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Giuste FO, He L, Lais P, Shi W, Zhu Y, Hornback A, Tsai C, Isgut M, Anderson B, Wang MD. Early and fair COVID-19 outcome risk assessment using robust feature selection. Sci Rep 2023; 13:18981. [PMID: 37923795 PMCID: PMC10624921 DOI: 10.1038/s41598-023-36175-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 05/29/2023] [Indexed: 11/06/2023] Open
Abstract
Personalized medicine plays an important role in treatment optimization for COVID-19 patient management. Early treatment in patients at high risk of severe complications is vital to prevent death and ventilator use. Predicting COVID-19 clinical outcomes using machine learning may provide a fast and data-driven solution for optimizing patient care by estimating the need for early treatment. In addition, it is essential to accurately predict risk across demographic groups, particularly those underrepresented in existing models. Unfortunately, there is a lack of studies demonstrating the equitable performance of machine learning models across patient demographics. To overcome this existing limitation, we generate a robust machine learning model to predict patient-specific risk of death or ventilator use in COVID-19 positive patients using features available at the time of diagnosis. We establish the value of our solution across patient demographics, including gender and race. In addition, we improve clinical trust in our automated predictions by generating interpretable patient clustering, patient-level clinical feature importance, and global clinical feature importance within our large real-world COVID-19 positive patient dataset. We achieved 89.38% area under receiver operating curve (AUROC) performance for severe outcomes prediction and our robust feature ranking approach identified the presence of dementia as a key indicator for worse patient outcomes. We also demonstrated that our deep-learning clustering approach outperforms traditional clustering in separating patients by severity of outcome based on mutual information performance. Finally, we developed an application for automated and fair patient risk assessment with minimal manual data entry using existing data exchange standards.
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Affiliation(s)
- Felipe O Giuste
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, 30322, USA
| | - Lawrence He
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, 30322, USA
| | - Peter Lais
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, 30322, USA
| | - Wenqi Shi
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, 30322, USA
| | - Yuanda Zhu
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, 30322, USA
| | - Andrew Hornback
- School of Computer Science and Engineering, Georgia Institute of Technology, Atlanta, GA, 30322, USA
| | - Chiche Tsai
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, 30322, USA
| | - Monica Isgut
- School of Biology, Georgia Institute of Technology, Atlanta, GA, 30322, USA
| | - Blake Anderson
- Department of Medicine, Emory University, Atlanta, GA, 30322, USA
| | - May D Wang
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, 30322, USA.
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2
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Hautefort C, Corré A, Poillon G, Jourdaine C, Housset J, Eliezer M, Verillaud B, Slama D, Ayache D, Herman P, Yavchitz A, Guillaume J, Hervé C, Bakkouri WE, Salmon D, Daval M. Local budesonide therapy in the management of persistent hyposmia in suspected non-severe COVID-19 patients: Results of a randomized controlled trial. Int J Infect Dis 2023; 136:70-76. [PMID: 37652094 DOI: 10.1016/j.ijid.2023.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 08/20/2023] [Accepted: 08/25/2023] [Indexed: 09/02/2023] Open
Abstract
OBJECTIVES Consequences of COVID-19 on olfactory functions remained unclear during the pandemic. We assessed the efficacy of local budesonide in addition to olfactory rehabilitation when managing non-severe COVID-19 patients with persistent hyposmia. METHODS A multicentric, randomized, superiority trial was conducted (ClinicalTrials.gov NCT04361474). The experimental group (EG) received budesonide and physiological saline nasal irrigations administered via three syringes of 20 ml in each nasal cavity in the morning and evening for 30 days. The control group (CG) received a similar protocol without budesonide. Patients were included if they were >18 years old, with a SARS-CoV-2 infection and presenting an isolated hyposmia persisting 30 days after symptom onset. The primary endpoint was the percentage of patients with improvement of more than two points on the ODORATEST score after 30 days of treatment. RESULTS In total, 123 patients were included and randomized (EG: 62 vs CG: 61). Two patients from the EG met the primary endpoint with no statistical difference between the two groups (P = 0.5). CONCLUSION To our knowledge, this is the first study evaluating local budesonide for COVID-19 related hyposmia treatment even though previous trials were performed with other local corticosteroids. Local budesonide efficacy was not demonstrated for persistent hyposmia related to COVID-19.
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Affiliation(s)
- Charlotte Hautefort
- Hôpital Lariboisière, Université de Paris, APHP, ENT Department, Paris, France
| | - Alain Corré
- Hôpital Fondation Adolphe de Rothschild, ENT Department, Paris, France
| | - Guillaume Poillon
- Hôpital Fondation Adolphe de Rothschild, Imaging Department, Paris, France
| | - Clément Jourdaine
- Hôpital Lariboisière, Université de Paris, APHP, ENT Department, Paris, France
| | - Juliette Housset
- Hôpital Lariboisière, Université de Paris, APHP, ENT Department, Paris, France
| | - Michael Eliezer
- Hôpital Lariboisière, Université de Paris, APHP, Neuroradiology Department, Paris, France
| | - Benjamin Verillaud
- Hôpital Lariboisière, Université de Paris, APHP, ENT Department, Paris, France
| | - Dorsaf Slama
- Hôpital Hotel Dieu, Université de Paris, APHP, Department of Infectious Disease, Paris, France
| | - Denis Ayache
- Hôpital Fondation Adolphe de Rothschild, ENT Department, Paris, France
| | - Philippe Herman
- Hôpital Lariboisière, Université de Paris, APHP, ENT Department, Paris, France
| | - Amélie Yavchitz
- Hôpital Fondation Adolphe de Rothschild, Clinical Research Department, Paris, France
| | - Jessica Guillaume
- Hôpital Fondation Adolphe de Rothschild, Clinical Research Department, Paris, France
| | - Camille Hervé
- Hôpital Fondation Adolphe de Rothschild, ENT Department, Paris, France
| | | | - Dominique Salmon
- Hôpital Hotel Dieu, Université de Paris, APHP, Department of Infectious Disease, Paris, France
| | - Mary Daval
- Hôpital Fondation Adolphe de Rothschild, ENT Department, Paris, France.
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3
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Li X, Yuan X, Xu Z, Huang L, Shi L, Lu X, Wang FS, Fu J. Effect of methylprednisolone therapy on hospital stay and viral clearance in patients with moderate COVID-19. Infect Med (Beijing) 2022; 1:236-244. [PMID: 38013911 PMCID: PMC9584857 DOI: 10.1016/j.imj.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/11/2022] [Accepted: 09/29/2022] [Indexed: 11/05/2022]
Abstract
Background The benefits and harms of methylprednisolone treatment in patients with moderate coronavirus disease 2019 (COVID-19) remain controversial. In this study, we investigated the effect of methylprednisolone on mortality rate, viral clearance, and hospitalization stay in patients with moderate COVID-19. Methods This retrospective study included 4827 patients admitted to Wuhan Huoshenshan and Wuhan Guanggu hospitals from February to March 2020 diagnosed with COVID-19 pneumonia. The participants' epidemiological and demographic data, comorbidities, laboratory test results, treatments, outcomes, and vital clinical time points were extracted from electronic medical records. The primary outcome was in-hospital death; secondary outcomes were time from admission to viral clearance and hospital stay. Univariate and multivariate logistic or linear regression analysis were used to assess the roles of methylprednisolone in different outcomes. The propensity score matching (PSM) method was used to control for confounding factors. Results A total of 1320 patients were included in this study, of whom 100 received methylprednisolone. Overall, in-hospital mortality was 0.91% (12/1320); the 12 patients who died were all in the methylprednisolone group, though multivariate logistic regression analysis showed methylprednisolone treatment was not a risk factor for in-hospital death in moderate patients before or after adjustment for confounders by PSM. Methylprednisolone treatment was correlated with longer length from admission to viral clearance time and hospital stay before and after adjustment for confounders. Conclusions Methylprednisolone therapy was not associated with increased in-hospital mortality but with delayed viral clearance and extended hospital stay in moderate COVID-19 patients.
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Affiliation(s)
- Xiaoyan Li
- Medical School of Chinese PLA, Beijing, China
- Senior Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
- National Clinical Research Center for Infectious Diseases, Beijing, China
| | - Xin Yuan
- Medical School of Chinese PLA, Beijing, China
- Senior Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
- National Clinical Research Center for Infectious Diseases, Beijing, China
| | - Zhe Xu
- Medical School of Chinese PLA, Beijing, China
- Senior Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
- National Clinical Research Center for Infectious Diseases, Beijing, China
| | - Lei Huang
- Medical School of Chinese PLA, Beijing, China
- Senior Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
- National Clinical Research Center for Infectious Diseases, Beijing, China
| | - Lei Shi
- Medical School of Chinese PLA, Beijing, China
- Senior Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
- National Clinical Research Center for Infectious Diseases, Beijing, China
| | - Xuechun Lu
- Department of Hematology, the Second Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Fu-Sheng Wang
- Medical School of Chinese PLA, Beijing, China
- Senior Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
- National Clinical Research Center for Infectious Diseases, Beijing, China
| | - Junliang Fu
- Medical School of Chinese PLA, Beijing, China
- Senior Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
- National Clinical Research Center for Infectious Diseases, Beijing, China
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4
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Kumari P, Pradhan B, Koromina M, Patrinos GP, Steen KV. Discovery of new drug indications for COVID-19: A drug repurposing approach. PLoS One 2022; 17:e0267095. [PMID: 35609015 PMCID: PMC9129022 DOI: 10.1371/journal.pone.0267095] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 04/03/2022] [Indexed: 11/19/2022] Open
Abstract
Motivation
The outbreak of coronavirus health issues caused by COVID-19(SARS-CoV-2) creates a global threat to public health. Therefore, there is a need for effective remedial measures using existing and approved therapies with proven safety measures has several advantages. Dexamethasone (Pubchem ID: CID0000005743), baricitinib(Pubchem ID: CID44205240), remdesivir (PubchemID: CID121304016) are three generic drugs that have demonstrated in-vitro high antiviral activity against SARS-CoV-2. The present study aims to widen the search and explore the anti-SARS-CoV-2 properties of these potential drugs while looking for new drug indications with optimised benefits via in-silico research.
Method
Here, we designed a unique drug-similarity model to repurpose existing drugs against SARS-CoV-2, using the anti-Covid properties of dexamethasone, baricitinib, and remdesivir as references. Known chemical-chemical interactions of reference drugs help extract interactive compounds withimprovedanti-SARS-CoV-2 properties. Here, we calculated the likelihood of these drug compounds treating SARS-CoV-2 related symptoms using chemical-protein interactions between the interactive compounds of the reference drugs and SARS-CoV-2 target genes. In particular, we adopted a two-tier clustering approach to generate a drug similarity model for the final selection of potential anti-SARS-CoV-2 drug molecules. Tier-1 clustering was based on t-Distributed Stochastic Neighbor Embedding (t-SNE) and aimed to filter and discard outlier drugs. The tier-2 analysis incorporated two cluster analyses performed in parallel using Ordering Points To Identify the Clustering Structure (OPTICS) and Hierarchical Agglomerative Clustering (HAC). As a result, itidentified clusters of drugs with similar actions. In addition, we carried out a docking study for in-silico validation of top candidate drugs.
Result
Our drug similarity model highlighted ten drugs, including reference drugs that can act as potential therapeutics against SARS-CoV-2. The docking results suggested that doxorubicin showed the least binding energy compared to reference drugs. Their practical utility as anti-SARS-CoV-2 drugs, either individually or in combination, warrants further investigation.
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Affiliation(s)
- Priyanka Kumari
- GIGA-R Medical Genomics - BIO3 Systems Genomics, University of Liège, Liège, Belgium
- Laboratory of Pharmaceutical Analytical Chemistry, CIRM, University of Liège, Liège, Belgium
- * E-mail: (PK); (KVS)
| | - Bikram Pradhan
- Indian Space Research Organisation (ISRO) Headquarters, Bengaluru, India
| | - Maria Koromina
- University of Patras, School of Health Sciences, Department of Pharmacy, Patras, Greece
| | - George P. Patrinos
- University of Patras, School of Health Sciences, Department of Pharmacy, Patras, Greece
- Department of Pathology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE
- Zayed Bin Sultan Center for Health Sciences, United Arab Emirates University, Al Ain, UAE
| | - Kristel Van Steen
- GIGA-R Medical Genomics - BIO3 Systems Genomics, University of Liège, Liège, Belgium
- Department of Human Genetics - BIO3 Systems Medicine, University of Leuven, Leuven, Belgium
- * E-mail: (PK); (KVS)
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Agustí A, De Stefano G, Levi A, Muñoz X, Romero-Mesones C, Sibila O, Lopez-Giraldo A, Moral VP, Curto E, Echazarreta AL, Márquez SE, Pascual-Guàrdia S, Santos S, Marin A, Valdés L, Saldarini F, Salgado C, Casanovas G, Varea S, Ríos J, Faner R. Add-on inhaled budesonide in the treatment of hospitalised patients with COVID-19: a randomised clinical trial. Eur Respir J 2022; 59:13993003.03036-2021. [PMID: 35144989 PMCID: PMC8832375 DOI: 10.1183/13993003.03036-2021] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 12/28/2021] [Indexed: 12/13/2022]
Abstract
SARS-CoV-2 vaccines have been extremely effective in reducing the incidence of severe coronavirus disease 2019 (COVID-19) [1, 2], but effective and safe treatments for acute infection are still limited [3, 4]. An uncontrolled pulmonary inflammatory response to SARS-CoV-2 is considered a key pathogenic mechanism of COVID-19 progression [5], so systemic dexamethasone is recommended in severe cases [4, 6]. On the other hand, in very mild patients at home, inhaled corticosteroids (ICS) may prevent disease progression [7–10]. Whether ICS can also prevent disease progression in patients hospitalised because of COVID-19 has not been explored previously. Accordingly, we designed an investigator-initiated, open-label, randomised clinical trial (RCT) to explore the efficacy of adding inhaled budesonide to usual care to prevent disease progression in patients hospitalised because of COVID-19 pneumonia. We also carefully monitored the safety of this intervention since there are concerns about the use of systemic corticosteroids in other viral (influenza) lung infections [11]. The addition of inhaled budesonide to usual care is safe and may reduce the risk of disease progression in patients hospitalised because of COVID-19 pneumoniahttps://bit.ly/3tEQo3p
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Affiliation(s)
- Alvar Agustí
- Hospital Clinic, Barcelona, Spain .,Universitat Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,CIBER Enfermedades Respiratorias, Spain
| | - Gaston De Stefano
- Servicio de Neumotisiologia, Hospital Francisco Muñiz, Buenos Aires, Argentina
| | - Alberto Levi
- Servicio de Neumotisiologia, Hospital Francisco Muñiz, Buenos Aires, Argentina
| | - Xavier Muñoz
- CIBER Enfermedades Respiratorias, Spain.,Servei Pneumologia H. Vall d'Hebron, Barcelona Spain.,Biostatistics Unit, Faculty of Medicine, Universitat Autònoma de Barcelona
| | | | - Oriol Sibila
- Hospital Clinic, Barcelona, Spain.,Universitat Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,CIBER Enfermedades Respiratorias, Spain
| | - Alejandra Lopez-Giraldo
- Universitat Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,CIBER Enfermedades Respiratorias, Spain
| | - Vicente Plaza Moral
- CIBER Enfermedades Respiratorias, Spain.,Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Institut d'Investigació Biomédica Sant Pau (IIB Sant Pau), Barcelona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Elena Curto
- CIBER Enfermedades Respiratorias, Spain.,Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Institut d'Investigació Biomédica Sant Pau (IIB Sant Pau), Barcelona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Andrés L Echazarreta
- Servicio de Neumonología, Hospital San Juan de Dios de La Plata, Buenos Aires, Argentina
| | - Silvana E Márquez
- Servicio de Neumonología, Hospital San Juan de Dios de La Plata, Buenos Aires, Argentina
| | - Sergi Pascual-Guàrdia
- CIBER Enfermedades Respiratorias, Spain.,Servei de Pneumologia, Hospital del Mar - IMIM, Barcelona, Spain.,Universitat Pompeu Fabra Barcelona, Spain
| | - Salud Santos
- Universitat Barcelona, Spain.,CIBER Enfermedades Respiratorias, Spain.,Department of Pulmonary Medicine, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain.,Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, Spain
| | - Alicia Marin
- CIBER Enfermedades Respiratorias, Spain.,Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Luis Valdés
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain.,Instituto de Investigaciones Sanitarias (IDIS), Santiago de Compostela, Spain.,Universidad de Santiago de Compostela, Spain
| | - Fernando Saldarini
- Sección de Neumotisiologia, Hospital Donación Francisco Santojanni, Buenos Aires, Argentina
| | - Clara Salgado
- Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno
| | - Georgina Casanovas
- Hospital Clinic, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Sara Varea
- Hospital Clinic, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - José Ríos
- Hospital Clinic, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Biostatistics Unit, Faculty of Medicine, Universitat Autònoma de Barcelona
| | - Rosa Faner
- Universitat Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,CIBER Enfermedades Respiratorias, Spain
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Bassetti M, Giacobbe DR, Bruzzi P, Barisione E, Centanni S, Castaldo N, Corcione S, De Rosa FG, Di Marco F, Gori A, Gramegna A, Granata G, Gratarola A, Maraolo AE, Mikulska M, Lombardi A, Pea F, Petrosillo N, Radovanovic D, Santus P, Signori A, Sozio E, Tagliabue E, Tascini C, Vancheri C, Vena A, Viale P, Blasi F. Clinical Management of Adult Patients with COVID-19 Outside Intensive Care Units: Guidelines from the Italian Society of Anti-Infective Therapy (SITA) and the Italian Society of Pulmonology (SIP). Infect Dis Ther 2021; 10:1837-1885. [PMID: 34328629 PMCID: PMC8323092 DOI: 10.1007/s40121-021-00487-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 06/15/2021] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION The Italian Society of Anti-Infective Therapy (SITA) and the Italian Society of Pulmonology (SIP) constituted an expert panel for developing evidence-based guidance for the clinical management of adult patients with coronavirus disease 2019 (COVID-19) outside intensive care units. METHODS Ten systematic literature searches were performed to answer ten different key questions. The retrieved evidence was graded according to the Grading of Recommendations Assessment, Development, and Evaluation methodology (GRADE). RESULTS AND CONCLUSION The literature searches mostly assessed the available evidence on the management of COVID-19 patients in terms of antiviral, anticoagulant, anti-inflammatory, immunomodulatory, and continuous positive airway pressure (CPAP)/non-invasive ventilation (NIV) treatment. Most evidence was deemed as of low certainty, and in some cases, recommendations could not be developed according to the GRADE system (best practice recommendations were provided in similar situations). The use of neutralizing monoclonal antibodies may be considered for outpatients at risk of disease progression. For inpatients, favorable recommendations were provided for anticoagulant prophylaxis and systemic steroids administration, although with low certainty of evidence. Favorable recommendations, with very low/low certainty of evidence, were also provided for, in specific situations, remdesivir, alone or in combination with baricitinib, and tocilizumab. The presence of many best practice recommendations testified to the need for further investigations by means of randomized controlled trials, whenever possible, with some possible future research directions stemming from the results of the ten systematic reviews.
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Affiliation(s)
- Matteo Bassetti
- Infectious Diseases Unit, Ospedale Policlinico San Martino-IRCCS, L.go R. Benzi, 10, 16132, Genoa, Italy.
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
| | - Daniele Roberto Giacobbe
- Infectious Diseases Unit, Ospedale Policlinico San Martino-IRCCS, L.go R. Benzi, 10, 16132, Genoa, Italy.
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
| | - Paolo Bruzzi
- Clinical Epidemiology Unit, Ospedale Policlinico San Martino-IRCCS, Genoa, Italy
| | - Emanuela Barisione
- Interventional Pulmonology, Ospedale Policlinico San Martino-IRCCS, Genoa, Italy
| | - Stefano Centanni
- Department of Health Sciences, University of Milan, Respiratory Unit, ASST Santi Paolo e Carlo, Milan, Italy
| | - Nadia Castaldo
- Infectious Diseases Clinic, Santa Maria Misericordia Hospital, Udine, Italy
| | - Silvia Corcione
- Department of Medical Sciences, Infectious Diseases, University of Turin, Turin, Italy
- Tufts University School of Medicine, Boston, MA, USA
| | | | - Fabiano Di Marco
- Department of Health Sciences, University of Milan, Respiratory Unit, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Andrea Gori
- Infectious Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- Centre for Multidisciplinary Research in Health Science (MACH), University of Milan, Milan, Italy
| | - Andrea Gramegna
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Internal Medicine Department, Respiratory Unit and Cystic Fibrosis Adult Center, Milan, Italy
| | - Guido Granata
- Clinical and Research Department for Infectious Diseases, National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy
| | - Angelo Gratarola
- Department of Emergency and Urgency, San Martino Policlinico Hospital, IRCCS, Genoa, Italy
| | | | - Malgorzata Mikulska
- Infectious Diseases Unit, Ospedale Policlinico San Martino-IRCCS, L.go R. Benzi, 10, 16132, Genoa, Italy
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Andrea Lombardi
- Infectious Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Federico Pea
- Department of Medical and Surgical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
- SSD Clinical Pharmacology Unit, University Hospital, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
| | - Nicola Petrosillo
- Clinical and Research Department for Infectious Diseases, National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy
- Infection Control and Infectious Disease Service, University Hospital "Campus-Biomedico", Rome, Italy
| | - Dejan Radovanovic
- Division of Respiratory Diseases, Ospedale L. Sacco, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Pierachille Santus
- Division of Respiratory Diseases, Ospedale L. Sacco, ASST Fatebenefratelli-Sacco, Milan, Italy
- Department of Biomedical and Clinical Sciences (DIBIC), Università degli Studi di Milano, Milan, Italy
| | - Alessio Signori
- Department of Health Sciences, Section of Biostatistics, University of Genoa, Genoa, Italy
| | - Emanuela Sozio
- Infectious Diseases Clinic, Santa Maria Misericordia Hospital, Udine, Italy
| | - Elena Tagliabue
- Interventional Pulmonology, Ospedale Policlinico San Martino-IRCCS, Genoa, Italy
| | - Carlo Tascini
- Infectious Diseases Clinic, Santa Maria Misericordia Hospital, Udine, Italy
| | - Carlo Vancheri
- Regional Referral Centre for Rare Lung Diseases-University Hospital "Policlinico G. Rodolico", Catania, Italy
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Antonio Vena
- Infectious Diseases Unit, Ospedale Policlinico San Martino-IRCCS, L.go R. Benzi, 10, 16132, Genoa, Italy
| | - Pierluigi Viale
- Department of Medical and Surgical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
- Infectious Diseases Unit, University Hospital IRCCS Policlinico Sant'Orsola, Bologna, Italy
| | - Francesco Blasi
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Internal Medicine Department, Respiratory Unit and Cystic Fibrosis Adult Center, Milan, Italy
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7
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Mohiuddin M, Kasahara K. Potential therapeutic role of budesonide to reduce COVID-19 severity. J Infect Public Health 2021; 15:109-111. [PMID: 34802976 PMCID: PMC8585565 DOI: 10.1016/j.jiph.2021.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/04/2021] [Accepted: 11/01/2021] [Indexed: 12/26/2022] Open
Affiliation(s)
- Md Mohiuddin
- Department of Respiratory Medicine, Kanazawa University, Ishikawa, Japan.
| | - Kazuo Kasahara
- Department of Respiratory Medicine, Kanazawa University, Ishikawa, Japan
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Bestetti RB, Furlan-Daniel R, Silva VMR. Pharmacological Treatment of Patients with Mild to Moderate COVID-19: A Comprehensive Review. Int J Environ Res Public Health 2021; 18:ijerph18137212. [PMID: 34281149 PMCID: PMC8297311 DOI: 10.3390/ijerph18137212] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/27/2021] [Accepted: 06/30/2021] [Indexed: 01/10/2023]
Abstract
Mild to moderate COVID-19 can be found in about 80% of patients. Although mortality is low, mild to moderate COVID-19 may progress to severe or even critical stages in about one week. This poses a substantial burden on the health care system, and ultimately culminates in death or incapacitation and hospitalization. Therefore, pharmacological treatment is paramount for patients with this condition, especially those with recognized risk factors to disease progression. We conducted a comprehensive review in the medical literature searching for randomized studies carried out in patients with mild to moderate COVID-19. A total of 14 randomized studies were identified, enrolling a total of 6848 patients. Nine studies (64%) were randomized, placebo-controlled trials, whereas five were open-label randomized trials (35%). We observed that Bamlanivimab and nitazoxanide reduced viral load, whereas ivermectin may have shortened time to viral clearance; Interferon Beta-1 reduced time to viral clearance and vitamin D reduced viral load; Favirapir, peginterferon, and levamisole improved clinical symptoms, whereas fluvoxamine halted disease progression; inhaled budesonide reduced the number of hospitalizations and visits to emergency departments; colchicine reduced the number of deaths and hospitalizations. Collectively, therefore, these findings show that treatment of early COVID-19 may be associated with reduced viral load, thus potentially decreasing disease spread in the community. Moreover, treatment of patients with mild to moderate COVID-19 may also be associated with improved clinical symptoms, hospitalization, and disease progression. We suggest that colchicine, inhaled budesonide, and nitazoxanide, along with nonpharmacological measures, based on efficacy and costs, may be used to mitigate the effects of the COVID-19 pandemic in middle-income countries.
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Zeitlinger M, Idzko M. Inhaled budesonide for early treatment of COVID-19. The Lancet Respiratory Medicine 2021; 9:e59. [PMID: 33991506 PMCID: PMC8115942 DOI: 10.1016/s2213-2600(21)00215-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 04/22/2021] [Indexed: 01/06/2023]
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Idzko M, Lommatzsch M, Taube C, Eber E, Lamprecht B, Horak F, Pohl W, Rabe KF, Virchow JC, Hamelmann E, Pfeifer M, Bauer T, Buhl R. [Treatment of COVID-19 with Inhaled Glucocorticoids - Statement of the German Respiratory Society (DGP), the Austrian Society of Pneumology (ÖGP) and the German Society of Allergology and Clinical Immunology (DGAKI)]. Pneumologie 2021; 75:418-420. [PMID: 34000741 DOI: 10.1055/a-1488-5373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Marco Idzko
- Universitätsklinikum AKH Wien, Medizinische Universität Wien
| | | | | | | | | | | | - Wolfgang Pohl
- Karl-Landsteiner-Institut für klinische und experimentelle Pneumologie, Wien
| | - Klaus F Rabe
- LungenClinic Grosshansdorf und Medizinische Klinik Universität Kiel, Deutsches Zentrum für Lungenforschung (DZL)
| | | | | | | | - Torsten Bauer
- Lungenklinik Heckeshorn, Helios-Klinikum Emil von Behring, Berlin
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