COVID-19 as a turning point in the need for specialized units for the sense of smell

Background: The unprecedented prevalence of olfactory disfunction (OD) by SARS-CoV- 2 has revealed the lack of specialized units dealing with sense of smell. The main objective of the study is to know the number of newly created olfactory units (OU) since the COVID-19 pandemic, as well as to evaluate the diagnosis, management and treatment of patients with OD. Method(s): Prospective cross-sectional study. Carried out by means of a survey with 20 items: having or not having an OU, demographic data, smell test, evolution and management of OD, data on treatments. The variables of the survey were approved by the rhinology commission of the Spanish society of ENT. The digital survey was distributed to all members of Spanish ENT and Allergy Societies. Result(s): A total of 16 responses were missing data, and further 12 responses were duplicated. Finally, 136 surveys were included. From them 82.4% answers were from otolaryngologists and 17.7% from allergists. The cohort of allergists and otolaryngologists was compared to ensure comparability of both samples. There were significant differences in the instrumental assessment of the olfaction, VAS and smell test (p = 0.016) was more common in otolaryngologists. Also, the prescription of olfactory rehabilitation (OR) (p < 0.001) was more common in otolaryngologists. The 40.5% (+/- 7.6) of all the existent OU were created after COVID-19 pandemics. The 33.9% (+/- 4.5) of the respondent have an OU now, while 22.3% (+/- 3.9) already had it before COVID-19 pandemics. It means that 17% of hospitals who did not have an OU before COVID-19, now they have it, while 82.8% are still lacking it. OR was prescribed for 1-3 months by 38%;3-6 months by 48.1% and > 6 months by 13.9%. Those with an OU prescribe OR during more time (p = 0.002) being the most frequent answer 3-6 months (69.4%) when they have OU while 1-3 months (52.4%) for those who do not have it. Conclusion(s): This study revealed that COVID-19 pandemic has stimulated the creation of OU and has demonstrated the utility of OU to deal with patients with OD, as their daily practice is more adapted to up-to- date clinical evidence between allergist and otolaryngologists.

Convenient Synthesis of Ellagic Acid from Methyl Gallate and SARS-CoV-2 3CLpro Antiviral Activity

A practical synthesis of ellagic acid has been achieved from methyl gallate by a proposed synthetic route of five steps, consisting of ketal protection, regioselective bromination, bis-lactonization, C-C bond formation between the aromatic rings of the galloyl groups, and ketal deprotection, in 38% overall yield. Ellagic acid showed a slight inhibitory activity against SARS-CoV-2 3CLpro. © 2022. Thieme. All rights reserved.

A convenient synthesis of ellagic acid from methyl gallate and SARS-CoV-2 3CLpro antiviral activity

A practical synthesis of ellagic acid has been achieved from methyl gallate ester by a proposed synthetic route of five steps, ketal protection, regioselective bromination, bis-lactonization, C-C bond formation between the aromatic rings of galloyl groups, and ketal-deprotection in 38% overall yield. Ellagic acid showed a slight inhibitory activity on the SARS-CoV-2 eCLpro protease. © 2022 Georg Thieme Verlag. All rights reserved.

Baricitinib in Patients with Severe Pneumonia due to COVID-19 in Veracruz, Mexico

Background. Patients affected by COVID-19 pneumonia who present severe symptoms with manifest hypoxemia and cytokine storm have a high mortality rate, which is why therapies focused on reducing inflammation and improving lung function have been used, one of them being jakinibs through of the blocking of the JAK tracks. Methods. Patients who presented data of severe pneumonia due to COVID-19 with data of severe hypoxemia and cytokine storm were selected, from June to August 2020, to whom the SaO2/FiO2 ratio is measured at the beginning, intermediate and end of treatment, as well as D dimer and serum ferritin. Comorbidity and drugs taken previously are analyzed. The patients being cared for at home. Results. We included data from 30 patients, 8 (27%) women and 22 (73%) men, with a median age of 58.5 (46.5 - 68.0) years. 23 patients (77%) had comorbidities, the most frequent being arterial hypertension (43%), followed by obesity (30%), type 2 diabetes mellitus (27%), among others. In the laboratory, the medians of D-Dimer 982 ng/ mL, Ferritin 1,375 ng/mL and C-Reactive Protein 10.0 mg/dL. Regarding the use of previous medications, we found that 29 (97%) patients had treatment with some medication, the most frequent: azithromycin (77%), ivermectin (53%) and dexamethasone (47%). The median number of medications received was 3. The initial pulse oximetry (SaO2) measurement with room air had a median of 80.5% and the median SaO2/FiO2 (SAFI) was 134;Regarding the type of SIRA, 90% had moderate SIRA and 10% had severe SIRA. The median day of evolution on which baricitinib was started was 10 days, all received 4 mg/day, and the median days of treatment with baricitinib was 14.0 days. At follow-up, SaO2 at 7 days had a median of 93.0% and the median SAFI at 7 days was 310.0;the median SaO2 at 14 days was 95.0% and the median SAFI at 14 days was 452.0. In comparative analysis, baseline SaO2/SAFI was significantly lower compared to 7 and 14 days (p = 0.001 for both comparisons). The outcomes, 27 (90%) patients improved and there were 3 (10%) who died. Conclusion. Baricitinib therapy in these patients with severe COVID-19 pneumonia who present with severe hypoxemia and cytokine storm presented good results by improving clinical status and pulmonary failure, with patients being cared for at home and avoiding mechanical ventilation.