Weight loss treatment of COVID-19 in patients with NCDs: a pilot prospective clinical trial (preprint)

Background COVID-19 in comorbidity with non-communicable chronic diseases (NCDs) complicate the diagnosis, treatment, prognosis, and increase mortality rate.Objective. To evaluate the effects of the weight loss treatment on clinic/laboratory inflammation and metabolic profile, reactive oxygen species (ROS) body composition in patients with COVID-19 in comorbidity with NCDs.Design: A 6-week open, pilot prospective clinical trial.Setting: The study included 72 adult patients with COVID and influenza in comorbidity with type 2 diabetes (T2D), hypertension, and NASH.Interventions: The treatment involved a fast-weight-loss-method (Analimentary detoxication, ANADETO) including calorie restriction to 50–100 kcal/day, salt intake to 5–6 gr/day, hot water drinking 1000–1500 ml/day, walking > 2,000 steps/day, and sexual self-restraint.Main outcome measures: Primary endpoints: Clinic/infectious/inflammation tests for COVID/Influenza; weight loss during 14 days. Secondary endpoints: fasting blood glucose, HbA1c, blood insulin; systolic/diastolic BP; blood lipids; ALT/AST, chest-CT-scan.Results The patients weight lost from baseline (-9,14 − 12,4%; P < 0.001); COVID and Influenza were a negative in > 96.3% patients at the 14 days. Systolic/diastolic BP normalized (P < 0.0001), glucose/lipids metabolism (P < 0.0001); ALT/AST normalized (P < 0.0001), platelets increased from baseline (P < 0.0001), chest-CT (P < 0.0001) at 6-week follow-up. The previous antidiabetic, antihypertensive, anti-inflammatory and hepatoprotective, and other symptomatic medications were adequately decreased in 2–5 days to completely stopping by 5–8 days treatment.Conclusions The non-pharmacological treatment including fast weight loss is clinical/laboratory benefit in treatment of patients with COVID-19 and Influenza in comorbidity with T2D, hypertension, and NASH.Trial Registration: ClinicalTrials.gov NCT05635539 (12/01/2022): https://clinicaltrials.gov/ct2/show/NCT05635539?term=NCT05635539&draw=2&rank=1 .

Weight loss in patients with COVID-19 and Influenza in comorbidity with NCDs: a pilot prospective clinical trial. (preprint)

Background COVID and Influenza with non-communicable chronic diseases (NCDs) complicate the diagnosis, treatment, prognosis, and increase mortality rate. The aim: to evaluate the effects of the fast weight loss on clinic and laboratory inflammation profile, metabolic profile, reactive oxygen species (ROS) and body composition in patients with COVID and Influenza in comorbidity with NCDs. Methods A 6-week open, pilot prospective clinical trial including 62 adult patients with COVID (n=27) and influenza (n=35) in comorbidity with T2D, hypertension, and NASH. Overweight in 33 patients (53.2%) with BMI 28.14{+/-}0.39 kg/m2, and 29 patients without overweight with BMI 23.37 {+/-} 0.38 kg/m2. T2D in 26 (41.9%); Hypertension in 38 (61.3%) (incl. 12 patients with T2D); NASH in 51 patients (82.2%) (incl. 8 patients with NASH, T2D and Hypertension; 6 patients with NASH and T2D; 18 patients with NASH and Hypertension; 19 patients with only NASH). Primary endpoints Clinic/infectious/inflammation tests for COVID and Influenza; weight loss during 14 days. Secondary endpoints: fasting blood glucose, HbA1c, blood insulin; systolic/diastolic BP; blood lipids; ALT, AST, chest CT-scan. Results The patients with overweight lost -12,4% from baseline or BMI= -4.2 kg/m2, and patients without overweight lost -9,14% from baseline or BMI= -2.2 kg/m2 (-9.7{+/-}0.7 kg vs. -6.4{+/-}0.6 kg, respectively; P<0.001) at 14-day of the treatment. Weight loss in both groups was due to reduction of fat mass (P<0.0001). Sputum production increased in 1.0-1.5 liter/day on 2-3 days, decreased in 7-9 days. Body temperature normalized in 6-9 days. On 3-5 days, in most patients their urine became turbid/muddy/intensively colored. Urine microscopy showed organic and non-organic salts, and leukocyturia (20-35/sight). White blood cells, lymphocytes, NLR normalized at 14 days (P<0.0001). Total-fibrinogen, C-reactive-protein, and Erythrocyte-sedimentation-rate, ROS normalized at 14-day of treatment (P<0.0001). COVID and Influenza were a negative in >96.3% patients at 14-day. Systolic/diastolic BP decreased (161.3{+/-}1.31/101.6{+/-}0.85 vs. 118.3{+/-}0.46/80.89{+/-}0.66, P<0.0001), glucose and lipids metabolism in patients with T2D (n=26) (P<0.0001); ALT and AST in patients with NASH (n=51) were significantly normalized (from baseline 134.3{+/-}5.4 and 166.5{+/-}5.5 U/L, respectively, and at 14-day to 78.4{+/-}4.2 and 92.4{+/-}4.9 U/L, respectively (P<0.0001)), platelets increased from baseline (186.5{+/-}4.6, x109/L) at 14-day of treatment (238.5{+/-}5.8, x109/L) (P<0.0001), and at 6-week follow-up (278.3{+/-}6.9, x109/L) (P<0.0001). The mean score of chest-CT for the patients (n=44) was 13.12{+/-}0.38 from baseline, and at 14-day the score was 1.72{+/-}0.12 (P<0.0001). ROS level normalized at 14-day treatment and 6-week follow-up from baseline (P<0.0001). The previous antidiabetic, antihypertensive, antiinflammatory and hepatoprotective, and other symptomatic medications were adequately decreased in 2-5 days to completely stopping by 5-8 days treatment. Conclusions The fast weight loss is clinical/laboratory benefit in treatment of patients with COVID-19 and Influenza in comorbidity with T2D, hypertension, and NASH.

Early transfusion of convalescent plasma improves the clinical outcome in severe SARS-CoV2 infection (preprint)

Plasma harvested from convalescent COVID-19 patients (CCP) has been applied as first-line therapy in the early phase of the SARS-CoV2 pandemic through clinical studies using various protocols. We present data from a cohort of 267 hospitalized, severe COVID-19 patients who received CCP. No transfusion-related complications were reported, indicating the overall safety of CCP therapy. Patients who eventually died from COVID-19 received CCP significantly later (3.95 versus 5.22 days after hospital admission) and had higher interleukin 6 (IL-6) levels (28.9 pg/ml versus 102.5 pg/ml) than those who survived. In addition, CCP-transfusion caused a significant reduction in the overall inflammatory status of the patients regardless of the severity of disease or outcome, as evidenced by decreasing C-reactive protein, IL6 and ferritin levels. We conclude that, CCP-transfusion is a safe and effective supplementary treatment modality for hospitalized COVID-19 patients characterized by better expected outcome if applied as early as possible. We also observed that, IL-6 may be a suitable laboratory parameter for patient selection and monitoring of CCP therapy effectiveness.