ABSTRACT
Purpose: Our group demonstrated the safety, efficacy, and antiviral effect of intranasally administered Chlorpheniramine Maleate (CPM) for treating coronavirus disease 2019 (COVID-19). Since the nasal cavity is the portal of entry for COVID pathogens, sensory and upper respiratory symptoms (URS) (e.g., cough, ageusia, anosmia, nasal congestion, etc.) are significant symptoms in the course of the disease. Intranasal therapies could alleviate the disease-induced URS faster. This study evaluated the effectiveness and safety of intranasal CPM for treating mild to moderate COVID-19-induced URS in the outpatient setting. Methods: The two-part Accelerating COVID-19 Clinical Recovery in an Outpatient Setting (ACCROS) research study was conducted to collect evidence from a randomized, double-blinded placebo-controlled trial (ACCROS-I). Both parts enrolled patients with mild to moderate COVID-19 confirmed by reverse transcription-polymerase chain reaction. The primary endpoint in ACCROS-I was time to clinical recovery, defined as the change from baseline to day 7 in COVID-19 symptoms reported as the percent change (Δ%) in the daily symptoms score (DSS) and the severity of the disease symptoms using a visual analog scale (VAS), on a scale of 1-10 (10=worst symptoms). COVID-19 patients (n = 101) were recruited and assigned to either a 10-day CPM treatment (n=61) or placebo (PLB) (n=40) in addition to standard of care (SoC). Secondary endpoints included the incidence of hospitalization and the proportion of patients with URS on day 7. ACCROS-II data were collected from medical records of COVID-positive subjects using a standardized form. Cohorts of patients treated with CPM and SoC (CPM+Soc) were compared for the duration of general symptoms and URS. Patient information was collected as part of routine visits and telehealth consultations. Results ACCROS-I: There was a statistically significant difference in the rate of clinical recovery (P<0.05) in Δ%DSS (M -18.8±SEM 7.9%) and Δ%VAS (-8.6±5.1%), such that the CPM group reported fewer symptoms than PLB. The proportion of patients who reported sensory deficits and URS at day 7 was significantly lower (P<0.05) in CPM vs. PLB for ageusia (1.7% vs. 15.0%), cough (16.4% vs. 35.0%) and nasal congestion (8.1%vs.20%). None of the patients required hospitalization. ACCROS-II: There was a statistically significant reduction (P<0.05) in total days reporting URS for general symptoms of COVID-19 in CPM+SoC (5.1 ± 0.1) compared to SoC (11.0 ± 0.2). CPM+SoC users also showed fewer days with cough, anosmia, and ageusia. Persistent anosmia (over 29 days) was found in 3% of the patients on SoC, whereas no persistent anosmia was reported in the CPM+SoC cohort (X2 = 10.18; P<0.001). Conclusion: The result of this two-part study supports the conclusion that intranasal CPM is an antiviral agent that can be administered intranasally to treat COVID-19-induced symptoms effectively. Intranasal CPM accelerates clinical recovery and reduces URS in patients with mild to moderate COVID-19. This study's important implications include individuals returning to daily life faster, reducing community and individual economic burden, and decreasing healthcare utilization. Trial registration: ClinicalTrials.gov.; ID: NCT05449405 ACCROS-I retrospectively registered on 7/13/2022, NCT05520944 ACCROS-R retrospectively registered on 08/27/2022.
Subject(s)
COVID-19ABSTRACT
Chlorpheniramine Maleate (CPM), also known as chlorphenamine, is a potent alkylamine first-generation H1 antihistamine that has been around since the 1950s. CPM is a widely popular drug commonly used to treat allergic conditions, given its antihistamine properties. Although mainly used in over-the-counter treatment for cough and colds, various studies discuss a wide range of CPM's clinical uses, such as treating asthma, plasma cell gingivitis, chronic urticaria, depression, among others. This antihistamine is usually taken orally; however, intravenous, intramuscular, and subcutaneous routes have been documented. Intranasal routes have recently been explored, especially due to its antiviral properties against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Accordingly, given CPM's extensive medical and safety profile, the present review explores this versatile drug's current and potential clinical applications. Although it is widely used mainly for treating common colds and aforementioned allergic conditions, it can be concluded that CPM can be considered to be used for other clinical indications. The repurposing of CPM for other clinical indications such as COVID-19 needs to be further explored through more extensive studies.
ABSTRACT
Social media is a source of big data. Media like Twitter and Facebook has been used for collecting and analyzing user data for different purposes. The data can be used to analyze people opinions towards certain topics and incidents by applying sentiment analysis and then certain useful insights can be drawn from the analyzed data. During the current time of Covid-19, people have been sharing information regarding Covid-19 statistics, vaccines, and discussing the effects of the vaccine concerning public health. The purpose of this study is to analyze tweet data regarding the Covid-19 vaccine by applying sentiment analysis and predicting the impact of the vaccine on public health. Also, the tweets are analyzed for hidden topics by applying Topic Modelling using Latent Dirichlet Allocation (LDA) and Latent Semantic Analysis (LSA). The source of data for this study is Twitter API. The coding and data analysis is done using Python programming language in the Spyder (Scientific Python Development Environment) that is an integrated development environment for scientific programming, testing, and data analysis. The results of the study indicate a greater positive sentiment reflecting a healthy public discussion about the Covid-19 vaccine, information, awareness, and public acceptance. With these results, a positive impact of the Covid-19 vaccine on public health is predicted. The results of topic modeling discovered 10 hidden topics from the tweet dataset. © 2022. All Rights Reserved.
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COVID-19 and its consequential impact on the economic fundamentals are highly discussed topics among the researchers. However, there is a literature void in the context of the Indian commodity and financial markets. To bridge this gap, the current study tried to investigate the influence of COVID-19 on the Indian commodity and financial markets by taking the data of the National Stock Exchange of India representing financial markets and the gold prices & oil prices representing commodity markets. The data were segregated into three-time lines, that is, whole period (April 1, 2020 – April 10, 2021), first wave (June 6 – September 30, 2020), and second-wave (February 2 – April 10, 2021) and to investigate the above relationship, the autoregressive distribution lag (ARDL) approach was employed. The findings suggested that during the whole period of the study and the first wave, coronavirus spread had a significant negative influence on the oil prices and the stock market. However, the impact was significant and positive for gold prices. The Wald test also confirmed a long-run cointegration among the variables in both periods of the study. In the context of the second wave, the study contradicted the above findings and concluded that during the second wave, the spread of COVID-19 cases had a positive impact on oil prices and stock markets;whereas, there was a negative impact on the gold prices. The findings highlighted the issue of uncertainty of pandemic, symmetry, demand theory and also highlighted the inverse relationship of gold and equity instruments, which will help in making appropriate policy-oriented decisions. © 2021, Associated Management Consultants Pvt. Ltd.. All rights reserved.
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With the increase in the pace of globalization, SMEs are facing stiff competition from multinational firms. The entrepreneurs owning SMEs have fewer funds, but they need to improve the output of their organizations. Technology adoption can help owners of SMEs to match up with the pace of multinational firms because it can increase their reach and improve overall performance. In this paper, the authors will discuss whether online resource adoption (social media, e -commerce, technology 4.0) will enhance the marketing standard of small and medium enterprises or not. SMEs can achieve economies of scale because of the prominent usage of technology. The findings of this paper will help owners/managers of Indian SMEs to understand the use of online resources in improving marketing within a limited budget. COVID -19 has also pushed all the organizations towards the usage of technology. Either big or small organizations, none of them can ignore the use of technical sources for marketing in this digital era. © 2021 Australasian College of Health Service Management. All Rights Reserved.
ABSTRACT
While the Coronavirus Disease 2019 (COVID-19) pandemic continues to wreak havoc across the nation and the globe as one of the most significant global health crises of our time, recent attention has been turned to the effects of COVID-19 on pregnancy and the puerperium. Although most cases have been asymptomatic, for some patients, the disease may be accompanied by serious complications such as pneumonia, acute respiratory distress, multi organ failure, and death. Several case studies have noted that patients with co-morbidities are at a significant risk of these complications. In a recent systematic review and meta-analysis, authors conclude that cardiovascular disease was associated with increased composite poor outcome in patients with COVID-19. The following case report highlights the multi-system complications and severity of symptoms that can take place after childbirth in a patient with co-morbid obstetric and prenatal conditions and an initially asymptomatic COVID-19 infection.
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INTRODUCTION: SARS-CoV-2 (COVID-19) is a novel coronavirus that emerged in Wuhan, China in late 2019 and since become a global pandemic. As such, its clinical behaviour is a subject of much interest. Initial reports suggested a significant proportion of patients have abnormal liver blood tests. Gwent has experienced one of the highest incidences of COVID-19 infection in the UK, which itself has among the highest COVID-19 impacts worldwide. METHOD: We set out to report the incidence, clinical pattern and severity of liver blood test abnormalities in hospitalised patients with confirmed COVID-19 in our institution over a 3-week period. Data on clinical outcomes such as admission to intensive therapy unit (ITU), hospital discharge and mortality were recorded. RESULTS: 318 hospitalised COVID-19 positive had liver blood tests available for analysis. Ninety-seven patients (31%) had one or more abnormal liver blood tests and were abnormal admission in 64%. Liver tests were predominantly cholestatic (72%) in contrast to other studies to date. Male gender and abnormal liver blood tests were associated with ITU admission. CONCLUSIONS: Almost one-third of admissions with COVID-19 have abnormal LBTs which are typically mild and are associated with male gender. Importantly, we have identified that cholestatic patterns dominate but were not clearly associated with ITU admission or death.
ABSTRACT
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the coronavirus responsible for our recent coronavirus disease 2019 pandemic, is driving a lung immunopathology that strongly resembles a severe form of hypersensitivity pneumonitis (HP). A review of recent Severe acute respiratory syndrome-related coronavirus (SARS-CoV) and SARS-CoV-2 medical reports, as well as described characteristics of HP, lead us to postulate a theory for SARS-CoV-2 severe disease. We propose that the novel SARS-CoV-2 can act as a trigger and substrate of an HP-like severe immune reaction especially in genetically vulnerable individuals in addition to those with immune senescence and dysregulation. Accordingly, the purpose of our letter is to shift the emphasis of concern surrounding immune activity from viral infection to an HP-like severe immune reaction. We review similarities in disease presentation between infection and allergy, relevant immunopathology, and outline phases of SARS-CoV-2 disease with perspectives on therapy and critical care. Altogether, the favored course is to begin treatments that address the disease at the earliest phase before immune dysregulation leading to uncontrolled pulmonary inflammation.