of viral load. High levels of viral RNA in biological samples correlate with main indicators of the T cell component of the immune system associated with disease severity. In a subgroup of patients with an extremely high viral load, strong positive correlations were found between the relative numbers of cytotoxic lymphocytes (CD3+CD8+), activated T lymphocytes (CD3+HLA-DR+), as well as absolute and relative numbers of activated B lymphocytes and NK cells (CD3-CD25+). Laboratory monitoring of the cellular component of the immune system, along with the assessment of viral loads, should improve early assessment of clinical condition in the patients with COVID-19. Changes in expression levels of activation markers on immune cells can be potentially viewed as indicators of recovery during COVID-19.Copyright © Nikitin Yu.V. et al., 2023 The article can be used under the Creative Commons Attribution 4.0 License.
ABSTRACT
Assessment of viral load levels in various biological samples taken from the respiratory tract can be an indicator of an ongoing process of active viral replication and may be used to monitor severe respiratory viral infections. The study of the relationship between SARS-CoV-2 viral load and immunological laboratory parameters is an important step in the search for clinical markers of COVID-19. The aim of this research was to quantify viral load in patients with COVID-19 and to identify the relationship between viral load and changes in the parameters of the cellular component of the immune system. A laboratory examination was carried out on 74 patients diagnosed with COVID-19, they were divided into 3 groups based on the severity of the disease: mild, moderate, severe. Total viral load in clinical samples was determined by the number of SARS-CoV-2 RNA copies per 100 copies of the reference RNaseP gene. A comprehensive assessment of the cellular component of the immune system was performed using flow cytometry and direct monoclonal antibodies, and the IL-6, and C-reactive protein concentrations were determined. We revealed a relationship between the development of serious clinical conditions in the patients with COVID-19, and the levels of viral load. High levels of viral RNA in biological samples correlate with main indicators of the T cell component of the immune system associated with disease severity. In a subgroup of patients with an extremely high viral load, strong positive correlations were found between the relative numbers of cytotoxic lymphocytes (CD3+CD8+), activated T lymphocytes (CD3+HLA-DR+), as well as absolute and relative numbers of activated B lymphocytes and NK cells (CD3-CD25+). Laboratory monitoring of the cellular component of the immune system, along with the assessment of viral loads, should improve early assessment of clinical condition in the patients with COVID-19. Changes in expression levels of activation markers on immune cells can be potentially viewed as indicators of recovery during COVID-19.Copyright © Nikitin Yu.V. et al., 2023 The article can be used under the Creative Commons Attribution 4.0 License.
ABSTRACT
AIM: To evaluate clinical efficacy of nucleoside analogues in therapy of moderate COVID-19 in in-patients. MATERIALS AND METHODS: Retrospective processing of 108 completed clinical cases with moderate novel coronavirus disease was carried out for the period 2020-2021. The duration of the disease at the time of admission did not exceed three days. Experimental group consisted of 53 patients who, in addition to standard therapy, were prescribed "off-label" riamilovir at a daily dosage of 1250 mg for 5 days by the decision of the medical commission. Comparison group included 55 patients who received a combination of umifenovir and ribavirin as antiviral therapy for 5 days. The duration of the main clinical manifestations of the disease, the indicators of clinical and biochemical blood tests, results of the SARS-CoV-2 virus RNA study using the nucleic acid amplification method (NAAT diagnostics). RESULTS: Significantly faster achievement of clinical improvement in the group of patients treated with riamilovir was shown, as well as faster sanitation from SARS-CoV-2 virus based on the results of etiological testing. CONCLUSION: The use of riamilovir for the treatment of patients with moderate novel coronavirus infection (COVID-19) resulted in a significant reduction of general infectious syndromes and respiratory symptoms. Patients from the experimental group significantly faster achieved clinical recovery and sanitation from the pathogen according to the results of NAAT diagnostics.
Subject(s)
COVID-19 Drug Treatment , Humans , SARS-CoV-2 , Nucleosides , Retrospective Studies , Antiviral Agents , Nucleic Acid Synthesis InhibitorsABSTRACT
We are now observing a constantly growing number of patients after SARS-CoV-2 infection who have active complains for more than 12 weeks. Long-term consequences of the disease significantly impair the quality of life and lead to an overburdened healthcare system, which, in the absence of effective therapeutic strategies, has a significant impact on the quality of medical care. This article discusses the main aspects of pathogenesis and clinical characteristics of post-COVID syndrome, as well as the experience of pharmacological correction of this condition. Objective. To evaluate the effect of azoximer bromide on the resolution of post-COVID syndrome by assessing the duration and severity of the main symptoms within 10 days since treatment initiation, as well as the level of chronic fatigue. Patients and methods. This study included 90 patients (both males and females). The experimental group comprised 55 individuals who received azoximer bromide for 10 days according to the package insert. The control group included 35 individuals who received no therapy. Treatment efficacy was evaluated using special questionnaires;Student's t-test and Pearson's chi-squared test were used for statistical analysis. Results. We found that significantly fewer patients from the experimental group had joint and muscle pain and headache on day 10 of the experiment than patients in the control group. Hyposmia was also less common in the experimental group then in controls by day 10. There was a significant decrease in the severity of headache, joint and muscle pain, attention impairment, dizziness, anosmia among patients receiving azoximer bromide by day 10 compared to those receiving no therapy. Patients in the experimental group also demonstrated significantly less severe fatigue compared to controls as early as day 5 of the experiment. No adverse events were registered during the study. Conclusion. Azoximer bromide demonstrated its clinical efficacy and safety in the treatment of post-COVID syndrome. © 2021, Dynasty Publishing House. All rights reserved.
ABSTRACT
Relevance. Despite the implementation of measures to reduce morbidity and mortality among medical workers who are in contact with patients hospitalized for a new coronavirus infection caused by SARS-CoV-2 (hereinafter – COVID-19), their level remains high today. Given the difficulty of achieving the required number of vaccinated to form collective immunity, the issue of finding additional drug-based ways to prevent COVID-19, especially in risk groups, becomes urgent. Aims. To evaluate the effect of azoximer bromide on the number of cases of confirmed COVID-19 disease among medical workers, as well as on the level of chronic fatigue in the study groups. Materials and methods: 78 men and women were included in the study. The experimental group consisted of 41 people who took azoximer bromide for 38 days. The comparison group consisted of 37 people who were not prescribed azoximer bromide. The epidemiological efficacy of the drug was evaluated. Statistical evaluation of the significance of the differences was carried out using the Student's t-test, Pearson's criterion χ2. Results. The number of study participants with COVID-19 in the experimental group was significantly lower than in the comparison group. A significantly faster reduction of manifestations of chronic fatigue syndrome was noted in study participants who took azoximer bromide. There were no adverse events during the administration of the studied drug by the study participants. Conclusions. Azoximer bromide has shown epidemiological efficacy when used by medical workers directly providing medical care to patients with COVID-19 (when working in the «red zone»), including contributing to the more rapid normalization of the psychological state of medical workers. © Kasyanenko KV, et al.
ABSTRACT
Aim. The study evaluates clinical effectiveness and safety of etiotropic antiviral medications with a direct mechanism of action (Riamiiovir, Ribavirin, Umifenovir) for the treatment of moderate SARS-CoV-2 infection in adults. Materials and methods. The study used the data from 59 health records of patients with moderate PCR-confirmed SARS-CoV-2 infection. Control group included 29 patients treated with 1250 mg Riamiiovir off-label per day for 5 days (250 mg 5 times a day), comparison group consisted of 30 patients, who received 800 mg Ribavirin and Umifenovir per day for 5 days. The effectiveness of the medications was assessed by the duration and severity of general infectious and respiratory syndromes, anosmia and ageusia, as well as the oxygen content in the blood, the timing of SARS-COV-2 virus elimination from the body according to the results of control studies of nasopharyngeal swabs using the PCR method and dynamics of blood tests results. Results. A statistically significant decrease in the duration of fever, cough, and anosmia and a more rapid elimination of the virus from the body were noted in the group of patients receiving Riamiiovir. Decreased levels of non-specific inflammatory markers in blood serum, as well as normal values of liver enzymes were observed in control group during therapy, as opposed to the comparison group. No serious adverse events were noted when using the medication. Conclusion. Nucleoside analogue medication Riamiiovir showed good effectiveness and safety profile in adult patients with moderate SARS-CoV-2 infection.
ABSTRACT
We consider the possibility of optimizing the diagnosis of infection caused by SARS-CoV-2 using polymerase chain reaction in a multi-specialty hospital, repurposed for the treatment of COVID-19 patients, using the example Of the military medical Academy named after S.M. Kirov. The analysis of scientific publications selected in accordance with the purpose of the study, analyzed data from 218 samples of polymerase chain reaction in patients with COVID-19, who were in the clinics Of the military medical Academy named after Sm. Time intervals were established depending on the clinical forms and severity of the infectious process, in which the probability of a positive and negative result of a polymerase chain reaction to SARS-CoV-2 RNA was maximum and minimum. It was shown that during the examination and treatment, molecular biological diagnostics were performed excessively (4 times in more than 50% of patients) and in 97,3% of patients unreasonably early (8,5+or-0,4 days). At the same time, the highest frequency of negative results of polymerase chain reaction to SARS-CoV-2 RNA was observed in the period from 9 to 10 and from 12 to 14 days, while it depended on the clinical form and severity of the infectious process. In this regard, the volume diagnosis using polymerase chain reaction should be reduced and to conduct research when entering the hospital, on the 9th-10th day (in patients inapparently forms and acute respiratory diseases, lung flow) and 12-14 days before discharge in patients with moderate and severe course of the infectious process.
ABSTRACT
AIM: In this study we evaluated the effects of Riamilovir on SARS-CoV-2 viral shedding and on admission duration in patients with moderate COVID-19. MATERIALS AND METHODS: We have used data from 69 health records of patients with moderate severe PCR confirmed SARS-CoV-2 infection. Control group included 34 patients treated with off-label riamilovir 1250 mg per day for 5 days (250 mg 5 times a day), comparison groups 35 patients, who received ribavirin and umifenovir 800 mg a day for 5 days. The antiviral therapy was administered within 72 hours from the onset of the disease. The primary endpoints were elimination of virus in oropharyngeal and nasopharyngeal swabs on 7 day of admission and discharge from the hospital by 14 day. RESULTS: Patients assigned to riamilovir had significantly shorter time to clinical improvement as well as increased PCR negative rate by day 7. CONCLUSION: Yearly administration of riamilovir as opposed to the umifenovir and ribavirin in therapy of moderate SARS-CoV-2 infection was associated with significant shorter time to clinical improvement by 14 day of hospitalization. PCR negative rate by 7 days of hospitalization is significantly more likely in riamilovir group.