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1.
N Engl J Med ; 388(6): 518-528, 2023 02 09.
Artículo en Inglés | MEDLINE | ID: mdl-36780676

RESUMEN

BACKGROUND: The efficacy of a single dose of pegylated interferon lambda in preventing clinical events among outpatients with acute symptomatic coronavirus disease 2019 (Covid-19) is unclear. METHODS: We conducted a randomized, controlled, adaptive platform trial involving predominantly vaccinated adults with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Brazil and Canada. Outpatients who presented with an acute clinical condition consistent with Covid-19 within 7 days after the onset of symptoms received either pegylated interferon lambda (single subcutaneous injection, 180 µg) or placebo (single injection or oral). The primary composite outcome was hospitalization (or transfer to a tertiary hospital) or an emergency department visit (observation for >6 hours) due to Covid-19 within 28 days after randomization. RESULTS: A total of 933 patients were assigned to receive pegylated interferon lambda (2 were subsequently excluded owing to protocol deviations) and 1018 were assigned to receive placebo. Overall, 83% of the patients had been vaccinated, and during the trial, multiple SARS-CoV-2 variants had emerged. A total of 25 of 931 patients (2.7%) in the interferon group had a primary-outcome event, as compared with 57 of 1018 (5.6%) in the placebo group, a difference of 51% (relative risk, 0.49; 95% Bayesian credible interval, 0.30 to 0.76; posterior probability of superiority to placebo, >99.9%). Results were generally consistent in analyses of secondary outcomes, including time to hospitalization for Covid-19 (hazard ratio, 0.57; 95% Bayesian credible interval, 0.33 to 0.95) and Covid-19-related hospitalization or death (hazard ratio, 0.59; 95% Bayesian credible interval, 0.35 to 0.97). The effects were consistent across dominant variants and independent of vaccination status. Among patients with a high viral load at baseline, those who received pegylated interferon lambda had lower viral loads by day 7 than those who received placebo. The incidence of adverse events was similar in the two groups. CONCLUSIONS: Among predominantly vaccinated outpatients with Covid-19, the incidence of hospitalization or an emergency department visit (observation for >6 hours) was significantly lower among those who received a single dose of pegylated interferon lambda than among those who received placebo. (Funded by FastGrants and others; TOGETHER ClinicalTrials.gov number, NCT04727424.).


Asunto(s)
Tratamiento Farmacológico de COVID-19 , COVID-19 , Interferón lambda , Adulto , Humanos , Teorema de Bayes , COVID-19/terapia , Método Doble Ciego , Interferón lambda/administración & dosificación , Interferón lambda/efectos adversos , Interferón lambda/uso terapéutico , Polietilenglicoles/administración & dosificación , Polietilenglicoles/efectos adversos , Polietilenglicoles/uso terapéutico , SARS-CoV-2 , Resultado del Tratamiento , Atención Ambulatoria , Inyecciones Subcutáneas , Antivirales/administración & dosificación , Antivirales/efectos adversos , Antivirales/uso terapéutico , Vacunas contra la COVID-19/uso terapéutico , Vacunación
2.
Braz J Biol ; 84: e265278, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36228229

RESUMEN

The contamination of natural resources with heavy metals released from steel mills is the primary cause of soil and water pollution in the Dargai Malakand, located on the northern side of Pakistan. Therefore, the present study was aimed to determine the level of heavy metals in soil and water samples of this area. The wild plant growing (nine native plants: Pteris vittata, Populus nigra, Eucalyptus camaldulensis, Persicaria maculosa, Arundo donax, Xanthium strumarium, Verbascum thapsus, Ricinus communis and Parthenium hysterophorus) there were then tested for their phytoremediation capabilities which is an environmentally friendly, generally utilized, and low-cost approach to eliminate heavy metals from polluted soils and water. Soil, water, and effluent samples were taken from the contaminated sites of seven steel mills in Dargai District Malakand and subjected to heavy metals analysis. Based on bioconcentration factor (BCF) and translocation factor (TF) calculated, The highest BCF for zinc was recorded for Pteris vittata roots (3.93), while the lowest value was observed for Verbascum thapsus leaves (0.306). Pteris vittata root showed the highest BCF for iron (1.618), while Ricinus communis leaves showed the lowest (0.023). The highest BCF value for chromium was highest for Populus nigra roots (0.717), while the lowest value was recorded for Persicaria maculosa leaves (0.031). For the selected metals; Fe, Zn and Cr the highest TF were recorded for Pteris vittata (0.988), Verbascum thapsus (0.944) and Xanthium strumairum (0.968) respectively. Therefore, it is recommended that these plants should be grown near to steel mills to reclaim heavy metals from industrial effluent, polluted soil as well as from polluted water.


Asunto(s)
Metales Pesados , Contaminantes del Suelo , Biodegradación Ambiental , Cromo/análisis , Hierro/análisis , Metales Pesados/análisis , Pakistán , Plantas , Ricinus , Suelo , Contaminantes del Suelo/análisis , Acero/análisis , Agua , Zinc/análisis
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