ABSTRACT
Metronidazole (MTZ) can decrease the levels of several cytokines. This research aimed at the investigation of the anti-inflammatory impact of MTZ in COVID-19. A randomized, single-blind clinical trial for comparing the anti-inflammatory effect of MTZ in two eligible groups of adult patients with lower respiratory tract involvement due to Covid-19 treated with a standard national method with or without MTZ was performed. Inflammatory markers were measured as the primary outcome in two groups. Oxygen saturation, length of hospital stays, and mortality of patients were evaluated as secondary outcomes. Among 44 patients with lower respiratory tract due to Covid-19, 20(45.5%) were randomly allocated in group A with the current standard treatment plus the MTZ tablet for 7 days orally and 24 (54.5%) in group B with the current standard treatment. The mean of ESR in group A was statistically significantly lower than that of group B on the seventh day (A: 38.25 ± 18.75 vs. B: 47.67 ± 26.41, p = 0.02). Moreover, the mean of IL6 diminished significantly in both A (p = 0.01) and B (p = 0.01) groups on the seventh day compared to the first day. The decrease of TNF was not significant in any of the groups A (p = 0.3) and B (p = 0.4) from the 7th day to the first day. No significant difference was not found between group A and group B groups on the CRP level (p = 0.1). Findings of this study showed the anti-inflammatory impact of MTZ in the patient with lower respiratory inflammation due to COVID-19.
ABSTRACT
Persian medicine has recommended clinical experiences and proper herbal remedies for prevention and treatment of microbial infections and respiratory diseases. An open-label, randomized, controlled, multicenter trial was conducted at five hospitals in Tehran and Isfahan provinces of Iran on 358 hospitalized adult patients. A total of 174 patients received standard care and 184 received herbal remedies (polyherbal decoction every 8 hr and two herbal capsules every 12 hr) plus standard care for 7 days. The primary clinical endpoint was the duration of hospital stay, and secondary outcomes were clinical improvement of symptoms based on self-assessment questionnaire. Results demonstrated that these natural decoction and capsules treatment plus routine care significantly decreased duration of hospital dyspnea (3.291 day vs. 6.468 days), accelerated clinical improvement, and decreased symptoms such as dry cough, dyspnea, muscle pain, headache, fatigue, anorexia, chills, runny nose, sputum cough, and vertigo in the treatment group compared with standard-care group. Significant effects of these polyherbal formulations on improving the symptoms of COVID-19 could be incredibly promising for managing this pandemic with acceptable tolerability.
Subject(s)
COVID-19 , Adult , Capsules , Humans , Iran , SARS-CoV-2 , Treatment OutcomeABSTRACT
PURPOSE: The COVID-19 outbreak is affecting people worldwide. Many infected patients have respiratory involvement that may progress to acute respiratory distress syndrome. This pilot study aimed to evaluate the clinical efficacy of low-dose whole-lung radiation therapy in patients with COVID-19 pneumonia. METHODS AND MATERIALS: In this clinical trial, conducted in Iran, we enrolled patients with COVID-19 who were older than 60 years and hospitalized to receive supplementary oxygen for their documented pneumonia. Participants were treated with whole-lung irradiation in a single fraction of 0.5 Gy plus the national protocol for the management of COVID-19. Vital signs (including blood oxygenation and body temperature) and laboratory findings (interleukin-6 and C-reactive peptide) were recorded before and after irradiation. RESULTS: Between May 21, 2020 and June 24, 2020, 5 patients received whole-lung irradiation. They were followed for 5 to 7 days to evaluate the response to treatment and toxicities. The clinical and paraclinical findings of 4 of the 5 patients (patient 4 worsened and died on day 3) improved on the first day of irradiation. Patient 3 opted out of the trial on the third day after irradiation. The mean time to discharge was 6 days for the other 3 patients. No acute radiation-induced toxicity was recorded. CONCLUSIONS: With a response rate of 80%, whole-lung irradiation in a single fraction of 0.5 Gy had encouraging results in oxygen-dependent patients with COVID-19 pneumonia.
