Oral Colchicine and Low-Dose Aspirin Combination Therapy for Non-elderly, Non-severe, Early Time From Onset, Adult Outpatients with Coronavirus Disease 2019 (COVID-19) during "The Fifth Pandemic Wave" in Japan.

BACKGROUND: Treatment with antiviral drugs for non-severe, early time from onset, adult outpatients with Coronavirus Disease 2019 (COVID-19) had not been established in 2021. However, some new variants of SARS-CoV-2 had caused rapid exacerbation and hospitalization among non-elderly outpatients with COVID-19, contributing to widespread crises within healthcare systems. METHODS: From July to October 2021, we urgently assessed a therapeutic program using oral colchicine (1.0 mg loading dose, followed approximately half a day later by 0.5 mg twice daily for 5 days, and then 0.5 mg once daily for 4 days) and low-dose aspirin (100 mg once daily for 10 days), for non-elderly, non-severe, early time from onset, adult outpatients with COVID-19. To verify its effectiveness, we set loxoprofen as a control arm, and com parison of these two arms was performed. The primary outcomes were hospitalization, criticality, and death rates. RESULTS: Thirty-eight patients (23 receiving colchicine and low-dose aspirin [CA]; 15 receiving loxoprofen [LO]) were evaluated. Hospitalization rate was lower in the CA group (1/23; 4.3%) than in the LO group (2/15; 13.3%); however, no significant difference was found between the two groups (p=0.34). No critical cases, deaths, or severe adverse events were found in either group. CONCLUSIONS: Our CA regimen did not show superiority over LO treatment. However, our clinical experience should be recorded as part of community health care activities carried out in Kurume City against the unprece dented COVID-19 pandemic.

Clinicopathologic study of neovascularization and VEGF expression in superficial esophageal carcinoma.

Among superficial esophageal carcinomas (SECs), mucosal carcinoma (m) and submucosal carcinoma (sm) markedly differ regarding the presence or absence of lymph node metastases and long-term survival. To clarify differences in the growth pattern of these two superficial carcinomas, we investigated neovascularization around the site of tumor growth and expression of vascular endothelial growth factor (VEGF) in tumor cells, in patients undergoing radical esophagectomy or endoscopic mucosal resection (EMR). Moreover, we investigated whether these factors were related to the prognosis in patients undergoing treatment of SEC. This study included 90 SEC patients undergoing radical esophagectomy (surgery group) and 35 patients undergoing EMR (EMR group). For immunohistochemical staining antibodies against factor VIII-related antigen and against VEGF were used. The microvessels around the tumor were counted to calculate the vascular index (VI). VI and VEGF expression in the tumor were compared in relation to clinicopathologic findings. In the surgery group, the VI and the percent of VEGF-positive cells were significantly higher in the case of sm carcinomas. Furthermore, tumors with a high VI showed a significantly worse prognosis. In the EMR group, the VI and percent of VEGF-positive cells increased with the depth of the tumor. The VI and VEGF expression were significantly higher in sm carcinomas. This may in part explain the difference in cancer progression between m and sm carcinomas. In patients undergoing resection or EMR, examination of neovascularization using VI may be potentially useful in evaluating the prognosis of SEC.