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1.
Caspian J Intern Med ; 12(Suppl 2): S474-S478, 2021.
Article in English | MEDLINE | ID: covidwho-1405579

ABSTRACT

BACKGROUND: Little is known about the development of acute pancreatitis as a complication of corona virus disease of 2019 (COVID-19) infection. This case report describes the presentation of acute pancreatitis in a young woman who then was diagnosed with COVID-19 infection. CASE PRESENTATION: An 18-year old previously healthy woman referred to Imam Raza hospital, Tabriz, Iran with a 3-day history of intermittent and crampy abdominal pain. She had serum amylase of 1288 IU/L and serum lipase of 1541 IU/L. She was diagnosed with acute pancreatitis. She was instructed nil per os (NPO) and serum therapy and also was given pantoprazole, and pethidine for her pain management. The laboratory tests for assessing the etiology of acute pancreatitis were normal. Abdominal and pelvic spiral computed tomography (CT) scan revealed edematous pancreas and enhancing loculi fluid accumulation around pancreas along with the small amount of ascites fluid that all suggest acute pancreatitis. Due to the presentation of fever and COVID-19 pandemic and her potential society exposure, we tested SARS CoV-2 by polymerase chain reaction which was positive. The blood C-reactive protein (CRP) level was 3+ but the chest x-ray showed no findings compatible with COVID-19. Eventually after receiving conservative therapy for her pancreatitis, she was discharged from hospital in the good general condition and she has not experienced any episodes of abdominal pain again. CONCLUSION: This case highlights acute pancreatitis as a suspected complication associated with COVID-19 and the need for further research.

2.
Int Immunopharmacol ; 95: 107522, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1385749

ABSTRACT

BACKGROUND: We examined the safety and efficacy of a treatment protocol containing Favipiravir for the treatment of SARS-CoV-2. METHODS: We did a multicenter randomized open-labeled clinical trial on moderate to severe cases infections of SARS-CoV-2. Patients with typical ground glass appearance on chest computerized tomography scan (CT scan) and oxygen saturation (SpO2) of less than 93% were enrolled. They were randomly allocated into Favipiravir (1.6 gr loading, 1.8 gr daily) and Lopinavir/Ritonavir (800/200 mg daily) treatment regimens in addition to standard care. In-hospital mortality, ICU admission, intubation, time to clinical recovery, changes in daily SpO2 after 5 min discontinuation of supplemental oxygen, and length of hospital stay were quantified and compared in the two groups. RESULTS: 380 patients were randomly allocated into Favipiravir (193) and Lopinavir/Ritonavir (187) groups in 13 centers. The number of deaths, intubations, and ICU admissions were not significantly different (26, 27, 31 and 21, 17, 25 respectively). Mean hospital stay was also not different (7.9 days [SD = 6] in the Favipiravir and 8.1 [SD = 6.5] days in Lopinavir/Ritonavir groups) (p = 0.61). Time to clinical recovery in the Favipiravir group was similar to Lopinavir/Ritonavir group (HR = 0.94, 95% CI 0.75 - 1.17) and likewise the changes in the daily SpO2 after discontinuation of supplemental oxygen (p = 0.46) CONCLUSION: Adding Favipiravir to the treatment protocol did not reduce the number of ICU admissions or intubations or In-hospital mortality compared to Lopinavir/Ritonavir regimen. It also did not shorten time to clinical recovery and length of hospital stay.


Subject(s)
Amides/administration & dosage , Amides/adverse effects , Antiviral Agents/administration & dosage , Antiviral Agents/adverse effects , COVID-19/drug therapy , Pyrazines/administration & dosage , Pyrazines/adverse effects , Adolescent , Adult , Aged , Aged, 80 and over , Drug Therapy, Combination , Female , Humans , Hydroxychloroquine/administration & dosage , Hydroxychloroquine/adverse effects , Intubation , Kaplan-Meier Estimate , Length of Stay , Lopinavir/administration & dosage , Lopinavir/adverse effects , Male , Middle Aged , Oxygen/blood , Ritonavir/administration & dosage , Ritonavir/adverse effects , Severity of Illness Index , Treatment Outcome , Young Adult
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