ABSTRACT
The SARS-CoV-2 virus spreading across the world has led to surges of COVID-19 illness, hospitalizations, and death. The complex and multifaceted pathophysiology of life-threatening COVID-19 illness including viral mediated organ damage, cytokine storm, and thrombosis warrants early interventions to address all components of the devastating illness. In countries where therapeutic nihilism is prevalent, patients endure escalating symptoms and without early treatment can succumb to delayed in-hospital care and death. Prompt early initiation of sequenced multidrug therapy (SMDT) is a widely and currently available solution to stem the tide of hospitalizations and death. A multipronged therapeutic approach includes 1) adjuvant nutraceuticals, 2) combination intracellular anti-infective therapy, 3) inhaled/oral corticosteroids, 4) antiplatelet agents/anticoagulants, 5) supportive care including supplemental oxygen, monitoring, and telemedicine. Randomized trials of individual, novel oral therapies have not delivered tools for physicians to combat the pandemic in practice. No single therapeutic option thus far has been entirely effective and therefore a combination is required at this time. An urgent immediate pivot from single drug to SMDT regimens should be employed as a critical strategy to deal with the large numbers of acute COVID-19 patients with the aim of reducing the intensity and duration of symptoms and avoiding hospitalization and death.
Subject(s)
COVID-19 Drug Treatment , Leprostatic Agents/therapeutic use , Pandemics , SARS-CoV-2 , Telemedicine/methods , COVID-19/epidemiology , Drug Therapy, Combination , HumansABSTRACT
The objective of this study was to determine the prevalence of maternal group B Streptococcal (GBS) colonization and compare risk factor data related to GBS colonization. A prospective surveillance study of 598 pregnant women was conducted in two socioeconomically diverse maternity hospitals in Ribeirão Preto, Brazil between June and October 1999. Swabs from the lower vagina were obtained between 35 and 37 weeks gestation and cultured on selective media. Risk factor data were obtained by patient interview and chart review. The overall maternal GBS colonization prevalence rate was 17.9%. There was no association of GBS colonization with maternity hospital and no association of GBS colonization with previously identified risk factors, such as age, race, martial status, maternal education, parity, smoking, or alcohol use. There is a relatively high prevalence of maternal GBS colonization in this Brazilian population, although previously-identified-risk factors were not found to be important. This study provides baseline data for the creation of community-based GBS disease prevention protocols.
Subject(s)
Pregnancy Complications, Infectious/epidemiology , Streptococcal Infections/epidemiology , Streptococcus agalactiae/isolation & purification , Adult , Brazil/epidemiology , Female , Humans , Infant, Newborn , Population Surveillance , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/microbiology , Prospective Studies , Risk Factors , Socioeconomic Factors , Streptococcal Infections/diagnosis , Streptococcal Infections/microbiologyABSTRACT
The objective of this study was to determine the prevalence of maternal group B Streptococcal (GBS) colonization and compare risk factor data related to GBS colonization. A prospective surveillance study of 598 pregnant women was conducted in two socioeconomically diverse maternity hospitals in Ribeirão Preto, Brazil between June and October 1999. Swabs from the lower vagina were obtained between 35 and 37 weeks gestation and cultured on selective media. Risk factor data were obtained by patient interview and chart review. The overall maternal GBS colonization prevalence rate was 17.9 percent. There was no association of GBS colonization with maternity hospital and no association of GBS colonization with previously identified risk factors, such as age, race, martial status, maternal education, parity, smoking, or alcohol use. There is a relatively high prevalence of maternal GBS colonization in this Brazilian population, although previously-identified-risk factors were not found to be important. This study provides baseline data for the creation of community-based GBS disease prevention protocols.