ABSTRACT
The current outbreak of COVID-19 is caused by the SARS-CoV-2 virus that has affected > 210 countries. Various steps are taken by different countries to tackle the current war-like health situation. In India, the Ministry of AYUSH released a self-care advisory for immunomodulation measures during the COVID-19 and this review article discusses the detailed scientific rationale associated with this advisory. Authors have spotted and presented in-depth insight of advisory in terms of immunomodulatory, antiviral, antibacterial, co-morbidity associated actions, and their probable mechanism of action. Immunomodulatory actions of advised herbs with no significant adverse drug reaction/toxicity strongly support the extension of advisory for COVID-19 prevention, prophylaxis, mitigations, and rehabilitation capacities. This advisory also emphasized Dhyana (meditation) and Yogasanas as a holistic approach in enhancing immunity, mental health, and quality of life. The present review may open-up new meadows for research and can provide better conceptual leads for future researches in immunomodulation, antiviral-development, psychoneuroimmunology, especially for COVID-19.Copyright © 2021, Institute of Korean Medicine, Kyung Hee University.
ABSTRACT
Coronavirus 19 (COVID-19) may cause a cytokine release syndrome inducing the severity of the disease. Various immune modulating agents are suggested due to the lack of definitive treatment and vaccine. In this case report, we aimed to share the clinical course of a Covid 19 patient who was given tocilizumab (TCZ) for severe ARDS on the 5th day of hospitalization. Although, the patient was extubated 12 days after TCZ treatment with a rapid recovery, we believe that more cases are needed to determine the efficiency and timing of TCZ treatment.Copyright © 2020 Necati Ozpinar. All rights reserved.
ABSTRACT
Background: Despite its widespread usage, invasive positive pressure ventilation (IPPV) has a dismal track record in COVID-19 patients with SARDS. Currently, there is a paucity of evidence supporting the usefulness of noninvasive positive pressure ventilation (NIPPV) in the treatment of severe ARDS, as well as a significant risk of aerosol formation in patients with COVID-19 infection. Objective(s): This study aims to assess the efficacy and safety of NIPPV administration to COVID-19 patients. Method(s): The trial included 130 participants with moderate tosevere ARDS based to the Berlin criteria (PaO2/FiO2 ratio of 200mmHg, GCS > 13, respiratory breathing index (RBI) of 105, and no systemic issues). They were treated with NIPPV with awake proaning up to 12 hours per day at a hospital in Muzaffarabad. The addition of a heat and moisture exchanger (HME) and viral/bacterial filters to the expiratory limb of the ventilator circuit represented a minor improvement. Result(s): In an average of six days, the PaO2/FiO2 ratio indicates that the severity of ARDS has improved from moderate/severe to mild in 64 percent of patients. 36 percent of individuals who had a defined airway experienced IPPV or failure of NIV. During the study period, 1 % the of healthcare workers (HCW) were infected with COVID19. The delivery of NIPPV was associated with claustrophobia, nasal crusting, aspiration, and barotrauma (0.7 percent). Conclusion(s): In selected patients, NIV with awake proaning up to 12 hours per day can be employed to give respiratory support without the need for IPPV, hence eliminating the need for IPPV in those patients. However, larger-scale investigations are required to validate our findings. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.