A randomized, double-blind study on the efficacy of oral domperidone versus placebo for reducing SARS-CoV-2 viral load in mild-to-moderate COVID-19 patients in primary health care.

INTRODUCTION: The clinical effect of domperidone against COVID-19 has been investigated in a double-blind phase III clinical trial (EudraCT number 2021-001228-17). Domperidone has shown in vitro antiviral activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and potential immudolatory properties through the stimulation of prolactin secretion. PATIENTS AND METHODS: The efficacy of oral domperidone plus standard of care (SOC; n = 87) versus placebo plus SOC (n = 86) was evaluated in a 28-day randomized double-blind multicentre study in primary health care centres. A total of 173 outpatients with mild-to-moderate COVID-19 were included. Three daily doses of 10 mg (30 mg/day) of domperidone or placebo were administered for 7 days. Reduction of viral load on day 4 was the primary efficay endpoint. It was estimated in saliva samples by reverse transcription-quantitative polymerase chain reaction (RT-qPCR), as the cycle thresholds detected ORF1ab, N Protein and S Protein genes. RESULTS: A significant reduction in the viral load was observed (p < 0.001) from baseline to days 4, 7 and 14 of the three genes studied with non-significant differences between domperidone and placebo groups. Twenty-three patients (13.3%) experienced adverse events, 14 patients in the domperidone group (16.1%) and 9 patients in the placebo group (10.5%). No patients needed to be hospitalized. CONCLUSION: Results do not prove the use of domperidone as antiviral in patients with COVID-19.

A 28-day double-blind clinical trial was performed to investigate the antiviral effect of domperidone, 30 mg/day for 7 days (n = 87) versus placebo (n = 86) in outpatients with mild-to-moderate COVID-19.The primary efficacy endpoint was the reduction of viral load on day 4 as compared with baseline, estimated as the cycle thresholds to detect ORF1ab, N Protein and S Protein genes by RT-qPCR in saliva samples.The study findings do not prove the use of domperidone as antiviral in patients with COVID-19.

Prevalence of insulin resistance in a young adult population. Relationship with weight status.

AIM: To estimate the prevalence of insulin resistance using both the Homeostatic Model Assessment (HOMA) index and basal insulinemia, and to analyze its relationship to overweight, as measured by body mass index (BMI) and waist circumference (WC). PATIENTS AND METHODS: A series of 118 non-diabetic young adults aged 18 and 19 years attending a primary care health center were studied. They were contacted by telephone, and their BMI, WC, HOMA and basal insulinemia were measured, among other parameters. RESULTS: HOMA values ≥ P90 (HOMA ≥3.15) were found in 9.3% of the sample (50% in the obesity group). Insulinemia ≥ P90 (16,9) was found in 11%. Based on BMI, 17.8% were overweight (26.5% of men, 11.6% of women), and 6.8% were obese (6.1% of men, 7.2% of women). Based on WC, 5.71% were obese when waist was measured at the midpoint and 15.38%, when measured at the iliac crest. HOMA was found to be significantly correlated to weight increase, BMI, WC, systolic blood pressure, triglycerides, and blood glucose, while correlation was only found between insulinemia and increased WC and decreased high lipoprotein cholesterol (HDL) levels. CONCLUSION: In this young adult sample, increased BMI and WC were associated to increased insulin resistance. High HOMA values were found in 9.3% of subjects.

[Obesity and cardiovascular risk factors in adolescents. Association with cardiovascular risk factors in first degree relatives]. / Obesidad y factores de riesgo cardiovascular en adolescentes. Asociación con factores de riesgo cardiovascular en familiares de primer grado.

BACKGROUND AND OBJECTIVE: Obesity is a major concern in public health. The fact that most teenagers stop contacting the health system during this period of life prevents detection of this problem and its associated morbidity. The aim of this study is to measure the prevalence of obesity at 18. We also aimed to detect overweight, cardiovascular risk factors (CVRF) and association with CVRF in parents and siblings. PATIENTS AND METHOD: The research includes 153 children followed up to 18 years old in a community health center. Measures of body mass index (BMI), waist perimeter, CVRF, and familiar history were taken. RESULTS: The prevalence of obesity in our study group was 7.18%, (IC: 3.0-11.0), (6.25% male and 7.86% female). The prevalence of overweight was 18.3% (IC: 11.9-24.0), (26.56% male and 12.35% female). A familiy history of CVRF was found in 53.9% (IC: 46.1-61.9) of cases, including high blood pressure (25%), obesity (23.6%), dyslipemia (21.7%), and diabetes (7.2%). This finding was more prevalent in the obesity group (72.72%) than in those with overweight only (64.2%), or with normal weight (49.59%). A family history of obesity and diabetes in first-degree relatives was associated to obesity in the study group. Also, a family history of high blood pressure was associated to the presence of high blood pressure in this group. CONCLUSIONS: In order to detect obesity, overweight, and associated complications in young adults, specific attention to children and siblings of persons who present risk factors is recommended. Those with high blood pressure, diabetes or obesity have the higher risk.