Comparative analysis between Polymerized Type I Collagen (Fibroquel) and Baricitinib as a potential treatment for moderate-severe COVID-19 in outpatients and inpatients

Baricitinib is a treatment authorized by the FDA for the treatment of moderate to severe COVID-19, despite this there are few approved drugs;polymerized type I collagen (PTIC) is a drug that has been used in Mexico with great potential for treating moderate to severe cases of COVID-19. METHODS Comparative, descriptive, and retrospective analysis of two populations of adult patients affected by COVID-19 confirmed by antigen test or RT-PCR as well as CO-RADS 6 CT, who consented to be treated between 2020 and 2021, a population using oral baricitinib at a dose of 4mg/day/14 days and another using polymerized type I collagen intramuscularly at a dose of 1.5ml every 12 hours for 3 days, followed by 1.5ml every 24 hours for 4 days;The most affected age and gender, comorbidities and laboratory abnormalities are analyzed, as well as improvement in inflammatory and oxygenation indices measured by pulse oximetry and SAFI (SpO2/FiO2), finally the outcome of the patients and the presence of adverse events. RESULTS 80 patients for each group, the most affected gender was male;the average age in the PTIC group was 51 years and in the baricitinib group it was 56 years;the main comorbidities were obesity, diabetes, and hypertension in both groups;the decrease in acute phase reactants such as CRP, D-dimer and ferritin was greater in the PTIC group compared to the baricitinib group, the latter drug requiring a regimen of more days to achieve the objectives of the first drug (PTIC 7 days and baricitinib 14 days);Similarly, in oxygenation measured, the PTIC group reached goals in less time compared to the baricitinib group, which required twice as many days of treatment to achieve adequate oxygenation;Regarding the outcomes, there was higher mortality in the baricitinib group compared to the PTIC group (6.25% vs 3.75%). Regarding adverse events reported for the PTIC group, they were minor and related to the intramuscular administration of the drug in 7 patients, while in the baricitinib group, 5 patients were reported with added bacterial pneumonia. CONCLUSION Polymerized type I collagen has anti-inflammatory and immunomodulatory potential similar to baricitinib in cases of moderate to severe COVID-19, even reaching treatment goals in less time both in inflammatory indices and in oxygenation indices

Non-invasive oxygen therapy in patients with COVID-19: wu ji bi fan: too much of something is not good

In clinical practice, oxygen can save lives, although, wu ji bi fan: too much of something is not good and it can also cause toxicity;14% of patients with coronavirus disease 2019 (COVID-19) will need non-invasive oxygen therapy and approximately 5% will require invasive mechanical ventilation (IMV). Noninvasive oxygen therapy is the first-line treatment for patients with hypoxemic acute respiratory failure secondary to COVID-19. The devices through which this therapy is administered can be classified into low flow and high flow. In the presence of acute hypoxemic respiratory failure, the necessary flow can be 30 to 120 L/min, a number that cannot be achieved with conventional systems (low flow), therefore, high-flow devices can be effective in well-selected patients, the aim is to improve oxygenation, avoid orotracheal intubation of the patient, but without delaying it. Noninvasive oxygen therapy does not increase the risk of aerosol infection. (English) [ FROM AUTHOR]

Glycosylated hemoglobin as a predictor of mortality in severe pneumonia by COVID-19.

OBJECTIVE: Determine whether the levels of glycated hemoglobin (HbA1c) measured on admission to the intensive care unit (ICU) are associated with mortality in patients with severe SARS-CoV-2 pneumonia with invasive mechanical ventilation. DESIGN: Cohort study, retrospective, observational. A single center. PLACE: ICU of a second-level care hospital. PATIENTS: Severe SARS-CoV-2 pneumonia confirmed with IMV since admission to the ICU. INTERVENTIONS: none. RESULTS: A total of 56 patients with severe pneumonia, confirmed with SARS-CoV-2, all with IMV. The group with HbA1c <6.5% included 32 (57.14%) patients and the group with HbA1c ≥6.5% included 24 (42.86%) patients and the mortality rate in ICU was 43.8% and 70.8%, respectively, with p = 0.04. Predictors of mortality at 28 days in ICU were DHL >500 U/L, OR 3.65 (95% CI 1.18-11.29), HbA1c ≥6.5%, OR 3.12 (95% CI 1.01-9.6), SAH, OR 3.12 (95% CI 1.01-9.5), use of vasopressor, OR 0.2 (95% CI 0.05-0.73), diabetes was not statistically significant. CONCLUSION: The 28-day probability of survival in patients with severe SARS-CoV-2 pneumonia with IMV in the ICU is lower when the HbA1c level is ≥6.5% on admission.