The efficacy of corticosteroids therapy in patients with moderate to severe SARS-CoV-2 infection: a multicenter, randomized, open-label trial.

BACKGROUND: We performed a multicenter, randomized open-label trial in patients with moderate to severe Covid-19 treated with a range of possible treatment regimens. METHODS: Patients were randomly assigned to one of three regimen groups at a ratio of 1:1:1. The primary outcome of this study was admission to the intensive care unit. Secondary outcomes were intubation, in-hospital mortality, time to clinical recovery, and length of hospital stay (LOS). Between April 13 and August 9, 2020, a total of 336 patients were randomly assigned to receive one of the 3 treatment regimens including group I (hydroxychloroquine stat, prednisolone, azithromycin and naproxen; 120 patients), group II (hydroxychloroquine stat, azithromycin and naproxen; 116 patients), and group III (hydroxychloroquine and lopinavir/ritonavir (116 patients). The mean LOS in patients receiving prednisolone was 5.5 in the modified intention-to-treat (mITT) population and 4.4 days in the per-protocol (PP) population compared with 6.4 days (mITT population) and 5.8 days (PP population) in patients treated with Lopinavir/Ritonavir. RESULTS: The mean LOS was significantly lower in the mITT and PP populations who received prednisolone compared with populations treated with Lopinavir/Ritonavir (p = 0.028; p = 0.0007). We observed no significant differences in the number of deaths, ICU admission, and need for mechanical ventilation between the Modified ITT and per-protocol populations treated with prednisolone and Lopinavir/Ritonavir, although these outcomes were better in the arm treated with prednisolone. The time to clinical recovery was similar in the modified ITT and per-protocol populations treated with prednisolone, lopinavir/ritonavir, and azithromycin (P = 0.335; P = 0.055; p = 0.291; p = 0.098). CONCLUSION: The results of the present study show that therapeutic regimen (regimen I) with low dose prednisolone was superior to other regimens in shortening the length of hospital stay in patients with moderate to severe COVID-19. The steroid sparing effect may be utilized to increase the effectiveness of corticosteroids in the management of diabetic patients by decreasing the dosage.

Free radical scavengers from the aerial parts of Grammosciadium platycarpum Boiss. & Hausskn. (Apiaceae) and GC-MS analysis of the essential oils from its fruits / Substâncias eliminadoras de radicais livres das partes aéreas de Grammosciadium platycarpum Boiss. & Hausskn. (Apiaceae) e análise por CG-MS dos óleos essenciais de seus frutos

Grammosciadium platycarpum Boiss. & Hausskn (Apiaceae) is one of three endemic Iranian species of the genus Grammosciadium DC. Consumption of the aerial parts of this plant affects renal function and causes diuresis. In the DPPH assay the methanol extract showed the highest level of free radical scavenging activity (RC50 = 1.196 x 10-2 mg/mL) among the extracts. Reversed-phase preparative HPLC analyses of the methanol extract yielded nine flavonoids, which were responsible for the free radical scavenging activity of the MeOH extract. The GC-MS analyses of the essential oils led to the identification of 29 terpenoids, mainly monoterpenes (non-oxygenated 3.97 percent and oxygenated 77.49 percent) accounting for over 96 percent of the total oils.

Grammosciadium platycarpum Boiss. & Hausskn (Apiaceae) é uma das três espécies endémicas no Irã do gênero Grammosciadium DC. Consumo da parte aérea da planta afeta a função renal e causa diurese. No ensaio por DPPH o extrato metanólico apresentou o maior nível de atividade de antioxidante por radicais livres (RC50 = 1,196 x 10-2 mg/mL) entre os extratos. Análises por HPLC preparativa de fase reversa do extrato metanólico resultou no isolamento de nove flavonóides, os quais foram responsáveis pela atividade de antioxidante do extrato metanólico. A análises por CG-EM dos óleos essenciais levou à identificação de 29 terpenóides, principalmente monoterpenos (não-oxigenados 3,97 por cento e oxigenados, 77,49 por cento), os quais representam mais de 96 por cento do total de óleos.