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J Korean Med Sci ; 36(34): e245, 2021 Aug 30.
Article in English | MEDLINE | ID: covidwho-1379958


Since February 26, 2021, when vaccination against coronavirus disease 2019 (COVID-19) began in South Korea, patients who visited the Korea University Guro Hospital with suspected adverse events after COVID-19 vaccination were monitored actively with interest. We encountered five unusual cases of polyarthralgia and myalgia syndrome in patients who received the ChAdOx1 nCOV-19 (AstraZeneca) vaccine. The patients (median age 67 years) were not previously diagnosed with arthropathy and rheumatologic diseases. They developed fever, myalgia, joint pain, and swelling three to seven days after vaccination. The symptoms persisted for up to 47 days despite antipyretic treatment. Arthralgia occurred in multiple joints, including small and large joints. A whole-body Technetium-99m methylene diphosphonate bone scan revealed unusual uptakes in the affected joints. Non-steroidal anti-inflammatory drugs with or without prednisolone relieved the symptoms of all patients. Further monitoring is required to clarify the long-term prognosis of this syndrome.

Arthralgia/etiology , COVID-19 Vaccines/administration & dosage , COVID-19/prevention & control , Myalgia/etiology , Vaccination/adverse effects , Adult , Aged , Antipsychotic Agents/therapeutic use , Arthralgia/drug therapy , COVID-19/virology , Female , Humans , Joints/diagnostic imaging , Joints/pathology , Myalgia/drug therapy , Republic of Korea , SARS-CoV-2/isolation & purification , Tomography, X-Ray Computed
Pharmacol Res ; 161: 105126, 2020 11.
Article in English | MEDLINE | ID: covidwho-1318945


BACKGROUND: With the global epidemic of coronavirus disease (COVID-19), China has made progress in the prevention and control of the epidemic, and traditional Chinese medicine (TCM) has played a key role in dealing with the disease's effects on the respiratory system. This randomized controlled clinical trial evaluated the clinical efficacy and prognosis of Huoxiang Zhengqi dropping pills and Lianhua Qingwen granules in patients with COVID-19. METHODS: A total of 283 patients participated in this clinical trial, and participants were randomly assigned to receive either 1) Huoxiang Zhengqi dropping pills and Lianhua Qingwen granules or 2) Linahua granules, both combined with western medicine, or 3) western medicine alone for 14 days. At the end of the trial, the improvement and resolution rates of clinical symptoms and the rate of patients who progressed to severe disease status were evaluated. RESULTS: After 14 days of treatment, there was no significant difference in the improvement rate of clinical symptoms among the three groups (P > 0.05). Huoxiang Zhengqi dropping pills combined with Lianhua Qingwen granules has advantages in the treatment of nausea, vomiting and limb soreness. During treatment, all participants were treated with western medicine, and there was a significant difference in the use of macrolides among the three groups (P < 0.05). Specifically, the utilization rate of antibiotics in the western medicine group was significantly greater than that of the other two groups. Among the 182 diagnosed patients who completed this clinical trial, 13 patients progressed to severe disease, including one case in the Huoxiang + Lianhua group (1.6 %), five cases in the Lianhua group (8.6 %), and seven cases in the western medicine group (11.1 %). There was no statistical differences in this rate among the three groups (P > 0.05). However, the proportion of patients who progressed to severe disease in the Huoxiang + Lianhua group was the lowest, suggesting that the combination of TCM with western medicine has a potential advantage in improving the prognosis of patients with COVID-19. CONCLUSION: The use of Huoxiang Zhengqi dropping pills and Lianhua Qingwen granules combined with western medicine may have clinical advantages for COVID-19 patients in improving clinical symptoms, reducing utilization rate of anti-infective drugs, and improving patient prognosis, which could pave the way for the use of complementary medicine in treating this infection.

COVID-19/drug therapy , Drugs, Chinese Herbal/therapeutic use , Adult , Aged , COVID-19/complications , COVID-19/diagnosis , China , Disease Progression , Drugs, Chinese Herbal/administration & dosage , Female , Humans , Male , Medicine, Chinese Traditional , Middle Aged , Myalgia/drug therapy , Myalgia/etiology , Nausea/drug therapy , Nausea/etiology , Powders , Tablets , Treatment Outcome , Vomiting/drug therapy , Vomiting/etiology
J Neurovirol ; 27(1): 26-34, 2021 02.
Article in English | MEDLINE | ID: covidwho-1046668


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.

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