Clinical characteristics and outcomes of hospitalized patients with COVID-19 in a Brazilian hospital: a retrospective study of the first and second waves.

Objectives: To describe clinical characteristics, hospitalization flow and outcomes in a cohort of patients with coronavirus disease 2019 (COVID-19) in a Brazilian hospital in the first and second waves of the pandemic. Methods: This retrospective, observational study included patients with confirmed COVID-19 who were evaluated in the emergency department (ED) between 1 March 2020 and 30 June 2021. Descriptive statistics have been used to report clinical characteristics, admissions and outcomes. Comparison between the two waves was inferred using hypothesis test techniques. Results: During the study period, 7723 (86.54%) patients were evaluated in the ED, of which 1908 (24.70%) were admitted. Of these, 476 (24.95%) patients were initially allocated to the intensive care unit (ICU) and 1432 (75.05%) to the general ward. Of the patients initially allocated to the general ward, 349 (24.37%) were later transferred to the ICU. One hundred and fifty-eight patients were intubated (19.15% of ICU admissions) and 110 patients died (5.77% of all admissions). In the second wave, the admission rates decreased in both the ICU (from 13.84% to 9.56%; P<0.01) and the general ward (from 22.41% to 17.16%; P<0.01). The average age in the second wave decreased from 44.06 to 41.87 years (P<0.01). Patients with severe symptoms, such as dyspnoea, decreased from 25.51% to 13.13% (P<0.01) in the second wave. The death rate among admitted patients decreased by 17.84% (from 6.52% to 5.38%; P<0.01). Conclusion: Despite the greater number of patients in the second wave, the admission and death rates were lower compared with the first wave. The mean age of patients was lower in the second wave, and patients arrived at the hospital with less severe symptoms compared with the first wave.

The effect of a minor constituent of essential oil from Citrus aurantium: the role of ß-myrcene in preventing peptic ulcer disease.

The monoterpene ß-myrcene has been widely used in cosmetics, food and beverages, and it is normally found in essential oil from citrus fruit. The aim of this study was to investigate the anti-ulcer effects of ß-myrcene on experimental models of ulcers that are induced by ethanol, NSAIDs (non-steroidal anti-inflammatory drugs), stress, Helicobacter pylori, ischaemia-reperfusion injury (I/R) and cysteamine in order to compare with the essential oil of Citrus aurantium and its major compound limonene. The results indicate that the oral administration of ß-myrcene at a dose of 7.50mg/kg has important anti-ulcer activity with significantly decreased gastric and duodenal lesions as well as increased gastric mucus production. The results showed treatment with ß-myrcene caused a significant increase in mucosal malondialdehyde level (MDA), an important index of oxidative tissue damage. The ß-myrcene was also endowed with marked enhancement of antioxidant enzyme activity from GR system as evidenced by the decreased activity of superoxide dismutase (SOD) and increased levels of glutathione peroxidase (GPx), glutathione reductase (GR), and total glutathione in gastric tissue. Our results also shown that treatment with ß-myrcene is not involved with thioredoxin reductase (TrxR) activity. Our results reveal, for the first time, the importance of ß-myrcene as an inhibitor of gastric and duodenal ulcers and demonstrate that an increase in the levels of gastric mucosa defence factors is involved in the anti-ulcer activity of ß-myrcene.

Gastroprotective and antisecretory effects of Ailanthus excelsa (Roxb).

Ailanthus excelsa (Roxb), an Egyptian medicinal species highly important for treating numerous diseases, was investigated against experimentally induced gastric ulcer in rodents. We evaluated the gastroprotective effect of four extracts (petroleum ether, diethyl ether, chloroform, and methanol) of A. excelsa bark by using the ethanol-induced gastric lesion model. The pretreatment of animals with methanolic, petroleum ether, and chloroformic extracts (100 mg/kg, oral (p.o.)) from A. excelsa significantly reduced gastric lesion induced by ulcerogenic agent (56, 47, and 70%, respectively) when compared with animals pretreated with vehicle. However, the diethyl ether pretreatment led to the least gastric lesion damage (83%), similar to the standard antiulcer drug, cimetidine, at the same dose (100 mg/kg, p.o.). The lower effective dose of diethyl ether extract, as well as cimetidine, given by intraduodenal route, significantly increased the pH values and reduced the acid output of gastric juice. Sterols, triterpenes,and quassinoids are present in the diethyl ether extract of A. excelsa stem bark, which presented the best gastroprotective action among the studied extracts. Our study confirmed the traditional indications of A. excelsa for the treatment of gastric ulcer.

Effects of limonene and essential oil from Citrus aurantium on gastric mucosa: role of prostaglandins and gastric mucus secretion.

Essential oil from Citrus aurantium and the monoterpene limonene are widely used flavoring agents that are found in some common food items. This specie is also used medicinally throughout the world to treat gastritis and gastric disorders. Therefore, biological assays were performed in vivo on essential oil of C. aurantium (OEC) and its majority compound limonene (LIM) to evaluate their effect on gastric mucosa. The OEC (250 mg/kg, p.o.) and LIM (245 mg/kg, p.o.) provided effective (99%) gastroprotection against lesions induced by absolute ethanol and NSAID (non-steroidal anti-inflammatory drug) in rats. OEC and LIM do not interfere with gastric H(+) secretion, serum gastrin or glutathione (GSH) level in gastric mucosa. But the gastroprotective action of OEC and LIM occurs due to an increase in the gastric mucus production induced by conserving the basal PGE(2) levels after challenge by agents harmful to the gastric mucosa. Given that LIM and OEC are excellent flavoring agents and also present gastroprotective actions, they can be regarded as a promising target for the development of a new drug for the prevention of gastric damage.