A Novel and Robust Analytical Technique for Determining Covid-19 Medications Used in Emergencies

To treat mild to moderate COVID-19, an investigational drug called nirmatrelvir in combination with ritonavir is being researched for which the potential hazards with this are still unknown. Nirmatrelvir has been approved for immediate use by the US Food and drug intake in conjunction with the drug ritonavir for the treatment of mild to medium COVID-19 in grown ups and individuals of more than 12 years who test positive for the virus and are at a high risk to develop severe COVID-19.To quantify the drugs simultaneously in tablet dosage forms, a novel, sensitive and reproducible reverse phase liquid chromatography method has been developed. Thechromatographic separation was performed using Phenomenex (250x4.6mm,5micro particle size) column. The separation and elution were carried out at an ambient temperature using a mobile phase consisting of 0.1% trifluoro acetic acid &acetonitrile in the ratio of 50:50%v/v. The maximum absorbance by UV spectrophotometer shown at wavelength 258.3nm& 271.4nm for nirmatrelvir and ritonavir. Also, 266nm was selected as detector wavelength by a photodiode array detector for the HPLC chromatrographic method.Beer lambert's law obeyed in the linear range of 37.5-225microg/mL(R2=0.9998) for nirmatrelvir and 25-150 microg/mL(R2=0.9994) for ritonavir. The method shows method and system precision with % RSD less than 1%.The percentage mean recovery was found to be 99.9-100.2%& 100.0-100.2%. The LOD 1.5 microg/mL &1 microg/mL values indicates the method sensitivity. The proposed stability indicating method was validated for precision,accuracy, specificity, selectivity, robustness and stability studies according to ICH guidelines.Copyright © 2022, Anka Publishers. All rights reserved.

Cardio-cerebral infarction, intraluminal carotid thrombosis and hyperperfusion in COVID-19

Objective: To report a unique presentation of acute synchronous cardio-cerebral infarction with intraluminal carotid thrombus (ICT) and hyperperfusion in the setting of a recent SARS-CoV-2 infection. Background: Simultaneous acute ischemic stroke (AIS) and acute myocardial infarction (AMI), also referred to as cardio-cerebral infarction, is an extremely rare entity. Additionally, AIS due to ICT is an infrequent condition and is often associated with ipsilateral carotid stenosis or underlying hypercoagulable state. Infection with SARS-CoV-2 is thought to cause endothelial inflammation and a hypercoagulable state. Here we report a case of concurrent AIS due to a partially occlusive ICT and AMI in the setting of recent SARS-CoV-2 infection. Design/Methods: Case report and literature review. Results: A middle-aged male presented with isolated transcortical sensory aphasia. CT angiography showed a free-floating intraluminal thrombus in the clinoid segment of the left internal carotid artery. There was an increase in regional cerebral blood flow (CBF) and cerebral blood volume (CBV) as well as decreased Tmax on perfusion imaging consistent with hyperperfusion. Additionally, he was found to have an acute inferior-wall ST-elevation MI. He did report a recent COVID-19 exposure and clinical symptoms of chills with pulmonary imaging concerning for COVID-19 pneumonia. Swab-based PCR testing for COVID-19 was negative, but IgG antibody test returned positive, suggesting a recent infection. D-dimer was elevated. Magnetic resonance imaging (MRI) brain confirmed an AIS involving the left MCA territory. Conclusions: We report a unique case of simultaneous AIS from ICT and AMI in the setting of recent SARS-CoV-2 infection and with the etiology of both events attributed to a COVID-19 hypercoagulable state. Additionally, imaging studies showed a rare phenomenon of hyperperfusion that occurs when cerebral blood flow increases in the region of previous ischemia (hypoperfusion and/or infarcted brain tissue) and is thought to be a form of dysfunctional autoregulation.