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1.
Rev Med Virol ; 31(6): e2288, 2021 11.
Article in English | MEDLINE | ID: covidwho-1384306

ABSTRACT

SARS Coronavirus-2 is one of the most widespread viruses globally during the 21st century, whose severity and ability to cause severe pneumonia and death vary. We performed a comprehensive systematic review of all studies that met our standardised criteria and then extracted data on the age, symptoms, and different treatments of Covid-19 patients and the prognosis of this disease during follow-up. Cases in this study were divided according to severity and death status and meta-analysed separately using raw mean and single proportion methods. We included 171 complete studies including 62,909 confirmed cases of Covid-19, of which 148 studies were meta-analysed. Symptoms clearly emerged in an escalating manner from mild-moderate symptoms, pneumonia, severe-critical to the group of non-survivors. Hypertension (Pooled proportion (PP): 0.48 [95% Confident interval (CI): 0.35-0.61]), diabetes (PP: 0.23 [95% CI: 0.16-0.33]) and smoking (PP: 0.12 [95% CI: 0.03-0.38]) were highest regarding pre-infection comorbidities in the non-survivor group. While acute respiratory distress syndrome (PP: 0.49 [95% CI: 0.29-0.78]), (PP: 0.63 [95% CI: 0.34-0.97]) remained one of the most common complications in the severe and death group respectively. Bilateral ground-glass opacification (PP: 0.68 [95% CI: 0.59-0.75]) was the most visible radiological image. The mortality rates estimated (PP: 0.11 [95% CI: 0.06-0.19]), (PP: 0.03 [95% CI: 0.01-0.05]), and (PP: 0.01 [95% CI: 0-0.3]) in severe-critical, pneumonia and mild-moderate groups respectively. This study can serve as a high evidence guideline for different clinical presentations of Covid-19, graded from mild to severe, and for special forms like pneumonia and death groups.


Subject(s)
COVID-19/pathology , Cough/pathology , Dyspnea/pathology , Fatigue/pathology , Fever/pathology , SARS-CoV-2/pathogenicity , Antiviral Agents/therapeutic use , COVID-19/drug therapy , COVID-19/mortality , COVID-19/virology , Comorbidity , Cough/drug therapy , Cough/mortality , Cough/virology , Diabetes Mellitus/diagnosis , Diabetes Mellitus/physiopathology , Dyspnea/drug therapy , Dyspnea/mortality , Dyspnea/virology , Fatigue/drug therapy , Fatigue/mortality , Fatigue/virology , Fever/drug therapy , Fever/mortality , Fever/virology , Humans , Hypertension/diagnosis , Hypertension/physiopathology , Immunologic Factors/therapeutic use , Prognosis , Respiratory Distress Syndrome/diagnosis , Respiratory Distress Syndrome/physiopathology , Severity of Illness Index , Smoking/physiopathology , Survival Analysis
2.
J Enzyme Inhib Med Chem ; 36(1): 1230-1235, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1254219

ABSTRACT

The ongoing Covid-19 is a contagious disease, and it is characterised by different symptoms such as fever, cough, and shortness of breath. Rising concerns about Covid-19 have severely affected the healthcare system in all countries as the Covid-19 outbreak has developed at a rapid rate all around the globe. Intriguing, a clinically used drug, acetazolamide (a specific inhibitor of carbonic anhydrase, CA, EC 4.2.1.1), is used to treat high-altitude pulmonary oedema (HAPE), showing a high degree of clinical similarities with the pulmonary disease caused by Covid-19. In this context, this preliminary study aims to provide insights into some factors affecting the Covid-19 patients, such as hypoxaemia, hypoxia as well as the blood CA activity. We hypothesise that patients with Covid-19 problems could show a dysregulated acid-base status influenced by CA activity. These preliminary results suggest that the use of CA inhibitors as a pharmacological treatment for Covid-19 may be beneficial.


Subject(s)
Acetazolamide/therapeutic use , Antiviral Agents/therapeutic use , COVID-19/drug therapy , Carbonic Anhydrase Inhibitors/therapeutic use , Carbonic Anhydrases/blood , Acid-Base Equilibrium/drug effects , Altitude Sickness/blood , Altitude Sickness/drug therapy , Anticonvulsants/therapeutic use , Bicarbonates/blood , COVID-19/blood , COVID-19/diagnostic imaging , COVID-19/virology , Carbon Dioxide/blood , Cough/blood , Cough/drug therapy , Cough/pathology , Cough/virology , Drug Repositioning , Dyspnea/blood , Dyspnea/drug therapy , Dyspnea/pathology , Dyspnea/virology , Fever/blood , Fever/drug therapy , Fever/pathology , Fever/virology , Humans , Hydrogen-Ion Concentration , Hypertension, Pulmonary/blood , Hypertension, Pulmonary/drug therapy , Hypoxia/blood , Hypoxia/drug therapy , Hypoxia/pathology , Hypoxia/virology , Oximetry , Research Design , SARS-CoV-2/pathogenicity , SARS-CoV-2/physiology , Severity of Illness Index , Tomography, X-Ray Computed
4.
JAMA Netw Open ; 4(2): e210369, 2021 02 01.
Article in English | MEDLINE | ID: covidwho-1084243

ABSTRACT

Importance: There is limited evidence regarding early treatment of novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection to mitigate symptom progression. Objective: To examine whether high-dose zinc and/or high-dose ascorbic acid reduce the severity or duration of symptoms compared with usual care among ambulatory patients with SARS-CoV-2 infection. Design, Setting, and Participants: This multicenter, single health system randomized clinical factorial open-label trial enrolled 214 adult patients with a diagnosis of SARS-CoV-2 infection confirmed with a polymerase chain reaction assay who received outpatient care in sites in Ohio and Florida. The trial was conducted from April 27, 2020, to October 14, 2020. Intervention: Patients were randomized in a 1:1:1:1 allocation ratio to receive either 10 days of zinc gluconate (50 mg), ascorbic acid (8000 mg), both agents, or standard of care. Outcomes: The primary end point was the number of days required to reach a 50% reduction in symptoms, including severity of fever, cough, shortness of breath, and fatigue (rated on a 4-point scale for each symptom). Secondary end points included days required to reach a total symptom severity score of 0, cumulative severity score at day 5, hospitalizations, deaths, adjunctive prescribed medications, and adverse effects of the study supplements. Results: A total of 214 patients were randomized, with a mean (SD) age of 45.2 (14.6) years and 132 (61.7%) women. The study was stopped for a low conditional power for benefit with no significant difference among the 4 groups for the primary end point. Patients who received usual care without supplementation achieved a 50% reduction in symptoms at a mean (SD) of 6.7 (4.4) days compared with 5.5 (3.7) days for the ascorbic acid group, 5.9 (4.9) days for the zinc gluconate group, and 5.5 (3.4) days for the group receiving both (overall P = .45). There was no significant difference in secondary outcomes among the treatment groups. Conclusions and Relevance: In this randomized clinical trial of ambulatory patients diagnosed with SARS-CoV-2 infection, treatment with high-dose zinc gluconate, ascorbic acid, or a combination of the 2 supplements did not significantly decrease the duration of symptoms compared with standard of care. Trial Registration: ClinicalTrials.gov Identifier: NCT04342728.


Subject(s)
Ascorbic Acid/therapeutic use , COVID-19/drug therapy , Dietary Supplements , Zinc/therapeutic use , Adult , Ambulatory Care , Antioxidants/therapeutic use , COVID-19/complications , Cough/drug therapy , Cough/etiology , Dyspnea/drug therapy , Dyspnea/etiology , Fatigue/drug therapy , Fatigue/etiology , Female , Fever/drug therapy , Fever/etiology , Gluconates/therapeutic use , Humans , Male , Middle Aged , SARS-CoV-2 , Severity of Illness Index , Standard of Care , Trace Elements/therapeutic use , Treatment Outcome
5.
J Neurovirol ; 27(1): 154-159, 2021 02.
Article in English | MEDLINE | ID: covidwho-1059492

ABSTRACT

As the SARS-COV-2 becomes a global pandemic, many researchers have a concern about the long COVID-19 complications. Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is a persistent, debilitating, and unexplained fatigue disorder. We investigated psychological morbidities such as CFS and post-traumatic stress disorder (PTSD) among survivors of COVID-19 over 6 months. All COVID-19 survivors from the university-affiliated hospital of Tehran, Iran, were assessed 6 months after infection onset by a previously validated questionnaire based on the Fukuda guidelines for CFS/EM and DSM-5 Checklist for PTSD (The Post-traumatic Stress Disorder Checklist for DSM-5 or PCL-5) to determine the presence of stress disorder and chronic fatigue problems. A total of 120 patients were enrolled. The prevalence rate of fatigue symptoms was 17.5%. Twelve (10%) screened positive for chronic idiopathic fatigue (CIF), 6 (5%) for CFS-like with insufficient fatigue syndrome (CFSWIFS), and 3 (2.5%) for CFS. The mean total scores in PCL-5 were 9.27 ± 10.76 (range:0-44), and the prevalence rate of PTSD was 5.8%. There was no significant association after adjusting between CFS and PTSD, gender, comorbidities, and chloroquine phosphate administration. The obtained data revealed the prevalence of CFS among patients with COVID-19, which is almost similar to CFS prevalence in the general population. Moreover, PTSD in patients with COVID-19 is not associated with the increased risk of CFS. Our study suggested that medical institutions should pay attention to the psychological consequences of the COVID-19 outbreak.


Subject(s)
COVID-19/psychology , Cough/psychology , Dementia/psychology , Dyspnea/psychology , Fatigue Syndrome, Chronic/psychology , Fever/psychology , Stress Disorders, Post-Traumatic/psychology , Adult , Aged , Antiviral Agents/therapeutic use , COVID-19/complications , COVID-19/drug therapy , COVID-19/virology , Cough/complications , Cough/drug therapy , Cough/virology , Dementia/complications , Dementia/drug therapy , Dementia/virology , Drug Combinations , Dyspnea/complications , Dyspnea/drug therapy , Dyspnea/virology , Fatigue Syndrome, Chronic/complications , Fatigue Syndrome, Chronic/drug therapy , Fatigue Syndrome, Chronic/virology , Female , Fever/complications , Fever/drug therapy , Fever/virology , Humans , Hydroxychloroquine/therapeutic use , Lopinavir/therapeutic use , Male , Middle Aged , Oseltamivir/therapeutic use , Research Design , Ritonavir/therapeutic use , SARS-CoV-2/drug effects , SARS-CoV-2/pathogenicity , Severity of Illness Index , Stress Disorders, Post-Traumatic/complications , Stress Disorders, Post-Traumatic/drug therapy , Stress Disorders, Post-Traumatic/virology , Surveys and Questionnaires , Survivors/psychology
6.
J Neurovirol ; 27(1): 26-34, 2021 02.
Article in English | MEDLINE | ID: covidwho-1046668

ABSTRACT

Opsoclonus-myoclonus-ataxia syndrome is a heterogeneous constellation of symptoms ranging from full combination of these three neurological findings to varying degrees of isolated individual sign. Since the emergence of coronavirus disease 2019 (COVID-19), neurological symptoms, syndromes, and complications associated with this multi-organ viral infection have been reported and the various aspects of neurological involvement are increasingly uncovered. As a neuro-inflammatory disorder, one would expect to observe opsoclonus-myoclonus syndrome after a prevalent viral infection in a pandemic scale, as it has been the case for many other neuro-inflammatory syndromes. We report seven cases of opsoclonus-myoclonus syndrome presumably parainfectious in nature and discuss their phenomenology, their possible pathophysiological relationship to COVID-19, and diagnostic and treatment strategy in each case. Finally, we review the relevant data in the literature regarding the opsoclonus-myoclonus syndrome and possible similar cases associated with COVID-19 and its diagnostic importance for clinicians in various fields of medicine encountering COVID-19 patients and its complications.


Subject(s)
Ataxia/physiopathology , COVID-19/physiopathology , Cough/physiopathology , Fever/physiopathology , Myalgia/physiopathology , Opsoclonus-Myoclonus Syndrome/physiopathology , SARS-CoV-2/pathogenicity , Adult , Anticonvulsants/therapeutic use , Ataxia/diagnostic imaging , Ataxia/drug therapy , Ataxia/etiology , Azithromycin/therapeutic use , COVID-19/complications , COVID-19/diagnostic imaging , COVID-19/drug therapy , Clonazepam/therapeutic use , Cough/diagnostic imaging , Cough/drug therapy , Cough/etiology , Dyspnea/diagnostic imaging , Dyspnea/drug therapy , Dyspnea/etiology , Dyspnea/physiopathology , Female , Fever/diagnostic imaging , Fever/drug therapy , Fever/etiology , Humans , Hydroxychloroquine/therapeutic use , Levetiracetam/therapeutic use , Male , Middle Aged , Myalgia/diagnostic imaging , Myalgia/drug therapy , Myalgia/etiology , Opsoclonus-Myoclonus Syndrome/diagnostic imaging , Opsoclonus-Myoclonus Syndrome/drug therapy , Opsoclonus-Myoclonus Syndrome/etiology , Oseltamivir/therapeutic use , SARS-CoV-2/drug effects , Valproic Acid/therapeutic use
7.
J Neurovirol ; 27(1): 12-25, 2021 02.
Article in English | MEDLINE | ID: covidwho-996484

ABSTRACT

With the growing number of COVID-19 cases in recent times. significant set of patients with extra pulmonary symptoms has been reported worldwide. Here we venture out to summarize the clinical profile, investigations, and radiological findings among patients with SARS-CoV-2-associated meningoencephalitis in the form of a systemic review. This review was carried out based on the existing PRISMA (Preferred Report for Systematic Review and Meta analyses) consensus statement. The data for this review was collected from four databases: Pubmed/Medline, NIH Litcovid, Embase, and Cochrane library and Preprint servers up till 30 June 2020. Search strategy comprised of a range of keywords from relevant medical subject headings which includes "SARS-COV-2," "COVID-19," and "meningoencephalitis." All peer reviewed, case-control, case report, pre print articles satisfying our inclusion criteria were involved in the study. Quantitative data was expressed in mean ± SD, while the qualitative date in percentages. Paired t test was used for analysing the data based on differences between mean and respective values with a p < 0.05 considered to be statistically significant. A total of 61 cases were included from 25 studies after screening from databases and preprint servers, out of which 54 of them had completed investigation profile and were included in the final analysis. Clinical, laboratory findings, neuroimaging abnormalities, and EEG findings were analyzed in detail. This present review summarizes the available evidences related to the occurrence of meningoencephalitis in COVID-19.


Subject(s)
COVID-19/physiopathology , Cough/physiopathology , Fatigue/physiopathology , Fever/physiopathology , Meningoencephalitis/physiopathology , SARS-CoV-2/pathogenicity , Adult , Aged , Antiviral Agents/therapeutic use , Azithromycin/therapeutic use , COVID-19/diagnostic imaging , COVID-19/drug therapy , COVID-19/virology , Confusion/diagnostic imaging , Confusion/drug therapy , Confusion/physiopathology , Confusion/virology , Cough/diagnostic imaging , Cough/drug therapy , Cough/virology , Dyspnea/diagnostic imaging , Dyspnea/drug therapy , Dyspnea/physiopathology , Dyspnea/virology , Electroencephalography , Fatigue/diagnostic imaging , Fatigue/drug therapy , Fatigue/virology , Female , Fever/diagnostic imaging , Fever/drug therapy , Fever/virology , Humans , Hydroxychloroquine/therapeutic use , Male , Meningoencephalitis/diagnostic imaging , Meningoencephalitis/drug therapy , Meningoencephalitis/virology , Middle Aged , Neuroimaging , SARS-CoV-2/drug effects
8.
J Cell Mol Med ; 25(1): 591-595, 2021 01.
Article in English | MEDLINE | ID: covidwho-934013

ABSTRACT

COVID-19 can present with a variety of clinical features, ranging from asymptomatic or mild respiratory symptoms to fulminant acute respiratory distress syndrome (ARDS) depending on the host's immune responses and the extent of the associated pathologies. This implies that several measures need to be taken to limit severely impairing symptoms caused by viral-induced pathology in vital organs. Opioids are most exploited for their analgesic effects but their usage in the palliation of dyspnoea, immunomodulation and lysosomotropism may represent potential usages of opioids in COVID-19. Here, we describe the mechanisms involved in each of these potential usages, highlighting the benefits of using opioids in the treatment of ARDS from SARS-CoV-2 infection.


Subject(s)
Analgesics, Opioid/therapeutic use , COVID-19/drug therapy , COVID-19/etiology , Respiratory Distress Syndrome/drug therapy , Analgesics, Opioid/administration & dosage , COVID-19/complications , Cytokine Release Syndrome/drug therapy , Cytokine Release Syndrome/virology , Dyspnea/drug therapy , Dyspnea/etiology , Humans , Immunomodulation/drug effects , Immunomodulation/physiology , Lysosomes/drug effects , Receptors, Opioid/immunology
10.
Palliat Med ; 34(9): 1249-1255, 2020 10.
Article in English | MEDLINE | ID: covidwho-690192

ABSTRACT

BACKGROUND: The literature contains limited information on the problems faced by dying patients with COVID-19 and the effectiveness of interventions to manage these. AIM: The aim of this audit was to assess the utility of our end-of-life care plan, and specifically the effectiveness of our standardised end-of-life care treatment algorithms, in dying patients with COVID-19. DESIGN: The audit primarily involved data extraction from the end-of-life care plan, which includes four hourly nursing (ward nurses) assessments of specific problems: patients with problems were managed according to standardised treatment algorithms, and the intervention was deemed to be effective if the problem was not present at subsequent assessments. SETTING/PARTICIPANTS: This audit was undertaken at a general hospital in England, covered the 8 weeks from 16 March to 11 May 2020 and included all inpatients with COVID-19 who had an end-of-life care plan (and died). RESULTS: Sixty-one patients met the audit criteria: the commonest problem was shortness of breath (57.5%), which was generally controlled with conservative doses of morphine (10-20 mg/24 h via a syringe pump). Cough and audible respiratory secretions were relatively uncommon. The second most common problem was agitation/delirium (55.5%), which was generally controlled with standard pharmacological interventions. The cumulative number of patients with shortness of breath, agitation and audible respiratory secretions increased over the last 72 h of life, but most patients were symptom controlled at the point of death. CONCLUSION: Patients dying of COVID-19 experience similar end-of-life problems to other groups of patients. Moreover, they generally respond to standard interventions for these end-of-life problems.


Subject(s)
Coronavirus Infections/mortality , Delirium/drug therapy , Drug Therapy/standards , Dyspnea/drug therapy , Hospice Care/standards , Palliative Care/standards , Pneumonia, Viral/mortality , Terminal Care/standards , Aged , Aged, 80 and over , Analgesics, Opioid/therapeutic use , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/nursing , Drug Therapy/statistics & numerical data , Female , Hospice Care/statistics & numerical data , Humans , Hypnotics and Sedatives/therapeutic use , Male , Middle Aged , Morphine/therapeutic use , Palliative Care/statistics & numerical data , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/nursing , Practice Guidelines as Topic , SARS-CoV-2 , Terminal Care/statistics & numerical data , United Kingdom/epidemiology
11.
Palliat Med ; 34(9): 1235-1240, 2020 10.
Article in English | MEDLINE | ID: covidwho-616769

ABSTRACT

BACKGROUND: Hospital clinicians have had to rapidly develop expertise in managing the clinical manifestations of COVID-19 including symptoms common at the end of life, such as breathlessness and agitation. There is limited evidence exploring whether end-of-life symptom control in this group requires new or adapted guidance. AIM: To review whether prescribing for symptom control in patients dying with COVID-19 adhered to existing local guidance or whether there was deviation which may represent a need for revised guidance or specialist support in particular patient groups. DESIGN/SETTING: A retrospective review of the electronic patient record of 61 hospital inpatients referred to the specialist palliative care team with swab-confirmed COVID-19 who subsequently died over a 1-month period. Intubated patients were excluded. RESULTS: In all, 83% (40/48) of patients were prescribed opioids at a starting dose consistent with existing local guidelines. In seven of eight patients where higher doses were prescribed, this was on specialist palliative care team advice. Mean total opioid dose required in the last 24 h of life was 14 mg morphine subcutaneous equivalent, and mean total midazolam dose was 9.5 mg. For three patients in whom non-invasive ventilation was in place higher doses were used. CONCLUSION: Prescription of end-of-life symptom control drugs for COVID-19 fell within the existing guidance when supported by specialist palliative care advice. While some patients may require increased doses, routine prescription of higher starting opioid and benzodiazepine doses beyond existing local guidance was not observed.


Subject(s)
Biopharmaceutics/statistics & numerical data , Coronavirus Infections/drug therapy , Delirium/drug therapy , Dyspnea/drug therapy , Pneumonia, Viral/drug therapy , Practice Guidelines as Topic , Terminal Care/methods , Terminal Care/standards , Adult , Aged , Aged, 80 and over , Analgesics, Opioid/therapeutic use , Betacoronavirus , COVID-19 , Female , Humans , Hypnotics and Sedatives/therapeutic use , Male , Midazolam/therapeutic use , Middle Aged , Morphine/therapeutic use , Pandemics , Retrospective Studies , SARS-CoV-2
12.
Int J Infect Dis ; 99: 307-309, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-548949

ABSTRACT

Coronavirus 2019 (COVID-19) is a pandemic with substantial mortality and no accepted therapy. We report here on four consecutive outpatients with clinical characteristics (CDC case definition) of and/or laboratory-confirmed COVID-19 who were treated with high dose zinc salt oral lozenges. All four patients experienced significant improvement in objective and symptomatic disease measures after one day of high dose therapy suggesting that zinc therapy was playing a role in clinical recovery. A mechanism for zinc's effects is proposed based on previously published studies on SARS- CoV-1, and randomized controlled trials assessing zinc shortening of common cold duration. The limited sample size and study design preclude a definitive statement about the effectiveness of zinc as a treatment for COVID-19 but suggest the variables to be addressed to confirm these initial findings in future trials.


Subject(s)
Betacoronavirus/drug effects , Coronavirus Infections/drug therapy , Gluconates/administration & dosage , Oxygen/administration & dosage , Pneumonia, Viral/drug therapy , Zinc Acetate/administration & dosage , Adult , COVID-19 , Coronavirus Infections/virology , Dyspnea/drug therapy , Female , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/virology , SARS-CoV-2
14.
Encephale ; 46(3): 169-172, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-322038

ABSTRACT

OBJECTIVES: The ongoing COVID-19 pandemic has caused approximately 2,350,000 infections worldwide and killed more than 160,000 individuals. In Sainte-Anne Hospital (GHU PARIS Psychiatrie & Neuroscience, Paris, France) we have observed a lower incidence of symptomatic forms of COVID-19 among patients than among our clinical staff. This observation led us to hypothesize that psychotropic drugs could have a prophylactic action against SARS-CoV-2 and protect patients from the symptomatic and virulent forms of this infection, since several of these psychotropic drugs have documented antiviral properties. Chlorpromazine (CPZ), a phenothiazine derivative, is also known for its antiviral activity via the inhibition of clathrin-mediated endocytosis. Recentin vitro studies have reported that CPZ exhibits anti-MERS-CoV and anti-SARS-CoV-1 activity. METHODS: In this context, the ReCoVery study aims to repurpose CPZ, a molecule with an excellent tolerance profile and a very high biodistribution in the saliva, lungs and brain. We hypothesize that CPZ could reduce the unfavorable course of COVID-19 infection among patients requiring respiratory support without the need for ICU care, and that it could also reduce the contagiousness of SARS-CoV-2. For this purpose, we plan a pilot, multicenter, randomized, single blind, controlled, phase III therapeutic trial (standard treatment vs. CPZ+standard treatment). CONCLUSION: This repurposing of CPZ for its anti-SARS-CoV-2 activity could offer an alternative, rapid strategy to alleviate infection severity. This repurposing strategy also avoids numerous developmental and experimental steps, and could save precious time to rapidly establish an anti-COVID-19 therapy with well-known, limited and easily managed side effects.


Subject(s)
Chlorpromazine/therapeutic use , Coronavirus Infections/drug therapy , Drug Repositioning , Pneumonia, Viral/drug therapy , Antiviral Agents/therapeutic use , Anxiety/complications , Anxiety/drug therapy , Anxiety/epidemiology , Anxiety/pathology , Betacoronavirus/pathogenicity , Blood-Brain Barrier/drug effects , COVID-19 , Clathrin-Coated Vesicles/drug effects , Coronavirus Infections/complications , Coronavirus Infections/epidemiology , Coronavirus Infections/pathology , Disease Progression , Dyspnea/drug therapy , Dyspnea/epidemiology , Dyspnea/pathology , Dyspnea/psychology , Endocytosis/drug effects , France/epidemiology , Humans , Length of Stay , Mortality , Pandemics , Patient Outcome Assessment , Pilot Projects , Pneumonia, Viral/complications , Pneumonia, Viral/epidemiology , Pneumonia, Viral/pathology , Recovery of Function , SARS-CoV-2 , Single-Blind Method , Time-to-Treatment , Treatment Outcome
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