The Rise of SARS-CoV-2 (COVID-19) Omicron Subvariant Pathogenicity.

During the COVID-19 pandemic, variants of the Betacoronavirus SARS-CoV-2, the etiologic agent of COVID-19 disease, progressively decreased in pathogenicity up to the Omicron strain. However, the case fatality rate has increased from Omicron through each major Omicron subvariant (BA.2/BA.4, BA.5, XBB.1.5) in the United States of America. World data also mirror this trend. We show that the rise of Omicron pathogenicity is exponential, and we have modeled the case fatality rate of the next major subvariant as 0.0413, 2.5 times that of the Alpha strain and 60% of the original Wuhan strain which caused the greatest morbidity and mortality during the pandemic. Small-molecule therapeutics have been developed, and some of these, such as chlorpheniramine maleate, may be useful in the event of an Omicron subvariant of higher risk.

Correction: The Rise of SARS-CoV-2 (COVID-19) Omicron Subvariant Pathogenicity.

[This corrects the article DOI: 10.7759/cureus.40148.].

Molecular Modeling and Preliminary Clinical Data Suggesting Antiviral Activity for Chlorpheniramine (Chlorphenamine) Against COVID-19.

Chlorpheniramine maleate, a widely used over-the-counter antihistamine, has been identified as a structural analog of aminoquinolines known to possess antiviral activity against the Betacoronavirus severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19). Structural similarities include the chlorophenyl group, pyridine ring, alkyl sidechain, and terminal tertiary amine; the comparison of aqueous energy-minimized structures indicates significant three-dimensional similarity as well. Preliminary clinical evidence supports these conclusions. The present study suggests that chlorpheniramine possesses antiviral activity against COVID-19.

Determining the efficacy of auricular acupuncture for reducing anxiety in patients withdrawing from psychoactive drugs.

Auricular acupuncture (AA) is a widely accepted treatment option for substance abuse that is used in more than 700 treatment centers worldwide. Despite claims of perceived clinical benefits by patients and treatment staff, research efforts have failed to substantiate purported benefits, and the mechanism(s) by which AA serves in the treatment of addiction remain inconclusive. Numerous studies have shown AA to be an effective treatment for perioperative anxiety. In this study, we hypothesize that AA reduces the anxiety associated with withdrawal from psychoactive drugs. The study used a randomized, controlled design and included a sample of 101 patients recruited from an addiction treatment service. Subjects were assigned to one of three treatment groups (National Acupuncture Detoxification Association [NADA] AA, AA at sham points, or treatment setting control) and were instructed to attend treatment sessions for 3 days. The primary outcome measure state anxiety was assessed using a pretest-posttest treatment design. The study hypothesis was not confirmed. The NADA protocol was not more effective than sham or treatment setting control in reducing anxiety. The widespread acceptance of AA in the treatment of addiction remains controversial.

Chair massage for treating anxiety in patients withdrawing from psychoactive drugs.

CONTEXT: Therapeutic massage has been proven to be an effective, nonpharmacologic, alternative for managing state and trait anxiety in a variety of clinical situations. However, no controlled study has investigated this effect in an addiction treatment setting. AIM: The aim of this study was to investigate the effectiveness of chair massage for reducing anxiety in persons participating in an inpatient withdrawal management program for psychoactive drugs. DESIGN: The design was a randomized, controlled clinical trial conducted from June 2008 to January 2009. SUBJECTS: Eighty-two (82) adult patients received inpatient treatment for psychoactive drug withdrawal (alcohol, cocaine, and opiates). SETTING: This study was conducted at the Withdrawal Management Services at the Capital District Health Authority, Halifax, Nova Scotia. INTERVENTIONS: Subjects were randomly assigned to receive chair massage (n = 40) or a relaxation control condition (n = 42). Treatments were offered for 3 consecutive days. Standard counseling and pharmacologic management were also offered concurrently to patients in all conditions. MEASUREMENTS: The primary outcome measure was anxiety assessed using the Spielberger State-Trait Anxiety Inventory (STAI). State and trait anxiety scores were determined immediately prior to and following each treatment intervention. RESULTS: Analysis of STAI scores showed a significant reduction in state and trait anxiety for both interventions (p < 0.001). The magnitude in the reduction in state (p = 0.001) and trait (p = 0.045) anxiety was significantly greater in the chair massage group where the effect on state anxiety was sustained, at least in part, for 24 hours. CONCLUSIONS: Within the clinical context of this study, chair massage was more effective that relaxation control in reducing anxiety. Further investigation of chair massage as a potential nonpharmacologic adjunct in the management of withdrawal related anxiety is warranted.