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Bouhadfane M, Monfardini E, Loundou A, Roy P, Martin F, Boufercha R, Bajon F, Beque C, Villa A, Lehucher-Michel MP. Correlation between unproven therapies and delayed return-to-work for COVID-19-infected healthcare workers. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2024:1-12. [PMID: 38767268 DOI: 10.1080/19338244.2024.2353264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 05/04/2024] [Indexed: 05/22/2024]
Abstract
The objective of this study is to investigate factors influencing the time to return to work (RTW) of HealthCare Workers (HCW) infected with COVID-19 during the initial wave of the pandemic in a southern French university hospital. Data collection of 170 HCW (between March 16 to June 1, 2020) included demographic and professional information, clinical profiles, comorbidities, medical management, therapies and RT-PCR results. The mean time to RTW was 15.6 days. Multivariate analyses revealed that the time to RTW was shorter among laboratory and emergency workers, while it was longer for HCW aged 40 to 49 years, at higher risk of severe illness, with a delayed negative SARS-CoV-2 PCR or those treated with azithromycin and/or hydroxychloroquine. This study highlights diverse factors affecting HCW RTW post-COVID-19 infection, underscoring the importance of exercising caution in administering unproven therapies to HCW during the early stages of a novel infectious pandemic.
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Affiliation(s)
| | | | | | - Pierre Roy
- APHM, Service de Médecine et Santé au Travail, Marseille, France
| | - Françoise Martin
- APHM, Service de Médecine et Santé au Travail, Marseille, France
| | - Rafika Boufercha
- APHM, Service de Médecine et Santé au Travail, Marseille, France
| | - Florence Bajon
- APHM, Service de Médecine et Santé au Travail, Marseille, France
| | - Christine Beque
- APHM, Service de Médecine et Santé au Travail, Marseille, France
| | - Antoine Villa
- APHM, Service de Médecine et Santé au Travail, Marseille, France
- Aix-Marseille Université, CEReSS, Marseille, France
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Hinshaw D. Seeing together: Lessons from the COVID-19 pandemic on understanding evidence. Healthc Manage Forum 2024; 37:173-176. [PMID: 37992273 PMCID: PMC11044506 DOI: 10.1177/08404704231215754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
Conversations about evidence have become much more personal and more divisive over the course of the COVID-19 pandemic. Using a metaphor to carefully consider all the different aspects of "seeing" evidence can remind us that assembling a complete picture of information on any topic is necessarily a communal effort, made more robust by actively seeking to learn about and mitigate our blind spots. An approach to evidence that is curious, humble, and seeks relationship and partnership with others can help us see more clearly and completely.
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3
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Zyoud SH. Global landscape of COVID-19 research: a visualization analysis of randomized clinical trials. Clin Exp Med 2024; 24:14. [PMID: 38252392 PMCID: PMC10803477 DOI: 10.1007/s10238-023-01254-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 12/18/2023] [Indexed: 01/23/2024]
Abstract
The emergence of COVID-19 in 2019 has resulted in a significant global health crisis. Consequently, extensive research was published to understand and mitigate the disease. In particular, randomized controlled trials (RCTs) have been considered the benchmark for assessing the efficacy and safety of interventions. Hence, the present study strives to present a comprehensive overview of the global research landscape pertaining to RCTs and COVID-19. A bibliometric analysis was performed using the Scopus database. The search parameters included articles published from 2020 to 2022 using keywords specifically related to COVID-19 and RCTs. The data were analyzed using various bibliometric indicators. The volume of publications, contributions of countries and institutions, funding agencies, active journals, citation analysis, co-occurrence analysis, and future research direction analysis were specifically analyzed. A total of 223,480 research articles concerning COVID-19 were published, with 3,727 of them related to RCTs and COVID-19. The ten most productive countries collectively produced 75.8% of the documents, with the United States leading the way by contributing 31.77%, followed by the UK with 14.03% (n = 523), China with 12.96% (n = 483) and Canada with 7.16% (n = 267). Trials (n = 173, 4.64%), BMJ Open (n = 81, 2.17%), PLOS One (n = 73, 1.96%) and JAMA Network Open (n = 53, 1.42%) were the most active journals in publishing articles related to COVID-19 RCTs. The co-occurrence analysis identified four clusters of research areas: the safety and effectiveness of COVID-19 vaccines, mental health strategies to cope with the impact of the pandemic, the use of monoclonal antibodies to treat patients with COVID-19, and systematic reviews and meta-analyses of COVID-19 research. This paper offers a detailed examination of the global research environment pertaining to RCTs and their use in the context of the COVID-19 pandemic. The comprehensive body of research findings was found to have been generated by the collaborative efforts of multiple countries, institutions, and funding organizations. The predominant research areas encompassed COVID-19 vaccines, strategies for mental health, monoclonal antibodies, and systematic reviews. This information has the potential to aid researchers, policymakers, and funders in discerning areas of weakness and establishing areas of priority.
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Affiliation(s)
- Sa'ed H Zyoud
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
- Clinical Research Centre, An-Najah National University Hospital, Nablus, 44839, Palestine.
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Murad MH, Wang Z, Chu H, Lin L, El Mikati IK, Khabsa J, Akl EA, Nieuwlaat R, Schuenemann HJ, Riaz IB. Proposed triggers for retiring a living systematic review. BMJ Evid Based Med 2023; 28:348-352. [PMID: 36889900 PMCID: PMC10579491 DOI: 10.1136/bmjebm-2022-112100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/23/2023] [Indexed: 03/10/2023]
Abstract
Living systematic reviews (LSRs) are systematic reviews that are continually updated, incorporating relevant new evidence as it becomes available. LSRs are critical for decision-making in topics where the evidence continues to evolve. It is not feasible to continue to update LSRs indefinitely; however, guidance on when to retire LSRs from the living mode is not clear. We propose triggers for making such a decision. The first trigger is to retire LSRs when the evidence becomes conclusive for the outcomes that are required for decision-making. Conclusiveness of evidence is best determined based on the GRADE certainty of evidence construct, which is more comprehensive than solely relying on statistical considerations. The second trigger to retire LSRs is when the question becomes less pertinent for decision-making as determined by relevant stakeholders, including people affected by the problem, healthcare professionals, policymakers and researchers. LSRs can also be retired from a living mode when new studies are not anticipated to be published on the topic and when resources become unavailable to continue updating. We describe examples of retired LSRs and apply the proposed approach using one LSR about adjuvant tyrosine kinase inhibitors in high-risk renal cell carcinoma that we retired from a living mode and published its last update.
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Affiliation(s)
- Mohammad Hassan Murad
- Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Kern Center for the Science of Healthcare Delivery Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Zhen Wang
- Kern Center for the Science of Healthcare Delivery Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Haitao Chu
- Department of Biostatistics, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Lifeng Lin
- Department of Statistics, University of Arizona Medical Center-South Campus, Tucson, Arizona, USA
| | | | - Joanne Khabsa
- Clinical Research Institute, American University of Beirut, Beirut, Lebanon
| | - Elie A Akl
- Clinical Research Institute, American University of Beirut, Beirut, Lebanon
- Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Robby Nieuwlaat
- Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Holger J Schuenemann
- Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- McMaster University, GRADE Center, Hamilton, Ontario, Canada
- Institute for Evidence in Medicine, University of Freiburg, Freiburg, Germany
- Department of Biomedical Sciences, Humanitas University, Milano, Italy
| | - Irbaz Bin Riaz
- Mayo Clinic, Phoenix, Arizona, USA
- Mass General Brigham Inc, Boston, Massachusetts, USA
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5
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Zhou G, Verweij S, Bijlsma MJ, de Vos S, Oude Rengerink K, Pasmooij AMG, van Baarle D, Niesters HGM, Mol P, Vonk JM, Hak E. Repurposed drug studies on the primary prevention of SARS-CoV-2 infection during the pandemic: systematic review and meta-analysis. BMJ Open Respir Res 2023; 10:e001674. [PMID: 37640510 PMCID: PMC10462970 DOI: 10.1136/bmjresp-2023-001674] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 07/31/2023] [Indexed: 08/31/2023] Open
Abstract
OBJECTIVE Current evidence on the effectiveness of SARS-CoV-2 prophylaxis is inconclusive. We aimed to systematically evaluate published studies on repurposed drugs for the prevention of laboratory-confirmed SARS-CoV-2 infection and/or COVID-19 among healthy adults. DESIGN Systematic review. ELIGIBILITY Quantitative experimental and observational intervention studies that evaluated the effectiveness of repurposed drugs for the primary prevention of SARS-CoV-2 infection and/or COVID-19 disease. DATA SOURCE PubMed and Embase (1 January 2020-28 September 2022). RISK OF BIAS Cochrane Risk of Bias 2.0 and Risk of Bias in Non-Randomised Studies of Interventions tools were applied to assess the quality of studies. DATA ANALYSIS Meta-analyses for each eligible drug were performed if ≥2 similar study designs were available. RESULTS In all, 65 (25 trials, 40 observational) and 29 publications were eligible for review and meta-analyses, respectively. Most studies pertained to hydroxychloroquine (32), ACE inhibitor (ACEi) or angiotensin receptor blocker (ARB) (11), statin (8), and ivermectin (8). In trials, hydroxychloroquine prophylaxis reduced laboratory-confirmed SARS-CoV-2 infection (risk ratio: 0.82 (95% CI 0.74 to 0.90), I2=48%), a result largely driven by one clinical trial (weight: 60.5%). Such beneficial effects were not observed in observational studies, nor for prognostic clinical outcomes. Ivermectin did not significantly reduce the risk of SARS-CoV-2 infection (RR: 0.35 (95% CI 0.10 to 1.26), I2=96%) and findings for clinical outcomes were inconsistent. Neither ACEi or ARB were beneficial in reducing SARS-CoV-2 infection. Most of the evidence from clinical trials was of moderate quality and of lower quality in observational studies. CONCLUSIONS Results from our analysis are insufficient to support an evidence-based repurposed drug policy for SARS-CoV-2 prophylaxis because of inconsistency. In the view of scarce supportive evidence on repurposing drugs for COVID-19, alternative strategies such as immunisation of vulnerable people are warranted to prevent the future waves of infection. PROSPERO REGISTRATION NUMBER CRD42021292797.
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Affiliation(s)
- Guiling Zhou
- Unit of PharmacoTherapy, Epidemiology & Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands
| | - Stefan Verweij
- Unit of PharmacoTherapy, Epidemiology & Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands
- Dutch Medicines Evaluation Board, Utrecht, The Netherlands
| | - Maarten J Bijlsma
- Unit of PharmacoTherapy, Epidemiology & Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands
| | - Stijn de Vos
- Unit of PharmacoTherapy, Epidemiology & Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands
| | | | | | - Debbie van Baarle
- Virology and Immunology Research Group, Department of Medical Microbiology and Infection Prevention, University Medical Centre, Groningen, The Netherlands
| | - Hubert G M Niesters
- Department of Medical Microbiology and Infection Prevention, University Medical Centre Groningen, Groningen, The Netherlands
| | - Peter Mol
- Dutch Medicines Evaluation Board, Utrecht, The Netherlands
- Department of Clinical Pharmacy and Pharmacology, University Medical Centre, Groningen, The Netherlands
| | - Judith M Vonk
- Groningen Research Institute for Asthma and COPD, University Medical Centre, Groningen, The Netherlands
- Department of Epidemiology, University Medical Centre, Groningen, The Netherlands
| | - Eelko Hak
- Unit of PharmacoTherapy, Epidemiology & Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands
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Ferreira A, Anjos R, José-Vieira R, Afonso M, Abreu AC, Monteiro S, Macedo M, Andrade JP, Furtado MJ, Lume M. Application of optical coherence tomography angiography for microvascular changes in patients treated with hydroxychloroquine: a systematic review and meta-analysis. Graefes Arch Clin Exp Ophthalmol 2023; 261:2221-2233. [PMID: 36884062 PMCID: PMC9993382 DOI: 10.1007/s00417-023-06023-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 02/02/2023] [Accepted: 02/11/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND Retinal toxicity with long-term hydroxychloroquine (HCQ) treatment is a major concern. This systematic review aims to assess the application of optical coherence tomography angiography (OCTA) to detect microvascular alterations in patients under HCQ. METHODS PubMed, Scopus, Web of Science, and Cochrane Library databases were systematically searched until January 14, 2023. Studies using OCTA as a primary diagnostic method to evaluate the macular microvasculature of HCQ users were included. Primary outcomes were macular vessel density (VD) and foveal avascular zone (FAZ) at the superficial (SCP) and deep (DCP) capillary plexus. Meta-analysis was performed using a random-effects model. RESULTS Of 211 screened abstracts, 13 were found eligible, enrolling 989 eyes from 778 patients. High-risk patients due to longer duration of treatment presented lower VD in the retinal microvasculature than those with low-risk in SCP (P = 0.02 in fovea; P = 0.004 in parafovea) and in DCP (P = 0.007 in fovea; P = 0.01 in parafovea). When compared with healthy controls, HCQ users had lower VD in both plexus-no quantitative synthesis was presented. CONCLUSIONS Microvascular changes were found in autoimmune patients under HCQ treatment without any documented retinopathy. However, the evidence produced so far does not allow to draw conclusion concerning the effect of drug as studies were not controlled for disease duration.
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Affiliation(s)
- André Ferreira
- Department of Ophthalmology, Centro Hospitalar Universitário Do Porto, Largo Do Prof. Abel Salazar, 4099-001, Porto, Portugal.
- Department of Biomedicine - Unit of Anatomy, Faculty of Medicine of University of Porto, Porto, Portugal.
| | - Rita Anjos
- Department of Ophthalmology, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
- Nova Medical School, Lisbon, Portugal
| | - Rafael José-Vieira
- MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS-Center for Health Technology and Services Research, Porto, Portugal
- RISE-Health Research Network, Porto, Portugal
| | - Miguel Afonso
- Department of Ophthalmology, Centro Hospitalar Universitário Do Porto, Largo Do Prof. Abel Salazar, 4099-001, Porto, Portugal
| | - Ana Carolina Abreu
- Department of Ophthalmology, Centro Hospitalar Universitário Do Porto, Largo Do Prof. Abel Salazar, 4099-001, Porto, Portugal
| | - Sílvia Monteiro
- Department of Ophthalmology, Centro Hospitalar Universitário Do Porto, Largo Do Prof. Abel Salazar, 4099-001, Porto, Portugal
| | - Mafalda Macedo
- Department of Ophthalmology, Centro Hospitalar Universitário Do Porto, Largo Do Prof. Abel Salazar, 4099-001, Porto, Portugal
- ICBAS - Instituto de Ciência Biomédicas Abel Salazar, Universidade Do Porto, Porto, Portugal
| | - José P Andrade
- Department of Biomedicine - Unit of Anatomy, Faculty of Medicine of University of Porto, Porto, Portugal
- CINTESIS-Center for Health Technology and Services Research, Porto, Portugal
| | - Maria João Furtado
- Department of Ophthalmology, Centro Hospitalar Universitário Do Porto, Largo Do Prof. Abel Salazar, 4099-001, Porto, Portugal
- ICBAS - Instituto de Ciência Biomédicas Abel Salazar, Universidade Do Porto, Porto, Portugal
| | - Miguel Lume
- Department of Ophthalmology, Centro Hospitalar Universitário Do Porto, Largo Do Prof. Abel Salazar, 4099-001, Porto, Portugal
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7
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Orellana-Manzano A, Cordeiro FB, Garcia-Angulo A, Centeno E, Vizcaíno-Tumbaco MJ, Poveda S, Murillo R, Andrade-Molina D, Mirabá M, Mehta S, Cárdenas W. A report on SARS-CoV-2 first wave in Ecuador: drug consumption dynamics. Front Pharmacol 2023; 14:1197973. [PMID: 37388452 PMCID: PMC10300276 DOI: 10.3389/fphar.2023.1197973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 05/30/2023] [Indexed: 07/01/2023] Open
Abstract
Introduction: The first COVID-19 wave in Ecuador started in March 2020 and extended until November. Several types of drugs have been proposed as a potential treatment during this period, and some affected people have self-medicated. Method: A retrospective study was conducted with 10,175 individuals who underwent RT-PCR tests for SARS-CoV-2 from July to November 2020. We compared the number of positive and negative cases in Ecuador with symptoms and drug consumption. The Chi-square test of independence compared clinical and demographic data and PCR test results. Odds ratios analyzed drug consumption dynamics. Results: Of 10,175 cases, 570 were positive for COVID-19, while 9,605 were negative. In positive cases, there was no association between the RT-PCR result and sex, age, or comorbidities. When considering demographic data, Cotopaxi and Napo had the highest rates of positive cases (25.7% and 18.8%, respectively). Manabí, Santa Elena, and Guayas regions had fewer than 10% positive cases. The Drug consumption dynamic analysis showed that negative COVID-19 cases presented higher drug consumption than positive cases. In both groups, the most consumed medication was acetaminophen. Acetaminophen and Antihistamines had higher odds of consumption in positive PCR cases than in negative. Symptoms like fever and cough were more related to positive RT-PCR results. Conclusion: The first COVID-19 wave in Ecuador has affected the provinces differently. At a national level, the consumption of drugs has been highly associated with self-medication.
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Affiliation(s)
- Andrea Orellana-Manzano
- Laboratorio Para Investigaciones Biomédicas, Facultad de Ciencias de la Vida, Escuela Superior Politécnica del Litoral (ESPOL), Guayaquil, Ecuador
| | - Fernanda B. Cordeiro
- Laboratorio Para Investigaciones Biomédicas, Facultad de Ciencias de la Vida, Escuela Superior Politécnica del Litoral (ESPOL), Guayaquil, Ecuador
| | - Andrea Garcia-Angulo
- Facultad de Ciencias Naturales y Matemáticas, Escuela Superior Politécnica del Litoral (ESPOL), Guayaquil, Ecuador
| | - Elizabeth Centeno
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States
| | - María José Vizcaíno-Tumbaco
- Laboratorio Para Investigaciones Biomédicas, Facultad de Ciencias de la Vida, Escuela Superior Politécnica del Litoral (ESPOL), Guayaquil, Ecuador
| | - Sebastián Poveda
- Facultad de Ciencias Naturales y Matemáticas, Escuela Superior Politécnica del Litoral (ESPOL), Guayaquil, Ecuador
| | - Ricardo Murillo
- Facultad de Ciencias Naturales y Matemáticas, Escuela Superior Politécnica del Litoral (ESPOL), Guayaquil, Ecuador
| | - Derly Andrade-Molina
- Laboratorio de Ciencias Omicas, Facultad de Ciencias de la Salud, Universidad Espíritu Santo, Samborondon, Ecuador
| | - Mariuxi Mirabá
- Laboratorio Para Investigaciones Biomédicas, Facultad de Ciencias de la Vida, Escuela Superior Politécnica del Litoral (ESPOL), Guayaquil, Ecuador
| | - Saurabh Mehta
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States
| | - Washington Cárdenas
- Laboratorio Para Investigaciones Biomédicas, Facultad de Ciencias de la Vida, Escuela Superior Politécnica del Litoral (ESPOL), Guayaquil, Ecuador
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8
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Thirumugam G, Radhakrishnan Y, Ramamurthi S, Bhaskar JP, Krishnaswamy B. A systematic review on impact of SARS-CoV-2 infection. Microbiol Res 2023; 271:127364. [PMID: 36989761 PMCID: PMC10015779 DOI: 10.1016/j.micres.2023.127364] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 03/13/2023] [Accepted: 03/13/2023] [Indexed: 03/17/2023]
Abstract
Innumerable pathogens including RNA viruses have catastrophic pandemic propensity, in turn, SARS-CoV-2 infection is highly contagious. Emergence of SARS-CoV-2 variants with high mutation rate additionally codifies infectious ability of virus and arisen clinical imputations to human health. Although, our knowledge of mechanism of virus infection and its impact on host system has been substantially demystified, uncertainties about the emergence of virus are still not fully understood. To date, there are no potentially curative drugs are identified against the viral infection. Even though, drugs are repurposed in the initial period of infection, many are significantly negative in clinical trials. Moreover, the infection is dependent on organ status, co-morbid conditions, variant of virus and geographic region. This review article aims to comprehensively describe the SARS-CoV-2 infection and the impacts in the host cellular system. This review also briefly provides an overview of genome, proteome and metabolome associated risk to infection and the advancement of therapeutics in SARS-CoV-2 infection management.
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Key Words
- sars-cov-2, severe acute respiratory syndrome coronavirus 2
- who, world health organization
- mers-cov-middle, east respiratory syndrome coronavirus
- ig, immunoglobulin
- rgd, arginine-glycine-aspartic
- nk-natural, killer cells
- s1 and s2, subunits of s protein
- nsp, non-structural proteins
- voi, varian of interest
- voc, variant of concern
- vum-variant, under monitoring
- ace2, angiotensin converting enzyme 2
- nsp-non-structural, proteins
- orf-open, reading frame
- sars-cov-2
- variants
- omics
- alternative medicines
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Affiliation(s)
- Gowripriya Thirumugam
- Department of Biotechnology, Science Campus, Alagappa University, Karaikudi 630 003, Tamil Nadu, India
| | - Yashwanth Radhakrishnan
- ITC - Life Sciences and Technology Centre, Peenya Industrial Area, 1(st) Phase, Bangalore 560058, Karnataka, India
| | - Suresh Ramamurthi
- ITC - Life Sciences and Technology Centre, Peenya Industrial Area, 1(st) Phase, Bangalore 560058, Karnataka, India
| | - James Prabhanand Bhaskar
- ITC - Life Sciences and Technology Centre, Peenya Industrial Area, 1(st) Phase, Bangalore 560058, Karnataka, India
| | - Balamurugan Krishnaswamy
- Department of Biotechnology, Science Campus, Alagappa University, Karaikudi 630 003, Tamil Nadu, India,Corresponding author
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9
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Mitjà O, Reis G, Boulware DR, Spivak AM, Sarwar A, Johnston C, Webb B, Hill MD, Smith D, Kremsner P, Curran M, Carter D, Alexander J, Corbacho M, Lee TC, Hullsiek KH, McDonald EG, Hess R, Hughes M, Baeten JM, Schwartz I, Metz L, Richer L, Chew KW, Daar E, Wohl D, Dunne M. Hydroxychloroquine for treatment of non-hospitalized adults with COVID-19: A meta-analysis of individual participant data of randomized trials. Clin Transl Sci 2023; 16:524-535. [PMID: 36601684 PMCID: PMC10014689 DOI: 10.1111/cts.13468] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 11/18/2022] [Accepted: 11/22/2022] [Indexed: 01/06/2023] Open
Abstract
Hydroxychloroquine (HCQ) was initially promoted as an oral therapy for early treatment of coronavirus disease 2019 (COVID-19). Conventional meta-analyses cannot fully address the heterogeneity of different designs and outcomes of randomized controlled trials (RCTs) assessing the efficacy of HCQ in outpatients with mild COVID-19. We conducted a pooled analysis of individual participant data from RCTs that evaluated the effect of HCQ on hospitalization and viral load reduction in outpatients with confirmed COVID-19. We evaluated the overall treatment group effect by log-likelihood ratio test (-2LL) from a generalized linear mixed model to accommodate correlated longitudinal binary data. The analysis included data from 11 RCTs. The outcome of virological effect, assessed in 1560 participants (N = 795 HCQ, N = 765 control), did not differ significantly between the two treatment groups (-2LL = 7.66; p = 0.18) when adjusting for cohort, duration of symptoms, and comorbidities. The decline in polymerase chain reaction positive tests from day 1 to 7 was 42.0 and 41.6 percentage points in the HCQ and control groups, respectively. Among the 2037 participants evaluable for hospitalization (N = 1058 HCQ, N = 979 control), we found no significant differences in hospitalization rate between participants receiving HCQ and controls (odds ratio 0.995; 95% confidence interval 0.614-1.610; -2LL = 0.0; p = 0.98) when adjusting for cohort, duration of symptoms, and comorbidities. This individual participant data meta-analysis of 11 HCQ trials that evaluated severe acute respiratory syndrome-coronavirus 2 viral clearance and COVID-19 hospitalization did not show a clinical benefit of HCQ. Our meta-analysis provides evidence to support the interruption in the use of HCQ in mild COVID-19 outpatients to reduce progression to severe disease.
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Affiliation(s)
- Oriol Mitjà
- Fight AIDS and Infectious Diseases Foundation, Barcelona, Spain
- Hospital Universitari Germans Trias i Pujol, Badalona, Spain
- Lihir Medical Center-International SOS, Lihir Island, Papua New Guinea
| | - Gilmar Reis
- Research Division, Cardresearch Cardiologia Assistencial e de Pesquisa, Pontifícia Universidade Católica de Minas Gerais, Bello Horizonte, Brazil
- Cytel Inc., Vancouver, British Columbia, Canada
| | - David R Boulware
- Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | | | - Ammar Sarwar
- Harvard Medical School, Boston, Massachusetts, USA
| | - Christine Johnston
- Department of Medicine and Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
| | - Brandon Webb
- Intermountain Health Care, University of Utah, Salt Lake City, Utah, USA
| | | | - Davey Smith
- Division of Infectious Diseases & Global Public Health, UC San Diego School of Medicine, San Diego, California, USA
| | - Peter Kremsner
- University Hospital of Tübingen, Tübingen, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Marla Curran
- Bill & Melinda Gates Medical Research Institute, Cambridge, Massachusetts, USA
| | | | - Jim Alexander
- Bill & Melinda Gates Medical Research Institute, Cambridge, Massachusetts, USA
| | - Marc Corbacho
- Fight AIDS and Infectious Diseases Foundation, Barcelona, Spain
| | - Todd C Lee
- Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Katherine Huppler Hullsiek
- Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Emily G McDonald
- Division of General Internal Medicine, McGill University Health Center, Montreal, Quebec, Canada
| | - Rachel Hess
- University of Utah, Salt Lake City, Utah, USA
| | | | - Jared M Baeten
- Department of Medicine and Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
| | | | - Luanne Metz
- University of Calgary, Calgary, Alberta, Canada
| | | | - Kara W Chew
- Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, California, USA
| | - Eric Daar
- Lundquist Institute at Harbor-UCLA Medical Center, Torrance, California, USA
| | - David Wohl
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Michael Dunne
- Bill & Melinda Gates Medical Research Institute, Cambridge, Massachusetts, USA
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10
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Alshamrani AA, Assiri AM, Almohammed OA. Comprehensive evaluation of six interventions for hospitalized patients with COVID-19: A propensity score matching study. Saudi Pharm J 2023; 31:517-525. [PMID: 36819112 PMCID: PMC9930407 DOI: 10.1016/j.jsps.2023.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 02/10/2023] [Accepted: 02/12/2023] [Indexed: 02/17/2023] Open
Abstract
Purpose The purpose of this study was to evaluate the effectiveness of either hydroxychloroquine, triple combination therapy (TCT), favipiravir, dexamethasone, remdesivir, or COVID-19 convalescent plasma (CCP) in comparison with standard-of-care for hospitalized patients with COVID-19 using real-world data from Saudi Arabia. Patients and methods A secondary database analysis was conducted using the Saudi Ministry of Health database for patients with COVID-19. Adult (≥ 18 years) hospitalized patients with COVID-19 between March 2020 and January 2021 were included in the analysis. A propensity score matching technique was used to establish comparable groups for each therapeutic approach. Lastly, an independent t-test and chi-square test were used to compare the matching groups in the aspects of the duration of hospitalization, length of stay (LOS) in intensive care units (ICU), in-hospital mortality, and composite poor outcome. Multilevel logistic regression model was used to assess the association between the severity stage of COVID-19 and the outcomes while using the medication or intervention used as a grouping variable in the model. Results The mean duration of hospitalization was significantly longer for patients who received TCT, favipiravir, dexamethasone, or CCP compared to patients who did not receive these therapies, with a mean difference ranging between 2.2 and 4.9 days for dexamethasone and CCP, respectively. Furthermore, the use of favipiravir or CCP was associated with a longer stay in ICU. Remdesivir was the only agent associated with in-hospital mortality benefit. A higher risk of mortality and poorer composite outcome were associated with the use of favipiravir or dexamethasone. However, the logistic regression model reveled that the difference between the two matched cohorts was due to the severity stage not the medication. Additionally, the use of hydroxychloroquine, TCT, or CCP had no impact on the incidence of in-hospital mortality or composite poor outcomes. Conclusion Remdesivir was the only agent associated with in-hospital mortality benefit. The observed worsened treatment outcomes associated with the use of dexamethasone or FPV shall be attributed to the severity stage rather than the medication use. In light of these varied results, additional studies are needed to continue evaluating the actual benefits of these therapies.
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Affiliation(s)
- Ali A Alshamrani
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Ahmed M Assiri
- Health Volunteering Center, Ministry of Health, Riyadh, Saudi Arabia
| | - Omar A Almohammed
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.,Pharmacoeconomics Research Unit, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
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11
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MORAES RR, CORREA MB, MARTINS-FILHO PR, LIMA GS, DEMARCO FF. COVID-19 incidence, severity, medication use, and vaccination among dentists: survey during the second wave in Brazil. J Appl Oral Sci 2022; 30:e20220016. [PMID: 36197403 PMCID: PMC9529204 DOI: 10.1590/1678-7757-2022-0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 08/25/2022] [Indexed: 11/07/2022] Open
Abstract
Objective This cross-sectional study with dentists in Brazil assessed the COVID-19 incidence and severity, its vaccination status, and the level of confidence in vaccines in May 2021 (COVID-19 second wave). The medications used to prevent or treat COVID-19, including controversial substances (vitamin D, ivermectin, zinc, and chloroquine), were analyzed. Methodology Dentists were recruited by email and responded to a pretested questionnaire until May 31, 2021. Bivariate and multivariate regression analyses were performed (α=0.05). Prevalence ratios were calculated for the association between professional characteristics and two outcomes: SARS-CoV-2 infection and use of controversial substances. Results In total, 1,907 responses were received (return rate of 21.2%). One third of dentists reported intermediate levels of confidence in the safety and efficacy of COVID-19 vaccines, but 96% had received at least one vaccine dose, mainly CoronaVac. The effect of the pandemic on dental practice was classified as lower/much lower, in comparison with the first wave, by 46% of participants. Moreover, 27% of dentists had already tested positive for SARS-CoV-2 and about 50% had relatives or friends who had been hospitalized or died from COVID-19. At least one medication was used by 59% of participants and 43% used two or more substances. Vitamin D (41%), ivermectin (35%), and zinc (29%) were the most frequent substances. More experienced dentists (≥21 years of professional experience) were 42% more likely to use controversial substances than less experienced dentists. The prevalence of use of controversial substances was 30% higher among dentists with residency or advanced training, such as postgraduate degrees, in comparison with participants holding MSc or PhD degrees. Participants with low confidence in vaccines were 2.1 times more likely to use controversial substances than participants with a very high confidence. Conclusion The results of this study show the high severity of the COVID-19 pandemic in Brazil and raised questions about the use of scientific evidence by dentists in their decision to use controversial substances.
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Affiliation(s)
- Rafael R MORAES
- Universidade Federal de PelotasBrasilUniversidade Federal de Pelotas, Brasil.
| | - Marcos B CORREA
- Universidade Federal de PelotasBrasilUniversidade Federal de Pelotas, Brasil.
| | | | - Giana S LIMA
- Universidade Federal de PelotasBrasilUniversidade Federal de Pelotas, Brasil.
| | - Flavio F DEMARCO
- Universidade Federal de PelotasBrasilUniversidade Federal de Pelotas, Brasil.
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12
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Efficacy and safety of nitazoxanide in treating SARS-CoV-2 infection: a systematic review and meta-analysis of blinded, placebo-controlled, randomized clinical trials. Eur J Clin Pharmacol 2022; 78:1813-1821. [PMID: 36066651 PMCID: PMC9446612 DOI: 10.1007/s00228-022-03380-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 08/30/2022] [Indexed: 12/15/2022]
Abstract
Purpose Nitazoxanide is a broad-spectrum antiparasitic that has been tested for COVID-19 due to its anti-inflammatory effects and in vitro antiviral activity. This study synthesized the best evidence on the efficacy and safety of nitazoxanide in COVID-19. Methods Searches for studies were performed in peer-reviewed and grey-literature from January 1, 2020 to May 23, 2022. The following elements were used to define eligibility criteria: (1) Population: individuals with COVID-19; (2) Intervention: nitazoxanide; (3) Comparison: placebo; (4) Outcomes: primary outcome was death, and secondary outcomes were viral load, positive RT-PCR status, serum biomarkers of inflammation, composite measure of disease progression (ICU admission or invasive mechanical ventilation), and any adverse events; (5) Study type: blinded, placebo-controlled, randomized clinical trials (RCTs). Treatment effects were reported as relative risk (RR) for dichotomous variables and standardized mean difference (SMD) for continuous variables with 95% confidence intervals (CI). Results Five blinded, placebo-controlled RCTs were included and enrolled individuals with mild or moderate SARS-CoV-2 infection. We found no difference between nitazoxanide and placebo in reducing viral load (SMD = − 0.16; 95% CI − 0.38 to 0.05) and the frequency of positive RTP-PCR results (RR = 0.92; 95% CI 0.81 to 1.06). In addition, there was no decreased risk for disease progression (RR = 0.63; 95% CI 0.38 to 1.04) and death (RR = 0.81; 95% CI 0.36 to 1.78) among patients receiving nitazoxanide. Patients with COVID-19 treated with nitazoxanide had decreased levels of white blood cells (SMD = − 0.15; 95% − 0.29 to − 0.02), lactate dehydrogenase (LDH) (SMD − 0.32; 95% − 0.52 to − 0.13), and D-dimer (SMD − 0.49; 95% CI − 0.68 to − 0.31) compared to placebo, but the magnitude of effect was considered small to moderate. Conclusion This systematic review showed no evidence of clinical benefits of the use of nitazoxanide to treat patients with mild or moderate COVID-19. In addition, we found a reduction in WBC, LDH, and D-dimer levels among nitazoxanide-treated patients, but the effect size was considered small to moderate. Supplementary Information The online version contains supplementary material available at 10.1007/s00228-022-03380-5.
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13
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de Almeida L, Carelli PV, Cavalcanti NG, do Nascimento JD, Felinto D. Quantifying political influence on COVID-19 fatality in Brazil. PLoS One 2022; 17:e0264293. [PMID: 35820102 PMCID: PMC9275831 DOI: 10.1371/journal.pone.0264293] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 06/28/2022] [Indexed: 12/05/2022] Open
Abstract
The COVID-19 pandemic was severely aggravated in Brazil due to its politicization by the country’s federal government. However, the impact of diffuse political forces on the fatality of an epidemic is notoriously difficult to quantify. Here we introduce a method to measure this effect in the Brazilian case, based on the inhomogeneous distribution throughout the national territory of political support for the federal government. This political support is quantified by the voting rates in the last general election in Brazil. This data is correlated with the fatality rates by COVID-19 in each Brazilian state as the number of deaths grows over time. We show that the correlation between fatality rate and political support grows as the government’s misinformation campaign is developed. This led to the dominance of such political factor for the pandemic impact in Brazil in 2021. Once this dominance is established, this correlation allows for an estimation of the total number of deaths due to political influence as 350±70 thousand up to the end of 2021, corresponding to (57±11)% of the total number of deaths.
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Affiliation(s)
- Leandro de Almeida
- Departamento de Física, Univ. Federal de Pernambuco, Recife, Pernambuco, Brazil
- * E-mail:
| | - Pedro V. Carelli
- Departamento de Física, Univ. Federal de Pernambuco, Recife, Pernambuco, Brazil
| | | | - José-Dias do Nascimento
- Dep. de Física, Univ. Federal do Rio G. do Norte, Natal, Rio Grande do Norte, Brazil
- Harvard-Smithsonian Center for Astrophysics, Cambridge, Massachusetts, United States of America
| | - Daniel Felinto
- Departamento de Física, Univ. Federal de Pernambuco, Recife, Pernambuco, Brazil
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14
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Bajka A, Toro M, Kniestedt C, Zweifel S. Decrease in Visual Acuity in a 77-Year-old Woman with Age-Related Macular Degeneration after a SARS-CoV-2 Infection Treated with Hydroxychloroquine. Klin Monbl Augenheilkd 2022; 239:527-530. [PMID: 35472798 DOI: 10.1055/a-1766-7035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Anahita Bajka
- Ophthalmology, University Hospital of Zürich, Zürich, Switzerland
| | - Mario Toro
- Ophthalmology, University Hospital of Zürich, Zürich, Switzerland
| | | | - Sandrine Zweifel
- Ophthalmology, University Hospital of Zürich, Zürich, Switzerland
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15
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The unjustified and politicized battle against vaccination of children and adolescents in Brazil. LANCET REGIONAL HEALTH. AMERICAS 2022; 8:100206. [PMID: 35224530 PMCID: PMC8857864 DOI: 10.1016/j.lana.2022.100206] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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16
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Mariam SH. The Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) Pandemic: Are Africa's Prevalence and Mortality Rates Relatively Low? Adv Virol 2022; 2022:3387784. [PMID: 35256885 PMCID: PMC8898136 DOI: 10.1155/2022/3387784] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/14/2022] [Accepted: 01/28/2022] [Indexed: 12/13/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the cause of coronavirus disease 19 (COVID-19), has been rapidly spreading since December 2019, and within a few months, it turned out to be a global pandemic. The disease affects primarily the lungs, but its pathogenesis spreads to other organs as well. However, its mortality rates vary, and in the majority of infected people, there are no serious consequences. Many factors including advanced age, preexisting health conditions, and genetic predispositions are believed to exacerbate outcomes of COVID-19. The virus contains several structural proteins including the spike (S) protein with subunits for binding, fusion, and internalization into host cells following interaction with host cell receptors and proteases (ACE2 and TMPRSS2, respectively) to cause the subsequent pathology. Although the pandemic has spread into all countries, most of Africa is thought of as having relatively less prevalence and mortality. Several hypotheses have been forwarded as reasons for this and include warmer weather conditions, vaccination with BCG (i.e., trained immunity), and previous malaria infection. From genetics or metabolic points of view, it has been proposed that most African populations could be protected to some degree because they lack some genetic susceptibility risk factors or have low-level expression of allelic variants, such as ACE2 and TMPRSS2 that are thought to be involved in increased infection risk or disease severity. The frequency of occurrence of α-1 antitrypsin (an inhibitor of a tissue-degrading protease, thereby protecting target host tissues including the lung) deficiency is also reported to be low in most African populations. More recently, infections in Africa appear to be on the rise. In general, there are few studies on the epidemiology and pathogenesis of the disease in African contexts, and the overall costs and human life losses due to the pandemic in Africa will be determined by all factors and conditions interacting in complex ways.
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Affiliation(s)
- Solomon H. Mariam
- Infectious Diseases Program, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
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17
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Chabert C, Vitte AL, Iuso D, Chuffart F, Trocme C, Buisson M, Poignard P, Lardinois B, Debois R, Rousseaux S, Pepin JL, Martinot JB, Khochbin S. AKR1B10, One of the Triggers of Cytokine Storm in SARS-CoV2 Severe Acute Respiratory Syndrome. Int J Mol Sci 2022; 23:ijms23031911. [PMID: 35163833 PMCID: PMC8836815 DOI: 10.3390/ijms23031911] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/02/2022] [Accepted: 02/04/2022] [Indexed: 02/07/2023] Open
Abstract
Preventing the cytokine storm observed in COVID-19 is a crucial goal for reducing the occurrence of severe acute respiratory failure and improving outcomes. Here, we identify Aldo-Keto Reductase 1B10 (AKR1B10) as a key enzyme involved in the expression of pro-inflammatory cytokines. The analysis of transcriptomic data from lung samples of patients who died from COVID-19 demonstrates an increased expression of the gene encoding AKR1B10. Measurements of the AKR1B10 protein in sera from hospitalised COVID-19 patients suggests a significant link between AKR1B10 levels and the severity of the disease. In macrophages and lung cells, the over-expression of AKR1B10 induces the expression of the pro-inflammatory cytokines Interleukin-6 (IL-6), Interleukin-1β (IL-1β) and Tumor Necrosis Factor a (TNFα), supporting the biological plausibility of an AKR1B10 involvement in the COVID-19-related cytokine storm. When macrophages were stressed by lipopolysaccharides (LPS) exposure and treated by Zopolrestat, an AKR1B10 inhibitor, the LPS-induced production of IL-6, IL-1β, and TNFα is significantly reduced, reinforcing the hypothesis that the pro-inflammatory expression of cytokines is AKR1B10-dependant. Finally, we also show that AKR1B10 can be secreted and transferred via extracellular vesicles between different cell types, suggesting that this protein may also contribute to the multi-organ systemic impact of COVID-19. These experiments highlight a relationship between AKR1B10 production and severe forms of COVID-19. Our data indicate that AKR1B10 participates in the activation of cytokines production and suggest that modulation of AKR1B10 activity might be an actionable pharmacological target in COVID-19 management.
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Affiliation(s)
- Clovis Chabert
- Institute for Advanced Biosciences—UGA—INSERM U1209—CNRS UMR 5309, 38700 La Tronche, France; (A.-L.V.); (D.I.); (F.C.); (S.R.); (S.K.)
- Correspondence: ; Tel.: +33-6-8898-4506
| | - Anne-Laure Vitte
- Institute for Advanced Biosciences—UGA—INSERM U1209—CNRS UMR 5309, 38700 La Tronche, France; (A.-L.V.); (D.I.); (F.C.); (S.R.); (S.K.)
| | - Domenico Iuso
- Institute for Advanced Biosciences—UGA—INSERM U1209—CNRS UMR 5309, 38700 La Tronche, France; (A.-L.V.); (D.I.); (F.C.); (S.R.); (S.K.)
| | - Florent Chuffart
- Institute for Advanced Biosciences—UGA—INSERM U1209—CNRS UMR 5309, 38700 La Tronche, France; (A.-L.V.); (D.I.); (F.C.); (S.R.); (S.K.)
| | - Candice Trocme
- Laboratoire BEP (Biochimie des Enzymes et les Protéines), Institut de Biologie et de Pathologie, CHU Grenoble Alpes, 38700 La Tronche, France;
| | - Marlyse Buisson
- Institut de Biologie Structurale, CEA, CNRS and Centre Hospitalier Universitaire Grenoble Alpes, Université Grenoble Alpes, 38000 Grenoble, France; (M.B.); (P.P.)
| | - Pascal Poignard
- Institut de Biologie Structurale, CEA, CNRS and Centre Hospitalier Universitaire Grenoble Alpes, Université Grenoble Alpes, 38000 Grenoble, France; (M.B.); (P.P.)
| | - Benjamin Lardinois
- Laboratory Department, CHU UCL Namur Site de Ste Elisabeth, 5000 Namur, Belgium; (B.L.); (R.D.)
| | - Régis Debois
- Laboratory Department, CHU UCL Namur Site de Ste Elisabeth, 5000 Namur, Belgium; (B.L.); (R.D.)
| | - Sophie Rousseaux
- Institute for Advanced Biosciences—UGA—INSERM U1209—CNRS UMR 5309, 38700 La Tronche, France; (A.-L.V.); (D.I.); (F.C.); (S.R.); (S.K.)
| | - Jean-Louis Pepin
- HP2 Laboratory, INSERM U1300, Grenoble Alpes University, 38000 Grenoble, France;
- Sleep Laboratory, Pole Thorax et Vaisseaux, Grenoble Alpes University Hospital, 38000 Grenoble, France
| | - Jean-Benoit Martinot
- Sleep Laboratory and Pulmonology and Allergy Department—CHU UCL Namur, St. Elisabeth Site, 5000 Namur, Belgium;
- Institute of Experimental and Clinical Research, UCL Bruxelles Woluwe, 1200 Brussels, Belgium
| | - Saadi Khochbin
- Institute for Advanced Biosciences—UGA—INSERM U1209—CNRS UMR 5309, 38700 La Tronche, France; (A.-L.V.); (D.I.); (F.C.); (S.R.); (S.K.)
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Preclinical Evaluation of Chicken Egg Yolk Antibody (IgY) Anti-RBD Spike SARS-CoV-2—A Candidate for Passive Immunization against COVID-19. Vaccines (Basel) 2022; 10:vaccines10010128. [PMID: 35062789 PMCID: PMC8778912 DOI: 10.3390/vaccines10010128] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 01/10/2022] [Accepted: 01/13/2022] [Indexed: 12/11/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) has become a substantial threat to the international health sector and the global economy. As of 26 December 2021, the number of mortalities resulting from COVID-19 exceeded 5.3 million worldwide. The absence of an effective non-vaccine treatment has prompted the quest for prophylactic agents that can be used to combat COVID-19. This study presents the feasibility of chicken egg yolk antibody (IgY) anti-receptor-binding domain (RBD) spike SARS-CoV-2 as a strong candidate to neutralize the virus for application in passive immunization. For the purpose of preclinical studies, we radiolabeled IgY anti-RBD spike SARS-CoV-2 with radionuclide iodine-131. This allowed us to evaluate several biological characteristics of IgY in vitro, in vivo, and ex vivo. The preclinical data suggest that IgY anti-RBD spike SARS-CoV-2 could specifically bind to the SARS-CoV-2 antigens; however, little uptake was observed in normal cells (MRC-5) (<2%). Furthermore, the ex vivo biodistribution study revealed that IgY predominantly accumulated in the trachea of normal mice compared to other organs. We also found that IgY possessed a good safety profile when used as an intranasal agent. Taken together, we propose that IgY anti-RBD spike SARS-CoV-2 has the potential for application in passive immunization against COVID-19.
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Pérez-Pérez MJ, Saiz JC, Priego EM, Martín-Acebes MA. Antivirals against (Re)emerging Flaviviruses: Should We Target the Virus or the Host? ACS Med Chem Lett 2022; 13:5-10. [PMID: 35059112 PMCID: PMC8762743 DOI: 10.1021/acsmedchemlett.1c00617] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The COVID pandemic has evidenced how vulnerable we are to emerging infectious diseases and how short our current armamentarium is. Flavivirus, single stranded RNA viruses transmitted by arthropods, are considered a global health challenge. No drugs to treat these infections have been approved. In this Viewpoint, we analyze the advantages and disadvantages of two different, but probably also complementary, therapeutic approaches: virus-targeting antivirals and host-targeting drugs.
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Affiliation(s)
| | - Juan-Carlos Saiz
- Departamento
de Biotecnología, Instituto Nacional
de Investigación y Tecnología Agraria y Alimentaria
(INIA-CSIC), Carretera de A Coruña km 7.5, 28040 Madrid, Spain
| | - Eva-María Priego
- Instituto
de Química Médica (IQM-CSIC), c/Juan de la Cierva 3, E-28006 Madrid, Spain
| | - Miguel A. Martín-Acebes
- Departamento
de Biotecnología, Instituto Nacional
de Investigación y Tecnología Agraria y Alimentaria
(INIA-CSIC), Carretera de A Coruña km 7.5, 28040 Madrid, Spain
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20
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Ghang B, Kim J. Colchicine as a Potential Treatment Choice for COVID-19 Patients in Developing Countries: COVID-19 and Colchicine. JOURNAL OF RHEUMATIC DISEASES 2022; 29:56-57. [PMID: 37476703 PMCID: PMC10324913 DOI: 10.4078/jrd.2022.29.1.56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/18/2021] [Accepted: 10/19/2021] [Indexed: 07/22/2023]
Affiliation(s)
- Byeongzu Ghang
- Division of Rheumatology, Department of Internal Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea
| | - Jinseok Kim
- Division of Rheumatology, Department of Internal Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea
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21
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Aulin LBS, Tandar ST, van Zijp T, van Ballegooie E, van der Graaf PH, Saleh MAA, Välitalo P, van Hasselt JGC. Physiologically Based Modelling Framework for Prediction of Pulmonary Pharmacokinetics of Antimicrobial Target Site Concentrations. Clin Pharmacokinet 2022; 61:1735-1748. [PMID: 36401151 PMCID: PMC9676785 DOI: 10.1007/s40262-022-01186-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVES Prediction of antimicrobial target-site pharmacokinetics is of relevance to optimize treatment with antimicrobial agents. A physiologically based pharmacokinetic (PBPK) model framework was developed for prediction of pulmonary pharmacokinetics, including key pulmonary infection sites (i.e. the alveolar macrophages and the epithelial lining fluid). METHODS The modelling framework incorporated three lung PBPK models: a general passive permeability-limited model, a drug-specific permeability-limited model and a quantitative structure-property relationship (QSPR)-informed perfusion-limited model. We applied the modelling framework to three fluoroquinolone antibiotics. Incorporation of experimental drug-specific permeability data was found essential for accurate prediction. RESULTS In the absence of drug-specific transport data, our QSPR-based model has generic applicability. Furthermore, we evaluated the impact of drug properties and pathophysiologically related changes on pulmonary pharmacokinetics. Pulmonary pharmacokinetics were highly affected by physiological changes, causing a shift in the main route of diffusion (i.e. paracellular or transcellular). Finally, we show that lysosomal trapping can cause an overestimation of cytosolic concentrations for basic compounds when measuring drug concentrations in cell homogenate. CONCLUSION The developed lung PBPK model framework constitutes a promising tool for characterization of pulmonary exposure of systemically administrated antimicrobials.
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Affiliation(s)
- Linda B. S. Aulin
- grid.5132.50000 0001 2312 1970Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
| | - Sebastian T. Tandar
- grid.5132.50000 0001 2312 1970Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
| | - Torben van Zijp
- grid.5132.50000 0001 2312 1970Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
| | - Etienne van Ballegooie
- grid.5132.50000 0001 2312 1970Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
| | - Piet H. van der Graaf
- grid.5132.50000 0001 2312 1970Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands ,Certara QSP, Canterbury, UK
| | - Mohammed A. A. Saleh
- grid.5132.50000 0001 2312 1970Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
| | - Pyry Välitalo
- grid.9668.10000 0001 0726 2490University of Eastern Finland, Kuopio, Finland ,grid.490668.50000 0004 0495 5912Finnish Medicines Agency, Kuopio, Finland
| | - J. G. Coen van Hasselt
- grid.5132.50000 0001 2312 1970Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
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22
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Furlan L, Caramelli B. The regrettable story of the "Covid Kit" and the "Early Treatment of Covid-19" in Brazil. LANCET REGIONAL HEALTH. AMERICAS 2021; 4:100089. [PMID: 34611650 PMCID: PMC8484817 DOI: 10.1016/j.lana.2021.100089] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/08/2021] [Accepted: 09/14/2021] [Indexed: 10/28/2022]
Affiliation(s)
- Leonardo Furlan
- University of São Paulo Medical School, São Paulo, Brazil,Corresponding Author: Leonardo Furlan, Address: Av. Dr. Arnaldo, 455 – Cerqueira César, CEP: 01246903, São Paulo, SP, Brasil, Telephone: +55 11 3061 7379
| | - Bruno Caramelli
- University of São Paulo Medical School, São Paulo, Brazil,Interdisciplinary Medicine in Cardiology Unit, InCor, São Paulo, Brazil
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