Broad-spectrum antiviral activity of naproxen: from Influenza A to SARS-CoV-2 Coronavirus

There is an urgent need for specific antiviral drugs directed against SARS-CoV-2 both to prevent the most severe forms of COVID-19 and to reduce viral excretion and subsequent virus dissemination; in the present pandemic context, drug repurposing is a priority. Targeting the nucleoprotein N of the SARS-CoV-2 coronavirus in order to inhibit its association with viral RNA could be a strategy to impeding viral replication and possibly other essential functions associated with viral N. The antiviral properties of naproxen, belonging to the NSAID family, previously demonstrated against Influenza A virus, were evaluated against SARS-CoV-2. Naproxen binding to the nucleoprotein of SARS-CoV2 was shown by molecular modeling. In VeroE6 cells and reconstituted human primary respiratory epithelium models of SARS-CoV-2 infection, naproxen inhibited viral replication and protected the bronchial epithelia against SARS-CoV-2 induced-damage. The benefit of naproxen addition to the standard of care is tested in an on-going clinical study.

[Current organization of disaster medicine]. / Organisation actuelle de la médecine de catastrophe.

The concept of disaster medicine, derivedfrom medical management of casualties caused by terrorist attacks or earthquakes, began to be taught in medical school in 1982. It adapts military intervention tactics to civilian practices, and differentiates major disasters (in which preformed teams are sent to the scene) from disasters with limited effects (predefined plans form the backbone of the rescue organization). Management of blast and crush syndromes, triage, care of numerous burn victims, on-site amputation, necrotomy, medicopsychological support, mass decontamination, and rescue management are some of the aspects with which physicians should be familiar. Predefined intervention teams and ad hoc materials have been created to provide autonomous logistic support. Regulations, ethical aspects and managerial methods still need to be refined, and research and teaching must be given a new impetus.

[First-aid in France. Current situation and future perspectives]. / Le Secourisme en France. Panorama et perspectives.

First-aid--treatment aimed at enabling a victim to survive pending the arrival of qualified medical support--is less well developed in France than in many other industrialized countries, especially among the general public. The current status of first-aid in France is paradoxical: schooling is free and obligatory, the ambulance service and emergency services are of the highest quality, but the general public are too often passive and unknowledgeable when faced with an emergency situation. This situation is due to several factors, including the complexity of first-aid training and regulations, the involvement of too many public bodies, the legal liability of the first-aider, and a lack of ongoing training. The French National Academy of Medicine recommends 8 measures to improve this situation: Provide a legal definition of first-aid: "a set of recognized measures aimed, in an emergency setting, at preserving the physical and psychological integrity of the victim of an accident or illness, notably pending the arrival of professional medical assistance". Waive, as in many other countries, civil and legal responsibility for the non professional first-aider, except in case of clear negligence. Reinforce the organization of first-aid in France in order to monitor the number and quality of first-aiders, and to ensure theoretical and pedagogic research; create a communications department capable of supporting and promoting first-aid. Improve access to first-aid training by increasing the number of situations in which it is obligatory (driving tuition, school and university examinations, group responsibility, at-risk practices), by providing financial assistance for certain groups, and by ensuring routine training at school, in the armed forces, and in the workplace. Create a progressive and integrated citizen first-aid training course with individual modules, ensuring that first-aiders update and perfect their knowledge throughout life. Soften pedagogic rules and shorten the training period in order to make volunteer first- aiding more accessible, notably by employing the latest teaching methods. Authorize professional first-aiders to use monitoring equipment, airway clearance techniques, and certain emergency medications. Finally, give first-aid a European dimension, underline the need for prevention, and reinforce and develop the ethical side of first-aiding. First-aid provides access to citizenship and altruism, is the first link in the chain of emergency medical assistance capable of saving lives, and is crucial for civil security As such, it is a national cause and must be strongly supported by the political and administrative authorities.