ABSTRACT
The aim of this study was to know the prevalence and severity of COVID-19 in patients treated with long-term macrolides and to describe the factors associated with worse outcomes. A cross-sectional study was conducted in Primary Care setting. Patients with macrolides dispensed continuously from 1 October 2019 to 31 March 2020, were considered. Main outcome: diagnosis of coronavirus disease-19 (COVID-19). Secondary outcomes: symptoms, severity, characteristics of patients, comorbidities, concomitant treatments. A total of 3057 patients met the inclusion criteria. Median age: 73 (64-81) years; 55% were men; 62% smokers/ex-smokers; 56% obese/overweight. Overall, 95% of patients had chronic respiratory diseases and four comorbidities as a median. Prevalence of COVID-19: 4.8%. This was in accordance with official data during the first wave of the pandemic. The most common symptoms were respiratory: shortness of breath, cough, and pneumonia. Additionally, 53% percent of patients had mild/moderate symptoms, 28% required hospital admission, and 19% died with COVID-19. The percentage of patients hospitalized and deaths were 2.6 and 5.8 times higher, respectively, in the COVID-19 group (p < 0.001). There was no evidence of a beneficial effect of long-term courses of macrolides in preventing SARS-CoV-2 infection or the progression to worse outcomes in old patients with underlying chronic respiratory diseases and a high burden of comorbidity.
ABSTRACT
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Subject(s)
Humans , Bleomycin/standards , Bleomycin/therapeutic use , Pharmacopoeias as Topic/standards , Dosage Forms/standards , Efficacy/standards , Cytostatic Agents/standards , Cytostatic Agents/therapeutic useABSTRACT
UNLABELLED: Dopamine autoxidation in an oxygenated physiological salt solution (37 degrees C, pH=7.4) mostly occurred in a 2.5 h time period. H(2)O(2) and dopamine quinones were produced during dopamine autoxidation. In partially pre-contracted rat aortic rings, 10-100 microm dopamine induced endothelium-independent contractions and 0.3-1 mm dopamine induced complete, slow-developing endothelium-independent relaxations. Indomethacin and catalase suppressed the endothelium-independent dopamine contractions. Catalase strongly reduced the endothelium-independent dopamine relaxations. Furthermore, 1 mm dopamine for 60 min followed by a 90 min washout period induced the release of lactate dehydrogenase and the complete impairment of ring reactivity to phenylephrine and KCl. Pre-treatment with catalase or glutathione prevented dopamine-induced deleterious effects so that further concentration-response curves to phenylephrine and KCl could be obtained. The phenylephrine potency was maintained in rings pre-treated with glutathione but not in rings pre-treated with catalase. IN CONCLUSION: (1) dopamine is rapidly and non-enzymatically oxidized in physiological solutions, generating H(2)O(2) and quinones; (2) low H(2)O(2) levels increase vascular tone by activating cyclooxygenase; (3) high H(2)O(2) levels cause irreversible relaxations due to unspecific cellular damage; and (4) dopamine quinones cause a specific alteration in the phenylephrine response.
