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1.
Embase; 2022.
Preprint in English | EMBASE | ID: ppcovidwho-335156

ABSTRACT

Sublineages of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) Omicron variants continue to amass mutations in the spike (S) glycoprotein, which leads to immune evasion and rapid spread of the virus across the human population. Here we demonstrate the susceptibility of the Omicron variant BA.1 (B.1.1.529.1) to four repurposable drugs, Methylene blue (MB), Mycophenolic acid (MPA), Posaconazole (POS), and Niclosamide (Niclo) in post-exposure treatments of primary human airway cell cultures. MB, MPA, POS, and Niclo are known to block infection of human nasal and bronchial airway epithelial explant cultures (HAEEC) with the Wuhan strain, and four variants of concern (VoC), Alpha (B.1.1.7), Beta (B.1.351), Gamma (B.1.1.28), Delta (B.1.617.2) (1, 2). Our results not only show broad anti-coronavirus effects of MB, MPA, POS and Niclo, but also demonstrate that the Omicron variant BA.1 (B.1.1.529.1) sheds infectious virus from HAEEC over at least 15 days, and maintains both intracellular and extracellular viral genomic RNA without overt toxicity, suggesting viral persistence. The data underscore the broad effects of MB, MPA, POS, and Niclo against SARS-CoV-2 and the currently circulating VoC, and reinforce the concept of repurposing drugs in clinical trials against COVID-19.

2.
SSRN; 2022.
Preprint in English | SSRN | ID: ppcovidwho-334535

ABSTRACT

Background: A booster dose of COVID-19 vaccine is required to prolong immune persistence and strengthen the protection against variants. Therefore, we assessed the safety and immunogenicity of homologous boosting with an inactivated vaccine (CoronaVac), as well as the cross-neutralising activity against the Omicron variant in children and adolescents aged 3-17 years. Methods: In the phase 2 clinical trial, in Hebei province, China, participants aged 3-17 years were initially assigned (2:2:1) to a 1.5 μg dose or 3.0 μg dose of CoronaVac or a placebo group. Following a protocol amendment on September 13, 2021, half of the participants (cohort 1) in vaccine group received a booster dose 10 months (window period 30 days) after dose 2, and the other half of the participants (cohort 2) received a booster dose 12 months (window period 30 days) after dose 2. Participants in placebo groups withdrew from the study since the emergency use of COVID-19 vaccine in children and adolescents. The main outcomes of the study were geometric mean titres (GMTs), geometric mean increases (GMIs), and seropositivity rate of neutralising antibody to the live prototype SARS-CoV-2 at baseline, 28 days, 3 months, 6 months, 10 months, 12 months after dose 2 and at 28 days after dose 3. The cross-neutralising immunity against the SARS-CoV-2 Omicron (B.1.1.529) variant was detected, and the primary safety endpoint was adverse reactions within 28 days after the third dose. The trial is ongoing and registered with ClinicalTrials.gov, NCT04551547. Findings: 171 participants in cohort 1 (89% of the 192 participants) received a third dose 10 months after dose 2. By 10 months after dose 2, the GMTs of neutralising antibody against the prototype SARS-CoV-2 strain was down to 12.7 (95% CI 10.4-15.5) and 20.8 (95% CI 16.5-26.1) in the 1.5 μg group and 3.0 μg group, respectively. A third dose of CoronaVac increased GMTs to 597.7 (452.4-789.6) in the 1.5 μg group and 681.0 (545.2-850.7) in the 3.0 μg group. Seropositivity rates against the prototype in both groups were 100% at 28 days after dose 3. The GMTs of cross-neutralising antibody against the Omicron variant was 23.6 (17.7-31.4) in the 1.5 μg group and 34.5 (27.2-43.7) in the 3.0 μg group on 28 days after dose 3. Seropositivity rates against the Omicron variant were 77.6% (1.5 μg group) and 90.6% (3.0 μg group). 175 participants in cohort 2 (91% of the 192 participants) received a third dose 12 months after the dose 2. By 12 months after dose 2, the GMTs of neutralising antibody against the prototype was down to 16.8 (13.3-21.3) and 21.7 (18.1-26.0) in the 1.5 μg group and 3.0 μg group, respectively. A third dose of CoronaVac increased GMTs to 462.4 (364.4-586.6) in the 1.5 μg group and 745.2 (577.0-962.3) in the 3.0 μg group. Seropositivity rates against the prototype in both groups were 100% at 28 days after dose 3. The GMTs of cross-neutralising antibody against the Omicron variant was 24.0 (18.0-32.2) in the 1.5 μg group, and 40.0 (30.7-52.3) in the 3.0 μg group at 28 days after dose 3. Seropositivity rates against the Omicron variant were 78.8% (1.5 μg group) and 91.5% (3.0 μg group). Severities of local and systemic adverse reactions reported within 28 days after dose 3 were mild and moderate in both cohorts. The most commonly reported reactions were injection-site pain (14 [4.1%] participants) and fever (5 [1.5%] participants). Only one (0.3%) of 346 participants reported serious adverse events within 28 days after dose 3 were mild and moderate in both cohorts. The most commonly reported reactions were injection-site pain (14 [4.1%] participants) and fever (5 [1.5%] participants). Only one (0.3%) of 346 participants reported serious adverse events within 28 days after dose 3. Interpretation: A third dose CoronaVac in children and adolescents inoculated 10 months or 12 months after dose 2 induced a robust immune anamnestic response to the prototype SARS-CoV-2, which remarkably increased the neutralising antibody titres and had a cross-neutralising immunity against the Omicron variant. Boosting with CoronaVac is safe and might have considerable neutralising potency against the Omicron variant in children and adolescents. Clinical Trial Registration Details: NCT04551547

3.
Chest ; 2021 Nov 14.
Article in English | MEDLINE | ID: covidwho-1828073

ABSTRACT

BACKGROUND: There is no pharmacologic treatment for ARDS. Platelets play an important role in the pathophysiology of ARDS. Preclinical, observational, and clinically relevant models of ARDS indicate aspirin as a potential therapeutic option. RESEARCH QUESTION: Is enteral aspirin (75 mg, once daily) safe and effective in improving surrogate outcomes in adult patients with ARDS? STUDY DESIGN AND METHODS: This randomized, double-blind (patient and investigator), allocation-concealed, placebo-controlled phase 2 trial was conducted in five UK ICUs. Patients fulfilling the Berlin definition of ARDS were randomly assigned at a 1:1 ratio to receive enteral aspirin (75 mg) or placebo, for a maximum of 14 days, using a computer-generated randomization schedule, with variable block size, stratified by vasopressor requirement. The primary end point was oxygenation index (OI) on day 7. Secondary outcomes included safety parameters and other respiratory physiological markers. Analyses were by intention to treat. RESULTS: The trial was stopped early, due to slow recruitment, after 49 of a planned 60 patients were recruited. Twenty-four patients were allocated to aspirin and 25 to placebo. There was no significant difference in day 7 OI [aspirin group: unadjusted mean, 54.4 (SD 26.8); placebo group: 42.4 (SD 25); mean difference, 12.0; 95% CI, -6.1 to 30.1; P = .19]. Aspirin did not significantly impact the secondary outcomes. There was no difference in the number of adverse events between the groups (13 in each; OR, 1.04; 95% CI, 0.56-1.94; P = .56). INTERPRETATION: Aspirin was well tolerated but did not improve OI or other physiological outcomes; a larger trial is not feasible in its current design. TRIAL REGISTRATION: ClinicalTrials.gov; No.: NCT02326350; URL: www. CLINICALTRIALS: gov.

4.
Indian Journal of Otolaryngology & Head & Neck Surgery ; : 1-10, 2022.
Article in English | Academic Search Complete | ID: covidwho-1827066

ABSTRACT

To assess the virucidal effect of povidone iodine (PVP-I) on severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) located in the nasopharynx and suitable dose-formulation for nasal application were the purpose of this clinical trial. This single-center, open-label randomized clinical trial with a 7-arm parallel-group design was conducted in Dhaka Medical College (DMC) Hospital. A total of 189 reverse transcription-polymerase chain reaction (RT-PCR)-confirmed SARS CoV-2 positive cases aged 12–90 years with symptoms was sequentially enrolled following randomization. Nasopharyngeal clearance of SARS-CoV-2 was tested against PVP-I nasal irrigation (NI) at diluted concentrations of 0.4%, 0.5% and 0.6%, and PVP-I nasal spray (NS) at diluted concentrations of 0.5% and 0.6%. All groups were compared to the corresponding controls (distilled water). Written informed consent was ensured before participation. All procedures were conducted in after ethical clearance from the Ethical Review Board and in accordance with the Declaration of Helsinki. Viral clearance in a repeat RT-PCR (qualitative) was the primary outcome, and occurrence of any adverse event following administration of testing drug was considered as the secondary outcome. Analysis was performed using SPSS (Version 26). All cases were randomized into seven groups and each group consists of 27-patient. Mean age of the cases 43.98 ± 12.67 years (SD). All strength of NI were effective in nasopharyngeal clearance compared to the control (0.4%, p = 0.006;0.5%, p < 0.001;and 0.6%, p = 0.018). Similarly, all strength of the NS is also effective than control (0.5%, p =  < 0.001;and 0.6%, p ≤ 0.001). Highest nasopharyngeal clearance was observed in patients using 0.5% NI (n = 25, 92.6%, p = 0.018). Nasal irritation was the single most adverse event recorded in this trial and found in two patients using 0.4%, and 0.6% PVP-I NI, respectively. Both PVP-I NS and NI are effective for nasopharyngeal clearance in-vivo. However, further community trials are needed to repurpose these solutions as preventive agents against SARS-CoV2.Ethical clearance memo no ERC-DMC/ECC/2020/93.Trial registration NCT Identifier number NCT04549376. [ FROM AUTHOR] Copyright of Indian Journal of Otolaryngology & Head & Neck Surgery is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

5.
27th Brazilian Congress on Biomedical Engineering, CBEB 2020 ; 83:2111-2116, 2022.
Article in English | Scopus | ID: covidwho-1826145

ABSTRACT

This work consists of a literature review that aims to evaluate the effects and efficacy of two drugs used to treat individuals with COVID-19: chloroquine (CQ) and hydroxychloroquine (HCQ). Both drugs have demonstrated antiviral activity against the new coronavirus in in vitro tests. However, there is currently no strong evidence from well-designed controlled studies of COVID-19 therapies tested in humans. In addition, the evidence on the effects of drugs on patients is extremely limited. The search for evidence was made from five chosen databases, and after applying the criteria for inclusion and exclusion of articles, 5 publications were obtained, which represented the basis for the construction of this work. We concluded that, in relation to CQ, no favorable outcomes were found in relation to its use. High doses of this drug can increase lethality due to the prolongation of the QT interval, and lower doses could not estimate evident benefits in infected patients. Assessing the results of HCQ, it can be concluded that more studies are needed to effectively use this drug in the treatment of individuals with COVID-19. © 2022, Springer Nature Switzerland AG.

6.
Journal of Advances in Medical and Biomedical Research ; 30(139):75-85, 2022.
Article in English | EMBASE | ID: covidwho-1822722

ABSTRACT

Novel coronavirus causes the outbreak of COVID-19. There is still no verified treatment regimen against this novel virus;however, different drugs and compounds have been tested against it. Ample proposals have led to a good understanding of pathogenesis and drug efficacy against the novel virus disease. Excess systemic inflammation, which is described as cytokine storm, in the severe cases of COVID-19 can pass through the blood-brain barrier, enter the brain tissue, and activate the microglial cells and oligodenritcytes. Activation of the microglia cells and oligodenritcytes can increase generation of reactive oxygen species in the brain. Excess generation of reactive oxygen species can in turn increase neuro-inflammation in some cases of patients with COVID-19. Treatment of COVID-19 is far from clear. Today, some antiviral drugs such as remdisivir, favipiravir, ribavirin, kaletra, and arbidol are being tested against the disease. Besides these drugs, corticosteroids, anti-malaria drugs (such as chloroquine family), anticoagulants (such as heparin or enoxaparin) are repurposed. In this paper, first we explained the pathogenesis of COVID-19 particles, particularly in the brain. Second, we reviewed recent treatment options up to now, including interferon therapy, convalescent plasma exchange, plasmapheresis, immunoglobin therapy, and use of specified monoclonal anti-bodies in COVID-19 patients.

7.
Journal of SAFOG ; 14(1):35-40, 2022.
Article in English | EMBASE | ID: covidwho-1822541

ABSTRACT

Importance: Given the high mortality and cost of health care, especially in isolation settings, the idea of using nebulized hydrogen peroxide may play a very significant role in inactivation of coronavirus, thus reducing the infectivity period leading to reduced requirement of isolation and improving morbidity and mortality in people suffering with coronavirus disease-2019 (COVID-2019). Aim and objective: Objective of this study was to determine the efficiency of nebulized hydrogen peroxide (H2O2) in reducing the viral load and disease severity of patients suffering with COVID-19. Design: Double-blinded randomized control trial. HOPE in COVID-19 study. Setting: Tertiary care COVID hospital (single center). Participants: Moderate sick COVID-19-positive patients were included in the study after they qualified the inclusion criteria. Intervention: Patients were nebulized using 1 mL of ozonized 3% H2O2 after diluting with 4 mL of normal saline three times a day for 5 days. The control group was nebulized with normal saline only. Main outcome: Outcome was assessed for reduction in oxygen requirement (number of days on oxygen), symptoms resolution (dyspnea, cough, and fever), and number of days it took to be RT-PCR negative for COVID-19. Results: The early data from trial showed promising trends toward a better outcome. The study showed that in the case group who were nebulized with hydrogen peroxide resulted in better outcome in terms of parameters assessed in the study and the differences from the control group were statistically significant (p ≤0.001, CI 95%). Outcome in the form of mortality (odds ratio 0.29, 95% CI 0.02–3.14, p = 0.31, z = 1.007) was statistically insignificant. The number needed to treat for our study was 10.

8.
Vaccines ; 10(4), 2022.
Article in English | EMBASE | ID: covidwho-1822460

ABSTRACT

The worldwide pandemic of coronavirus disease 2019 (COVID-19) has imposed a challenge on human health worldwide, and vaccination represents a vital strategy to control the pandemic. To date, multiple COVID-19 vaccines have been granted emergency use authorization, including inactivated vaccines, adenovirus-vectored vaccines, and nucleic acid vaccines. These vaccines have different technical principles, which will necessarily lead to differences in safety and efficacy. Therefore, we aim to implement a systematic review by synthesizing clinical experimental data combined with mass vaccination data and conducting a synthesis to evaluate the safety and efficacy of COVID-19 vaccines. Compared with other vaccines, adverse reactions after vaccination with inactivated vaccines are relatively low. The efficacy of inactivated vaccines is approximately 60%, adenovirus-vectored vaccines are 65%, and mRNA vaccines are 90%, which are always efficient against asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, symptomatic COVID-19, COVID-19 hospitalization, severe or critical hospitalization, and death. RNA-based vaccines have a number of advantages and are one of the most promising vaccines identified to date and are particularly important during a pandemic. However, further improvements are required. In time, all the antibody levels weaken gradually, so a booster dose is needed to maintain immunity. Compared with homologous prime-boost immunization, heterologous prime-boost immunization prompts more robust humoral and cellular immune responses.

9.
Cells ; 11(9), 2022.
Article in English | EMBASE | ID: covidwho-1822413

ABSTRACT

Background: Polyphenols are the largest class of bioactive compounds in plants, which are synthesized as secondary metabolites. In the last few years, interesting studies have demonstrated the efficacy of polyphenols against coronavirus infections. Methods: we conducted a phase II multicentric clinical trial (TAEROVID‐19) during the first wave of the COVID‐19 pandemic in order to assess the safety and feasibility of Taurisolo® aerosol formulation in hospitalized patients suffering from SARS‐CoV‐2 pneumonia. Results: we observed a rapid decline of symptoms and a low rate of intensive care in patients treated with Taurisolo®, with a faster decline of symptoms. Conclusions: This is the first trial assessing the safety and feasibility of Taurisolo® aerosol formulation. We could argue that this treatment could act as an add‐on therapy in the treatment of COVID‐ 19 patients, owing to both its anti‐inflammatory and antioxidant effects. Further controlled trials are needed, which may be of interest to evaluate the compound’s efficacy.

10.
Frontiers in Pharmacology ; 13, 2022.
Article in English | EMBASE | ID: covidwho-1822397

ABSTRACT

At the beginning of the pandemic, we observed that lithium carbonate had a positive effect on the recovery of severely ill patients with COVID-19. Lithium is able to inhibit the replication of several types of viruses, some of which are similar to the SARS-CoV-2 virus, increase the immune response and reduce inflammation by preventing or reducing the cytokine storm. Previously, we published an article with data from six patients with severe COVID-19 infection, where we proposed that lithium carbonate could be used as a potential treatment for COVID-19. Now, we set out to conduct a randomized clinical trial number EudraCT 2020–002008–37 to evaluate the efficacy and safety of lithium treatment in patients infected with severe SARS-CoV-2. We showed that lithium was able to reduce the number of days of hospital and intensive care unit admission as well as the risk of death, reduces inflammatory cytokine levels by preventing cytokine storms, and also reduced the long COVID syndromes. We propose that lithium carbonate can be used to reduce the severity of COVID-19.

11.
Trials ; 23(1), 2022.
Article in English | EMBASE | ID: covidwho-1822205

ABSTRACT

Background: Posttraumatic stress disorder occurs in as many as one in five combat veterans and is associated with a host of negative, long-term consequences to the individual, their families, and society at large. Trauma-focused treatments, such as Prolonged Exposure, result in clinically significant symptom relief for many. Adherence to these treatments (i.e., session attendance and homework compliance) is vital to ensuring recovery but can be challenging for patients. Engaging families in veterans’ treatment could prove to be an effective strategy for promoting treatment adherence while also addressing long-standing calls for better family inclusion in treatment for posttraumatic stress disorder. This paper describes the methods of a pragmatic randomized controlled trial designed to evaluate if family inclusion in Prolonged Exposure can improve treatment adherence. Methods: One hundred fifty-six veterans, with clinically significant symptoms of posttraumatic stress disorder, will be randomized to receive either standard Prolonged Exposure or Prolonged Exposure enhanced through family inclusion (Family-Supported Prolonged Exposure) across three different VA facilities. Our primary outcomes are session attendance and homework compliance. Secondary outcomes include posttraumatic stress disorder symptom severity, depression, quality of life, and relationship functioning. The study includes a concurrent process evaluation to identify potential implementation facilitators and barriers to family involvement in Prolonged Exposure within VA. Discussion: While the importance of family involvement in posttraumatic stress disorder treatment is non-controversial, there is no evidence base supporting best practices on how to integrate families into PE or any other individually focused trauma-focused treatments for posttraumatic stress disorder. This study is an important step in addressing this gap, contributing to the literature for both retention and family involvement in trauma-focused treatments. Trial registration: ClinicalTrials.govNCT03256227. Registered on August 21, 2017.

12.
Chinese Medicine (United Kingdom) ; 17(1), 2022.
Article in English | EMBASE | ID: covidwho-1822199

ABSTRACT

Objective: To explore the effect of Ludangshen oral liquid for treatment of convalescent patients with coronavirus disease 2019 (COVID-19) with randomized, double-blind, placebo-controlled multicenter method. Methods: 200 convalescent COVID-19 patients who had symptoms related to decreased digestive and respiratory function were randomly divided to either receive Ludangshen oral liquid or placebo for 2 weeks. The severity of clinical symptoms including fatigue, anorexia, abdominal distension, loose stools, and shortness of breath were assessed by visual analogue scale and observed at before and after treatment. The improvement and resolution rates of clinical symptoms were evaluated. Full analysis set (FAS) and per-protocol set (PPS) were used for statistical analyses. Adverse events were recorded during the study. Results: 8 patients did not complete the study. After 2 weeks of treatment, both FAS and PPS results showed that patients in Ludangshen group had significantly lower score of fatigue, anorexia, loose stools, and shortness of breath than placebo group (P < 0.05), while there was no significant difference in distention (P > 0.05). The improvement rate of fatigue, anorexia, distension, loose stools and shortness of breath were significantly higher in Ludangshen group (P < 0.05), as well as the resolution rates (P < 0.05) except for shortness of breath (P > 0.05). There were two cases of adverse events, with one nose bleeding in Ludangshen group and one headache in placebo group. Conclusion: The study suggested that two weeks of Ludangshen oral liquid treatment may have certain effects for convalescent COVID-19 patients on improving digestive and respiratory symptoms including fatigue, anorexia, loose stools and shortness of breath, which may be one of the choices for management of convalescent COVID-19 patients with digestive and respiratory symptoms.

13.
Therapeutic Advances in Psychopharmacology ; 12, 2022.
Article in English | EMBASE | ID: covidwho-1822143

ABSTRACT

Background: Data from case series suggest that clozapine may benefit inpatients with borderline personality disorder (BPD), but randomised trials have not been conducted. Methods: Multicentre, double-blind, placebo-controlled trial. We aimed to recruit 222 inpatients with severe BPD aged 18 or over, who had failed to respond to other antipsychotic medications. We randomly allocated participants on a 1:1 ratio to receive up to 400 mg of clozapine per day or an inert placebo using a remote web-based randomisation service. The primary outcome was total score on the Zanarini Rating scale for Borderline Personality Disorder (ZAN-BPD) at 6 months. Secondary outcomes included self-harm, aggression, resource use and costs, side effects and adverse events. We used a modified intention to treat analysis (mITT) restricted to those who took one or more dose of trial medication, using a general linear model fitted at 6 months adjusted for baseline score, allocation group and site. Results: The study closed early due to poor recruitment and the impact of the COVID-19 pandemic. Of 29 study participants, 24 (83%) were followed up at 6 months, of whom 21 (72%) were included in the mITT analysis. At 6 months, 11 (73%) participants assigned to clozapine and 6 (43%) of those assigned to placebo were still taking trial medication. Adjusted difference in mean total ZAN-BPD score at 6 months was -3.86 (95% Confidence Intervals = -10.04 to 2.32). There were 14 serious adverse events;6 in the clozapine arm and 8 in the placebo arm of the trial. There was little difference in the cost of care between groups. Interpretation: We recruited insufficient participants to test the primary hypothesis. The study findings highlight problems in conducting placebo-controlled trials of clozapine and in using clozapine for people with BPD, outside specialist inpatient mental health units. Trial registration: ISRCTN18352058. https://doi.org/10.1186/ISRCTN18352058.

15.
NeuroImage: Clinical ; 34, 2022.
Article in English | EMBASE | ID: covidwho-1821425

ABSTRACT

Purpose: Cerebral amyloid angiopathy (CAA) is a common neuropathological finding and clinical entity that occurs independently and with co-existent Alzheimer's disease (AD) and small vessel disease. We compared diffusion tensor imaging (DTI) metrics of the fornix, the primary efferent tract of the hippocampus between CAA, AD and Mild Cognitive Impairment (MCI) and healthy controls. Methods: Sixty-eight healthy controls, 32 CAA, 21 AD, and 26 MCI patients were recruited at two centers. Diffusion tensor images were acquired at 3 T with high spatial resolution and fluid-attenuated inversion recovery (FLAIR) to suppress cerebrospinal fluid (CSF) and minimize partial volume effects on the fornix. The fornix was delineated with deterministic tractography to yield mean diffusivity (MD), axial diffusivity (AXD), radial diffusivity (RD), fractional anisotropy (FA) and tract volume. Volumetric measurements of the hippocampus, thalamus, and lateral ventricles were obtained using T1-weighted MRI. Results: Diffusivity (MD, AXD, and RD) of the fornix was highest in AD followed by CAA compared to controls;the MCI group was not significantly different from controls. FA was similar between groups. Fornix tract volume was ∼ 30% lower for all three patient groups compared to controls, but not significantly different between the patient groups. Thalamic and hippocampal volumes were preserved in CAA, but lower in AD and MCI compared to controls. Lateral ventricular volumes were increased in CAA, AD and MCI. Global cognition, memory, and executive function all correlated negatively with fornix diffusivity across the combined clinical group. Conclusion: There were significant diffusion changes of the fornix in CAA, AD and MCI compared to controls, despite relatively intact thalamic and hippocampal volumes in CAA, suggesting the mechanisms for fornix diffusion abnormalities may differ in CAA compared to AD and MCI.

16.
Annals of Thoracic Surgery ; 113(5):1401-1404, 2022.
Article in English | EMBASE | ID: covidwho-1821141
17.
Infection ; 2022.
Article in English | EMBASE | ID: covidwho-1821025

ABSTRACT

Purpose: Apart from the global disease burden of acute COVID-19 disease, the health complications arising after recovery have been recognized as a long-COVID or post-COVID-19 syndrome. Evidences of long-COVID symptoms involving various organ systems are rapidly growing in literature. The objective was to perform a rapid review and evidence mapping of systemic complications and symptoms of long-COVID and underlying pathophysiological mechanisms. Methods: Publications reporting clinical trials, observational cohort studies, case–control studies, case-series, meta-analysis, and systematic reviews, focusing on the squeal of the disease, consequences of COVID-19 treatment/hospitalization, long-COVID, chronic COVID syndrome, and post acute COVID-19 were reviewed in detail for the narrative synthesis of frequency, duration, risk factors, and pathophysiology. Results: The review highlights that pulmonary, neuro-psychological, and cardiovascular complications are major findings in most epidemiological studies. However, dysfunctional gastrointestinal, endocrine, and metabolic health are recent findings for which underlying pathophysiological mechanisms are poorly understood. Analysis of the clinical trial landscape suggests that more than 50% of the industry-sponsored trials are focused on pulmonary symptoms. In contrast to the epidemiological trends and academic trials, cardiovascular complications are not a focus of industry-sponsored trials, suggestive of the gaps in the research efforts. Conclusion: The gap in epidemiological trends and academic trials, particularly concerning cardiovascular complications not being a focus of industry-sponsored trials is suggestive of the gaps in research efforts and longer follow-up durations would help identify other long-COVID-related health issues such as reproductive health and fertility.

18.
Chinese Journal of Pharmacology and Toxicology ; 35(1):1-13, 2021.
Article in Chinese | EMBASE | ID: covidwho-1820653

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has led to the urgent need to develop therapeutic drugs to respond to disease progression and treatment of patients. Drug repur- posing is one of the potential ways to rapidly find treatments for emerging viral infection. Favipiravir is a novel broad-spectrum antiviral drug that has been approved for new and re-emerging pandemic influenza. As a potential drug against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, favipiravir is currently under clinical trials in several countries and has shown promising results in clinical studies. This paper reviews the clinical studies on the treatment of COVID-19 with favipiravir or combination with other drugs by focusing on the data about dose, trial design, efficacy and safety in China, Japan, Russia and India. Favipiravir with proven safety profiles has proved to be effective in improving viral RNA clearance or clinical recovery in patients with mild and moderate symptoms. This review will help gain insights into the evidence based role of favipiravir in antiviral therapy of COVID-19.

19.
European Journal of Molecular and Clinical Medicine ; 9(3):2682-2693, 2022.
Article in English | EMBASE | ID: covidwho-1820559

ABSTRACT

The availability of different vaccines plays a crucial role in bringing the COVID-19 pandemic to a standstill. All the vaccines with two initial and a booster dose have reduced the mortality rate and do not elicit serious symptoms or illness. However, the clinical trials on different vulnerable populations are still not reliable. In particular, COVID-19 patients belonging to the diabetic population exhibited higher morbidity and mortality. Therefore, the prioritization of vaccination for these populations may reduce further complications. Yet, the hesitancy toward vaccines hinders the process of vaccination campaigns. Hence, this review focuses on the availability of different vaccines against COVID-19 and their role in eradicating previous epidemics. The effect of this vaccination on the diabetic group and the management of chronic illness have been emphasized.

20.
Vaccine ; 2022.
Article in English | ScienceDirect | ID: covidwho-1819623

ABSTRACT

Background More than 130 million individuals in the United States have now received at least one dose of a COVID-19 vaccine. Currently, all adults in the Unites States now have access to one of three COVID-19 vaccines. As part of the vaccination procedure, Emergency Use Authorization (EUA) fact sheets, which contain information regarding the vaccine, are provided. The purpose of this study was to analyze the ease of reading (i.e., readability) of the EUA-approved fact sheets for the vaccines currently available in the United States, the V-Safe adverse event survey script, and the Centers for Disease Control and Prevention (CDC) website information on COVID-19 vaccines designed for the general public in the United States. Methods We acquired the Pfizer, Moderna, and Janssen EUA fact sheets, as well as the V-Safe survey script and the CDC website information regarding COVID-19 vaccines. These documents were analyzed for their complexity regarding the following readability factors: average length of paragraphs, sentences, and words;font size and style;use of passive voice;the Gunning-Fog index;the Flesch Reading Ease index;and the Flesch-Kincaid Grade Level index. Results Only the V-Safe adverse-event survey script met readability standards for adequate comprehension. The mean readability scores of the EUA fact sheets and the CDC website were as follows: Flesch Reading Ease score (44.35 avg);Flesch-Kincaid Grade Level (10.48 avg);and Gunning-Fog index (11.8 avg).These scores indicate that at least a 10th-grade level education would be required to understand these reading materials. Conclusion The average person in the United States would have difficulty understanding the information provided in the EUA fact sheets and CDC COVID-19 vaccine website documents;however, the V-Safe survey was written at an adequate reading level. To ensure that the general public fully understands information regarding COVID-19 vaccines, greater care and effort should be given to the development of simplified information material.

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