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1.
Nat Commun ; 11(1): 2750, 2020 06 02.
Artículo en Inglés | MEDLINE | ID: covidwho-680538

RESUMEN

Influenza viruses annually kill 290,000-650,000 people worldwide. Antivirals can reduce death tolls. Baloxavir, the recently approved influenza antiviral, inhibits initiation of viral mRNA synthesis, whereas oseltamivir, an older drug, inhibits release of virus progeny. Baloxavir blocks virus replication more rapidly and completely than oseltamivir, reducing the duration of infectiousness. Hence, early baloxavir treatment may indirectly prevent transmission. Here, we estimate impacts of ramping up and accelerating baloxavir treatment on population-level incidence using a new model that links viral load dynamics from clinical trial data to between-host transmission. We estimate that ~22 million infections and >6,000 deaths would have been averted in the 2017-2018 epidemic season by administering baloxavir to 30% of infected cases within 48 h after symptom onset. Treatment within 24 h would almost double the impact. Consequently, scaling up early baloxavir treatment would substantially reduce influenza morbidity and mortality every year. The development of antivirals against the SARS-CoV2 virus that function like baloxavir might similarly curtail transmission and save lives.


Asunto(s)
Antivirales/uso terapéutico , Epidemias , Gripe Humana/tratamiento farmacológico , Orthomyxoviridae/efectos de los fármacos , Oxazinas/uso terapéutico , Piridinas/uso terapéutico , Tiepinas/uso terapéutico , Triazinas/uso terapéutico , Antivirales/farmacología , Betacoronavirus/efectos de los fármacos , Proliferación Celular , Infecciones por Coronavirus/tratamiento farmacológico , Humanos , Gripe Humana/virología , Oseltamivir/farmacología , Oseltamivir/uso terapéutico , Oxazinas/farmacología , Pandemias , Neumonía Viral/tratamiento farmacológico , Salud Pública , Piridinas/farmacología , ARN Mensajero/metabolismo , Estaciones del Año , Tiepinas/farmacología , Triazinas/farmacología , Carga Viral , Replicación Viral/efectos de los fármacos
3.
ACS Nano ; 14(8): 9364-9388, 2020 08 25.
Artículo en Inglés | MEDLINE | ID: covidwho-646861

RESUMEN

The SARS-Cov-2 pandemic has spread worldwide during 2020, setting up an uncertain start of this decade. The measures to contain infection taken by many governments have been extremely severe by imposing home lockdown and industrial production shutdown, making this the biggest crisis since the second world war. Additionally, the continuous colonization of wild natural lands may touch unknown virus reservoirs, causing the spread of epidemics. Apart from SARS-Cov-2, the recent history has seen the spread of several viral pandemics such as H2N2 and H3N3 flu, HIV, and SARS, while MERS and Ebola viruses are considered still in a prepandemic phase. Hard nanomaterials (HNMs) have been recently used as antimicrobial agents, potentially being next-generation drugs to fight viral infections. HNMs can block infection at early (disinfection, entrance inhibition) and middle (inside the host cells) stages and are also able to mitigate the immune response. This review is focused on the application of HNMs as antiviral agents. In particular, mechanisms of actions, biological outputs, and limitations for each HNM will be systematically presented and analyzed from a material chemistry point-of-view. The antiviral activity will be discussed in the context of the different pandemic viruses. We acknowledge that HNM antiviral research is still at its early stage, however, we believe that this field will rapidly blossom in the next period.


Asunto(s)
Antivirales/uso terapéutico , Betacoronavirus , Infecciones por Coronavirus/terapia , Nanoestructuras/uso terapéutico , Pandemias , Neumonía Viral/terapia , Inmunidad Adaptativa , Betacoronavirus/efectos de los fármacos , Betacoronavirus/fisiología , Betacoronavirus/ultraestructura , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Sistemas de Liberación de Medicamentos , Fulerenos/uso terapéutico , Interacciones Microbiota-Huesped/efectos de los fármacos , Humanos , Inmunidad Innata , Nanopartículas del Metal/uso terapéutico , Modelos Biológicos , Nanotecnología , Neumonía Viral/epidemiología , Neumonía Viral/virología , Especies Reactivas de Oxígeno/uso terapéutico , Internalización del Virus/efectos de los fármacos
4.
Int J Mol Med ; 46(3): 903-912, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: covidwho-750592

RESUMEN

The severe acute respiratory syndrome coronavirus 2 (SARS­CoV­2) is a novel ß coronavirus that is the etiological agent of the pandemic coronavirus disease 2019 (COVID­19) that at the time of writing (June 16, 2020) has infected almost 6 million people with some 450,000 deaths. These numbers are still rising daily. Most (some 80%) cases of COVID­19 infection are asymptomatic, a substantial number of cases (15%) require hospitalization and an additional fraction of patients (5%) need recovery in intensive care units. Mortality for COVID­19 infection appears to occur globally between 0.1 and 0.5% of infected patients although the frequency of lethality is significantly augmented in the elderly and in patients with other comorbidities. The development of acute respiratory distress syndrome and episodes of thromboembolism that may lead to disseminated intravascular coagulation (DIC) represent the primary causes of lethality during COVID­19 infection. Increasing evidence suggests that thrombotic diathesis is due to multiple derangements of the coagulation system including marked elevation of D­dimer that correlate negatively with survival. We propose here that the thromboembolic events and eventually the development of DIC provoked by SARS­CoV­2 infection may represent a secondary anti­phospholipid antibody syndrome (APS). We will apply both Baconian inductivism and Cartesian deductivism to prove that secondary APS is likely responsible for coagulopathy during the course of COVID­19 infection. Diagnostic and therapeutic implications of this are also discussed.


Asunto(s)
Síndrome Antifosfolípido/patología , Infecciones por Coronavirus/patología , Coagulación Intravascular Diseminada/patología , Neumonía Viral/patología , Tromboembolia/patología , Trombosis/patología , Síndrome Antifosfolípido/inmunología , Antivirales/uso terapéutico , Betacoronavirus , Coagulación Sanguínea/fisiología , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/inmunología , Coagulación Intravascular Diseminada/inmunología , Productos de Degradación de Fibrina-Fibrinógeno/metabolismo , Humanos , Pandemias , Fosfolípidos/inmunología , Neumonía Viral/tratamiento farmacológico , Neumonía Viral/inmunología , Tromboembolia/inmunología
5.
Mymensingh Med J ; 29(3): 747-754, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: covidwho-746334

RESUMEN

The sudden outbreak of a novel coronavirus in 2019 in Wuhan, China, that rapidly provoked a global concern, marked as the third attack of corona virus in the human society that affected the global healthcare system as well as the global economy. Until and unless an effective vaccine is discovered against the virus, the pharmacological intervention by different antivirals is in the run for remedy. The aim of this systematic review was to evaluate the role of favipiravir along with its safety and efficacy for the patients who are suffering from severe acute respiratory distress syndrome due to CoronaVirus-2 (SARS-CoV-2) as re-purposeful use. We searched PubMed, EMBASE for randomized controlled trials (RCTs), cilicaltrial.com for registered on going trails to evaluate the pros and cons of using favipiravir in COVID-19. After vigorous searching, screening and sorting of 314 articles for completed and published scientific evidences in electronic database, there were only 2 completed and published randomized control trials (RCT) and 17 ongoing or unpublished trials found until June 2020. The main outcome measures were viral clearance, clinical improvement and adverse events reported and published on 147 patients infected with SARS-CoV2. The 2 completed RCTs showed significantly better treatment effects on disease progression, viral clearance, improved the latency to relief for pyrexia and cough on favipiravir treated patients. Adverse effects caused Favipiravir are mild and manageable. Although 9 more RCTs and cohort studies are supposed to be completed by this time that may unveil some evidence for use of anti-RNA-viral drug favipiravir against influenza or Ebola to re-purposing against COVID-19 as adopted in different treatment guidelines.


Asunto(s)
Amidas/uso terapéutico , Antivirales/uso terapéutico , Infecciones por Coronavirus/tratamiento farmacológico , Reposicionamiento de Medicamentos , Pandemias , Neumonía Viral/tratamiento farmacológico , Pirazinas/uso terapéutico , Betacoronavirus , China , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Humanos , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Resultado del Tratamiento
6.
Vestn Oftalmol ; 136(4. Vyp. 2): 265-271, 2020.
Artículo en Ruso | MEDLINE | ID: covidwho-745625

RESUMEN

Coronavirus infection is currently en extremely relevant scientific topic due to the emergence of a new serotype that causes a condition identified as Severe Acute Respiratory Syndrome (SARS)-COV-2. Chloroquine and hydroxychloroquine have a long history of use against other infectious diseases, they are available and inexpensive, so the possibility of using them in vivo and in vitro to suppress the infectious agent was examined. Despite the noted therapeutic potential of these drugs, it was necessary to take into account the toxicological aspects that dictate the importance of rational use of 4-aminoquinoline derivatives. This review analyzes literature on the development patterns of hydroxychloroquine retinopathy, basic principles of diagnosis and differentiation of this condition from other types of retinal pathology.


Asunto(s)
Antivirales/uso terapéutico , Betacoronavirus , Neumonía Viral/diagnóstico , Neumonía Viral/tratamiento farmacológico , Diagnóstico Diferencial , Humanos , Hidroxicloroquina/uso terapéutico , Pandemias
7.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(5): 598-602, 2020 May 28.
Artículo en Inglés, Chino | MEDLINE | ID: covidwho-745317

RESUMEN

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of the outbreak of coronavirus disease 2019 in Wuhan City, China. The SARS-CoV-2 is genetically similar to the coronavirus derived from bat. The SARS-CoV-2, the SARS-CoV and the Middle East respiratory syndrome coronavirus (MERS-CoV) all belong to beta coronavirus. Since the outbreak of the coronavirus disease 2019, effective antiviral drugs have become a hot issue in the world. Very little about SARS-CoV-2 is known and there is no precedent for treatment. The National Health Commission has repeatedly revised the diagnosis and treatment guide for the coronavirus disease 2019. The latest guide is "New Coronary Virus-Infected Pneumonia Diagnosis and Treatment Plan (Seventh Trial Version)"(short for Seventh Version of Diagnosis and Treatment Plan). But the use of antiviral drugs is still on trial and no rigorous clinical trials data is available. Hot anti-SARS-CoV-2 drugs include interferon α, ribavirin, lopinavir/ritonavir, chloroquine phosphate, abidol, as well as hydroxychloroquine sulfate and remdesivir. But the later 2 drugs aren't mentioned in the Seventh Version of Diagnosis and Treatment Plan.


Asunto(s)
Antivirales/uso terapéutico , Infecciones por Coronavirus/tratamiento farmacológico , Neumonía Viral/tratamiento farmacológico , Betacoronavirus , China , Humanos , Pandemias , Guías de Práctica Clínica como Asunto
8.
Br J Hosp Med (Lond) ; 81(8): 1-10, 2020 Aug 02.
Artículo en Inglés | MEDLINE | ID: covidwho-743028

RESUMEN

The COVID-19 pandemic has predominantly affected the adult population. The disease is less well-defined in children (≤18 years). This review summarises the current understanding of the epidemiology, clinical manifestations, and management of COVID-19 in children and adolescents. The prevalence of COVID-19 is significantly lower in children than adults, but paediatric disease is likely underdiagnosed as a result of the high numbers of asymptomatic or mild cases. Children are vulnerable to family cluster outbreaks, but are unlikely to be index cases within a household. Vertical transmission or breast milk transmission are yet to be proven. Between 10 and 90% of paediatric COVID-19 cases are asymptomatic. Symptomatic cases typically present with mild symptoms, including cough, fever and sore throat. Intensive care admission and mortality are rare. Paediatric multisystem inflammatory syndrome temporally associated with COVID-19 is a rare, but severe, newly emerging phenotype. At present, there is no specific treatment for COVID-19 in adults or children; management is usually supportive. For severe or critical disease, including paediatric multisystem inflammatory syndrome temporally associated with COVID-19, the decision to start antiviral or immunomodulatory therapy should be on a case-by-case basis; in the UK, this should be done within a clinical trial. Further research is needed into both the disease course and treatment of paediatric COVID-19.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/fisiopatología , Neumonía Viral/epidemiología , Neumonía Viral/fisiopatología , Adolescente , Corticoesteroides/uso terapéutico , Antivirales/uso terapéutico , Betacoronavirus , Niño , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/tratamiento farmacológico , Oxigenación por Membrana Extracorpórea , Hemofiltración , Humanos , Unidades de Cuidado Intensivo Pediátrico/estadística & datos numéricos , Mortalidad , Pandemias , Neumonía Viral/diagnóstico , Neumonía Viral/tratamiento farmacológico , Reacción en Cadena en Tiempo Real de la Polimerasa , Síndrome de Respuesta Inflamatoria Sistémica/tratamiento farmacológico , Síndrome de Respuesta Inflamatoria Sistémica/epidemiología
9.
Ann Clin Microbiol Antimicrob ; 19(1): 40, 2020 Sep 02.
Artículo en Inglés | MEDLINE | ID: covidwho-742412

RESUMEN

A novel coronavirus (SARS-CoV-2), causing an emerging coronavirus disease (COVID-19), first detected in Wuhan City, Hubei Province, China, which has taken a catastrophic turn with high toll rates in China and subsequently spreading across the globe. The rapid spread of this virus to more than 210 countries while affecting more than 25 million people and causing more than 843,000 human deaths, it has resulted in a pandemic situation in the world. The SARS-CoV-2 virus belongs to the genus Betacoronavirus, like MERS-CoV and SARS-CoV, all of which originated in bats. It is highly contagious, causing symptoms like fever, dyspnea, asthenia and pneumonia, thrombocytopenia, and the severely infected patients succumb to the disease. Coronaviruses (CoVs) among all known RNA viruses have the largest genomes ranging from 26 to 32 kb in length. Extensive research has been conducted to understand the molecular basis of the SARS-CoV-2 infection and evolution, develop effective therapeutics, antiviral drugs, and vaccines, and to design rapid and confirmatory viral diagnostics as well as adopt appropriate prevention and control strategies. To date, August 30, 2020, no effective, proven therapeutic antibodies or specific drugs, and vaccines have turned up. In this review article, we describe the underlying molecular organization and phylogenetic analysis of the coronaviruses, including the SARS-CoV-2, and recent advances in diagnosis and vaccine development in brief and focusing mainly on developing potential therapeutic options that can be explored to manage this pandemic virus infection, which would help in valid countering of COVID-19.


Asunto(s)
Antivirales/uso terapéutico , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/prevención & control , Coronavirus/inmunología , Pandemias/prevención & control , Síndrome Respiratorio Agudo Grave/tratamiento farmacológico , Vacunas/uso terapéutico , Betacoronavirus , China/epidemiología , Infecciones por Coronavirus/epidemiología , Humanos , Síndrome Respiratorio Agudo Grave/epidemiología
10.
Nat Commun ; 11(1): 4252, 2020 08 25.
Artículo en Inglés | MEDLINE | ID: covidwho-741685

RESUMEN

The 2019 novel respiratory virus (SARS-CoV-2) causes COVID-19 with rapid global socioeconomic disruptions and disease burden to healthcare. The COVID-19 and previous emerging virus outbreaks highlight the urgent need for broad-spectrum antivirals. Here, we show that a defensin-like peptide P9R exhibited potent antiviral activity against pH-dependent viruses that require endosomal acidification for virus infection, including the enveloped pandemic A(H1N1)pdm09 virus, avian influenza A(H7N9) virus, coronaviruses (SARS-CoV-2, MERS-CoV and SARS-CoV), and the non-enveloped rhinovirus. P9R can significantly protect mice from lethal challenge by A(H1N1)pdm09 virus and shows low possibility to cause drug-resistant virus. Mechanistic studies indicate that the antiviral activity of P9R depends on the direct binding to viruses and the inhibition of virus-host endosomal acidification, which provides a proof of concept that virus-binding alkaline peptides can broadly inhibit pH-dependent viruses. These results suggest that the dual-functional virus- and host-targeting P9R can be a promising candidate for combating pH-dependent respiratory viruses.


Asunto(s)
Antivirales/farmacología , Coronavirus/efectos de los fármacos , Virus de la Influenza A/efectos de los fármacos , Péptidos/farmacología , Secuencia de Aminoácidos , Animales , Antivirales/química , Antivirales/metabolismo , Antivirales/uso terapéutico , Línea Celular , Endosomas/química , Endosomas/efectos de los fármacos , Femenino , Humanos , Concentración de Iones de Hidrógeno , Virus de la Influenza A/metabolismo , Ratones , Ratones Endogámicos BALB C , Infecciones por Orthomyxoviridae/tratamiento farmacológico , Infecciones por Orthomyxoviridae/metabolismo , Péptidos/química , Péptidos/metabolismo , Péptidos/uso terapéutico , Unión Proteica , Conformación Proteica , Rhinovirus/efectos de los fármacos , Rhinovirus/metabolismo , Carga Viral/efectos de los fármacos , Replicación Viral/efectos de los fármacos
11.
Adv Biol Regul ; 77: 100745, 2020 08.
Artículo en Inglés | MEDLINE | ID: covidwho-741319

RESUMEN

Coronavirus disease 2019 caused by SARS-CoV-2 originated from China and spread across every corner of the world. The scientific interest on COVID-19 increased after WHO declared it a pandemic in the early February of 2020. In fact, this pandemic has had a worldwide impact on economy, health, and lifestyle like no other in the last 100 years. SARS-CoV-2 belongs to Coronaviridae family and causes the deadliest clinical manifestations when compared to other viruses in the family. COVID-19 is an emerging zoonotic disease that has resulted in over 383,000 deaths around the world. Scientists are scrambling for ideas to develop treatment and prevention strategies to thwart the disease condition. In this review, we have attempted to summarize the latest information on the virus, disease, prevention, and treatment strategies. The future looks promising.


Asunto(s)
Betacoronavirus/patogenicidad , Control de Enfermedades Transmisibles/organización & administración , Infecciones por Coronavirus/epidemiología , Pandemias , Neumonía Viral/epidemiología , Antivirales/uso terapéutico , Ataxia/diagnóstico , Ataxia/fisiopatología , Ataxia/virología , Control de Enfermedades Transmisibles/métodos , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/terapia , Infecciones por Coronavirus/transmisión , Humanos , Hidroxicloroquina/uso terapéutico , Náusea/diagnóstico , Náusea/fisiopatología , Náusea/virología , Pandemias/prevención & control , Equipo de Protección Personal/provisión & distribución , Neumonía Viral/prevención & control , Neumonía Viral/terapia , Neumonía Viral/transmisión , Cuarentena/métodos , Cuarentena/organización & administración , Factores de Riesgo , Índice de Severidad de la Enfermedad , Distancia Social , Vómitos/diagnóstico , Vómitos/fisiopatología , Vómitos/virología
12.
Medwave ; 20(7): e7998, 2020 Aug 19.
Artículo en Español, Inglés | MEDLINE | ID: covidwho-740552

RESUMEN

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly spread throughout the world causing significant mortality in high risk patients with severe manifestations. To date, Remdesivir has been the only antiviral authorized by FDA as therapy for emergency use. One of the potential complications of this infection is cytokine storm, which optimal treatment remains unknown. We present the case of a 48-year-old man with no past medical history who presented to the hospital with dyspnea, cough, subjective fever, and diarrhea for 10 days. Nasopharyngeal PCR was positive for SARS-CoV-2. His respiratory status rapidly worsened to the point of requiring supplemental oxygen by high flow nasal cannula with FiO2 of 80%. Chest computed tomography showed confluent ground glass opacities in upper lobes accompanied by patchy airspace opacities in lower lobes bilaterally. He was started on hydroxychloroquine, which was switched to Remdesivir when it became available. Then, methylprednisolone was initiated for suspected cytokine storm. The patients oxygenation improved significantly over the following days and he was discharged home with no oxygen supplementation and saturating 96% on room air. Our case illustrates the role of Remdesivir for the treatment of severe COVID-19 pneumonia. We also observed a possible clinical benefit of corticosteroids in the context of suspected cytokine storm. Further studies are needed to evaluate this therapeutic strategy.


Asunto(s)
Adenosina Monofosfato/análogos & derivados , Alanina/análogos & derivados , Antivirales/uso terapéutico , Betacoronavirus , Infecciones por Coronavirus/tratamiento farmacológico , Neumonía Viral/tratamiento farmacológico , Adenosina Monofosfato/uso terapéutico , Alanina/uso terapéutico , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/diagnóstico , Síndrome de Liberación de Citoquinas/tratamiento farmacológico , Síndrome de Liberación de Citoquinas/etiología , Glucocorticoides/uso terapéutico , Humanos , Masculino , Metilprednisolona/uso terapéutico , Persona de Mediana Edad , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico
14.
Medicine (Baltimore) ; 99(35): e21804, 2020 Aug 28.
Artículo en Inglés | MEDLINE | ID: covidwho-740204

RESUMEN

INTRODUCTION: Pneumonia is one of the most important characteristics of coronavirus disease 2019 (COVID-19) and imaging findings of COVID-19 pneumonia are diverse and change over disease course. However, the detailed clinical course of organizing pneumonia (OP) caused by COVID-19 has not been clarified. PATIENT CONCERNS: A 60-year-old man and a 61-year-old woman diagnosed with mild COVID-19 were admitted to our hospital. Their respiratory symptoms were deteriorating even after initiating treatment with antiviral drugs. DIAGNOSIS: Chest X-rays and computed tomography scan showed a rapid progression of linear consolidation with reversed halo sign, distributed in subpleural and peri-bronchial regions. They also presented with pulmonary fibrosis findings, including traction bronchiectasis and marked lung volume reduction. They were diagnosed with rapidly progressing OP. INTERVENTIONS: They were treated with systemic corticosteroids. OUTCOMES: The patients' imaging findings and respiratory conditions improved rapidly without any adverse effects. CONCLUSION: Physicians should carefully monitor patients with COVID-19, as they can develop rapidly progressive and fibrotic OP, which respond to corticosteroids.


Asunto(s)
Infecciones por Coronavirus , Pulmón , Pandemias , Neumonía Viral , Prednisolona/administración & dosificación , Fibrosis Pulmonar , Antivirales/uso terapéutico , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/fisiopatología , Infecciones por Coronavirus/terapia , Progresión de la Enfermedad , Relación Dosis-Respuesta a Droga , Femenino , Glucocorticoides/administración & dosificación , Humanos , Pulmón/diagnóstico por imagen , Pulmón/patología , Masculino , Persona de Mediana Edad , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico , Neumonía Viral/etiología , Neumonía Viral/fisiopatología , Neumonía Viral/terapia , Fibrosis Pulmonar/diagnóstico por imagen , Fibrosis Pulmonar/etiología , Tomografía Computarizada por Rayos X/métodos , Resultado del Tratamiento
15.
Medicine (Baltimore) ; 99(33): e21614, 2020 Aug 14.
Artículo en Inglés | MEDLINE | ID: covidwho-740196

RESUMEN

BACKGROUND: As of June 2020, more than 7 million cases of coronavirus disease (COVID-2019) have been reported worldwide. At present, there is no vaccine or antiviral for the novel coronavirus pneumonia. Lianhua Qingwen (LQ), a Chinese medicine formula, has been authorized by the Chinese government for treating COVID-2019. This systematic review and meta-analysis will evaluate the efficacy and safety of LQ on patients with COVID-19. METHODS: Two independent reviewers will search the following databases of the China Biology Medicine disc, China National Knowledge Infrastructure, China Science and Technology Periodical Database, Wanfang database, Embase, PubMed, and Cochrane Library from the date of conception to June 1, 2020. We will use the MeSH/Emtree terms, combining free-text words that were properly adjusted for the different databases in all of the search strategies. We will take primary clinical symptoms, total efficacy, and adverse event into consideration for our primary outcomes. As secondary outcomes, we will estimate the chest computed tomography manifestations, the rate of conversion to severe cases, and secondary clinical symptoms. We will evaluate the quality of including studies through the risk of bias assessment tool provided by the Cochrane Collaboration. Fixed-or random-effect model will be utilized to calculate the overall pooled risk estimates. Forest plots will be generated to prove the pooled results. Sensitivity analysis will be carried out to identify sources of heterogeneity. The Begg rank correlation test and Egger linear regression test will be used to explore publication bias. RESULTS: This systematic review and meta-analysis will compare the primary and secondary outcomes at baseline and endpoint in the treatment and control groups to investigate the efficacy and safety of LQ for treatment COVID-2019. DISCUSSION: Data from this study will provide strong evidence for clinical decision if the findings are positive.PROSPERO registration number: CRD42020190757.


Asunto(s)
Antivirales/uso terapéutico , Betacoronavirus , Infecciones por Coronavirus/tratamiento farmacológico , Medicamentos Herbarios Chinos/uso terapéutico , Neumonía Viral/tratamiento farmacológico , Infecciones por Coronavirus/virología , Femenino , Humanos , Masculino , Metaanálisis como Asunto , Pandemias , Neumonía Viral/virología , Proyectos de Investigación , Revisiones Sistemáticas como Asunto , Resultado del Tratamiento
16.
Ann Ital Chir ; 91: 273-276, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-739593

RESUMEN

CASE REPORT: A 64-year-old woman presented to our emergency department during the outbreak of the covid-19 emergency in Italy with syncope, anosmia, mild dyspnoea and atypical chest and dorsal pain. A chest CT scan showed an acute type B aortic dissection (ATBAD) and bilateral lung involvement with ground-glass opacity, compatible with interstitial pneumonia. Nasopharyngeal swabs resulted positive for SARS-CoV-2. For the persistence of chest pain, despite the analgesic therapy, we decided to treat her with a TEVAR. Patient's chest and back pain resolved during the first few days after the procedure. No surgical or respiratory complications occurred and the patient was discharged 14 days after surgery. DISCUSSION: By performing the operation under local anesthesia, it was possible to limit both the staff inside the operatory room and droplet/aerosol release. Since we had to perform the operation in a hemodynamics room, thanks to the limited extension of the endoprosthesis and the good caliber of the right vertebral artery we were able to reduce the risk of spinal cord ischemia despite the lack of a revascularization of the left subclavian artery. CONCLUSIONS: A minimally invasive total endovascular approach allows, through local anesthesia and percutaneous access, to avoid surgical cut down and orotracheal intubation. This, combined with a defined management protocol for infected patients, seems to be a reasonable way to perform endovascular aortic procedures in urgent setting, even in a SARSCoV- 2 positive patient. KEY WORDS: COVID-19, Dissection, TEVAR.


Asunto(s)
Aneurisma Disecante/cirugía , Aneurisma de la Aorta Torácica/cirugía , Betacoronavirus/aislamiento & purificación , Implantación de Prótesis Vascular/métodos , Infecciones por Coronavirus/prevención & control , Procedimientos Endovasculares/métodos , Control de Infecciones/métodos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Pandemias/prevención & control , Neumonía Viral/prevención & control , Anestesia Local , Aneurisma Disecante/complicaciones , Profilaxis Antibiótica , Anticoagulantes/uso terapéutico , Antivirales/uso terapéutico , Aneurisma de la Aorta Torácica/complicaciones , Contraindicaciones de los Procedimientos , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/transmisión , Darunavir/uso terapéutico , Diabetes Mellitus Tipo 2/complicaciones , Quimioterapia Combinada , Enoxaparina/uso terapéutico , Femenino , Humanos , Hidroxicloroquina/uso terapéutico , Complicaciones Intraoperatorias/prevención & control , Intubación Intratraqueal/efectos adversos , Persona de Mediana Edad , Nasofaringe/virología , Quirófanos , Aislamiento de Pacientes , Neumonía Viral/complicaciones , Neumonía Viral/tratamiento farmacológico , Neumonía Viral/transmisión , Ritonavir/uso terapéutico , Isquemia de la Médula Espinal/prevención & control , Arteria Vertebral/cirugía
17.
Clin Sci (Lond) ; 134(17): 2235-2241, 2020 09 18.
Artículo en Inglés | MEDLINE | ID: covidwho-738221

RESUMEN

Human serine protease inhibitors (serpins) are the main inhibitors of serine proteases, but some of them also have the capability to effectively inhibit cysteine proteases. Severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) main protease (Mpro) is a chymotrypsin-type cysteine protease that is needed to produce functional proteins essential for virus replication and transcription. Serpin traps its target proteases by presenting a reactive center loop (RCL) as protease-specific cleavage site, resulting in protease inactivation. Mpro target sites with its active site serine and other flanking residues can possibly interact with serpins. Alternatively, RCL cleavage site of serpins with known evidence of inhibition of cysteine proteases can be replaced by Mpro target site to make chimeric proteins. Purified chimeric serpin can possibly inhibit Mpro that can be assessed indirectly by observing the decrease in ability of Mpro to cleave its chromogenic substrate. Chimeric serpins with best interaction and active site binding and with ability to form 1:1 serpin-Mpro complex in human plasma can be assessed by using SDS/PAGE and Western blot analysis with serpin antibody. Trapping SARS-CoV-2 Mpro cysteine protease using cross-class serpin cysteine protease inhibition activity is a novel idea with significant therapeutic potential.


Asunto(s)
Antivirales/farmacología , Betacoronavirus/efectos de los fármacos , Infecciones por Coronavirus/tratamiento farmacológico , Neumonía Viral/tratamiento farmacológico , Serpinas/farmacología , Proteínas no Estructurales Virales/antagonistas & inhibidores , Antivirales/uso terapéutico , Betacoronavirus/enzimología , Western Blotting , Infecciones por Coronavirus/virología , Cisteína Endopeptidasas/química , Electroforesis en Gel de Poliacrilamida , Humanos , Pandemias , Neumonía Viral/virología , Serpinas/uso terapéutico , Proteínas no Estructurales Virales/química
18.
J Int Med Res ; 48(8): 300060520949077, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: covidwho-737978

RESUMEN

The emergence of coronavirus disease 2019 (COVID-19) in December 2019 has resulted in over 20 million cases and 741,808 deaths globally, affecting more than 200 countries. COVID-19 was declared a pandemic on 11 March 2020 by the World Health Organization. The disease is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). There is limited information on COVID-19, and treatment has so far focused on supportive care and use of repurposed drugs. COVID-19 can be transmitted via person-to-person contact through droplet spread. Some of the recommended precautionary measures to reduce the rate of disease spread include social distancing, good hygiene practices, and avoidance of crowded areas. These measures are effective because the droplets are heavy and can only travel approximately 1 meter in the air, settling quickly on fixed surfaces. Promising strategies to combat SARS-CoV-2 include discovery of therapeutic targets/drugs and vaccines. In this review, we summarize the epidemiology, pathophysiology, and diagnosis of COVID-19. We also address the mechanisms of action of approved repurposed drugs for therapeutic management of the disease.


Asunto(s)
Antivirales/uso terapéutico , Betacoronavirus/patogenicidad , Control de Enfermedades Transmisibles/organización & administración , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/terapia , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/terapia , Adenosina Monofosfato/análogos & derivados , Adenosina Monofosfato/uso terapéutico , Factores de Edad , Alanina/análogos & derivados , Alanina/uso terapéutico , Anticuerpos Monoclonales Humanizados/uso terapéutico , Betacoronavirus/efectos de los fármacos , Betacoronavirus/genética , Cloroquina/uso terapéutico , Control de Enfermedades Transmisibles/métodos , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/fisiopatología , Reposicionamiento de Medicamentos , Humanos , Incidencia , Equipo de Protección Personal/provisión & distribución , Neumonía Viral/diagnóstico , Neumonía Viral/fisiopatología , Cuarentena/métodos , Cuarentena/organización & administración , Índice de Severidad de la Enfermedad , Distancia Social , Análisis de Supervivencia
19.
Molecules ; 25(17)2020 Aug 27.
Artículo en Inglés | MEDLINE | ID: covidwho-737517

RESUMEN

Three types of new coronaviruses (CoVs) have been identified recently as the causative viruses for the severe pneumonia-like respiratory illnesses, severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and corona-virus disease 2019 (COVID-19). Neither therapeutic agents nor vaccines have been developed to date, which is a major drawback in controlling the present global pandemic of COVID-19 caused by SARS coronavirus 2 (SARS-CoV-2) and has resulted in more than 20,439,814 cases and 744,385 deaths. Each of the 3C-like (3CL) proteases of the three CoVs is essential for the proliferation of the CoVs, and an inhibitor of the 3CL protease (3CLpro) is thought to be an ideal therapeutic agent against SARS, MERS, or COVID-19. Among these, SARS-CoV is the first corona-virus isolated and has been studied in detail since the first pandemic in 2003. This article briefly reviews a series of studies on SARS-CoV, focusing on the development of inhibitors for the SARS-CoV 3CLpro based on molecular interactions with the 3CL protease. Our recent approach, based on the structure-based rational design of a novel scaffold for SARS-CoV 3CLpro inhibitor, is also included. The achievements summarized in this short review would be useful for the design of a variety of novel inhibitors for corona-viruses, including SARS-CoV-2.


Asunto(s)
Antivirales/química , Betacoronavirus/química , Coronavirus del Síndrome Respiratorio de Oriente Medio/patogenicidad , Inhibidores de Proteasas/química , Virus del SRAS/patogenicidad , Proteínas no Estructurales Virales/antagonistas & inhibidores , Antivirales/clasificación , Antivirales/uso terapéutico , Betacoronavirus/efectos de los fármacos , Betacoronavirus/enzimología , Dominio Catalítico , Infecciones por Coronavirus/tratamiento farmacológico , Cristalografía por Rayos X , Cisteína Endopeptidasas/química , Cisteína Endopeptidasas/genética , Cisteína Endopeptidasas/metabolismo , Humanos , Cinética , Coronavirus del Síndrome Respiratorio de Oriente Medio/genética , Coronavirus del Síndrome Respiratorio de Oriente Medio/metabolismo , Simulación del Acoplamiento Molecular , Pandemias , Neumonía Viral/tratamiento farmacológico , Inhibidores de Proteasas/clasificación , Inhibidores de Proteasas/uso terapéutico , Unión Proteica , Conformación Proteica en Hélice alfa , Conformación Proteica en Lámina beta , Dominios y Motivos de Interacción de Proteínas , Virus del SRAS/genética , Virus del SRAS/metabolismo , Síndrome Respiratorio Agudo Grave/tratamiento farmacológico , Especificidad por Sustrato , Termodinámica , Proteínas no Estructurales Virales/química , Proteínas no Estructurales Virales/genética , Proteínas no Estructurales Virales/metabolismo
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