Atovaquone for Treatment of COVID-19 (Ataq COVID-19) Trial

Background. Our group performed an in-silico screen to identify FDA approved drugs that inhibit SARS-C0V-2 main protease (Mpro), followed by in vitro viral replication assays, and in vivo pharmacokinetic studies in mice. These studies identified atovaquone as a promising candidate for inhibiting viral replication. Methods. Enrolled patients were randomized in a 2:1 fashion to atovaquone 1500 mg twice daily versus matched placebo. Patients received standard of care treatment including remdesivir, dexamethasone, or convalescent plasma as deemed necessary by the treating team. Patients agreed to allow collection of saliva at baseline and twice a day while hospitalized or up to 10 days. Saliva was collected and RNA extracted for viral load (VL) measurement by Real-time PCR. Our primary outcome was to examine the between group differences in log transformed VL(copies/mL) using generalized linear mixed-effect models of repeated measures from all samples. Additional analysis of Atovquone plasma concentrations were examined and correlated with viral load and body mass index (BMI). Results. Of the 61 patients enrolled;41 were received atovaquone and 19 placebo. Overall the population was predominately male Hispanic with a mean age of 51 years. The two groups were balanced (Table 1) with regard to age, gender, race, co-morbidities, days from onset of symptoms, baseline oxygen requirements, and receipt of COVID-19 specific standard of care treatment. A higher proportion with diabetes was noted in the Atovaquone arm. The log10 VL was 5.25 copies/mL vs. 4.79 copies/mL at baseline in the atovaquone vs. placebo group. Although there was a decrease in VL over time, there was no differences between the atovaquone plus standard of care arm versus the standard of care arm (Figure 1). Additional analysis of atovaquone plasma concentration demonstrated a wide variation in atovaquone levels, inverse association between atovaquone levels and BMI (rho -0.44, p=0.03), and Day 5 concentrations and VL (rho -0.54, p=0.005). Conclusion. Although atovaquone showed promising in vitro antiviral properties for COVID-19, in this pilot study we did not detect a change in VL in patients who received atovaquone compared to placebo, possibly due to failure of patients achieve adequate drug levels.

Reshaping HRD in Light of the COVID-19 Pandemic: An Ethics of Care Approach

The Problem The COVID-19 pandemic has shone a stark light on workplace inequities and injustices. Aside from disrupting daily routines and ways of working, the pandemic has unmasked significant and troubling differences in the treatment and status of productive and reproductive labor. As we recover from the pandemic, how can workplaces properly recognize and value the contribution of reproductive labor? The Recommendation We focus on ethics of care as a foundational aspect of learning and human development. Care is proximal and contextual and expressions of care require managers and HRD professionals to engage with and address employees' needs in a way that recognizes the complexity of individual situations. This may lead to the transformation of work and workplaces and bring employees into a more participatory, inclusive and democratic relationship with employers. We offer four suggestions for how HRD practitioners can practically embed an ethics of care approach within organizations. The Stakeholders This article is relevant to human resource development (HRD) scholars and practitioners who are interested in building sustainable, caring and healthy workplaces in a post-pandemic world.