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1.
Eur J Med Res ; 26(1): 20, 2021 Feb 11.
Artículo en Inglés | MEDLINE | ID: mdl-33573699

RESUMEN

BACKGROUND: Vitamin C is an essential water-soluble nutrient that functions as a key antioxidant and has been proven to be effective for boosting immunity. In this study, we aimed to assess the efficacy of adding high-dose intravenous vitamin C (HDIVC) to the regimens for patients with severe COVID-19 disease. METHODS: An open-label, randomized, and controlled trial was conducted on patients with severe COVID-19 infection. The case and control treatment groups each consisted of 30 patients. The control group received lopinavir/ritonavir and hydroxychloroquine and the case group received HDIVC (6 g daily) added to the same regimen. RESULTS: There were no statistically significant differences between two groups with respect to age and gender, laboratory results, and underlying diseases. The mean body temperature was significantly lower in the case group on the 3rd day of hospitalization (p = 0.001). Peripheral capillary oxygen saturations (SpO2) measured at the 3rd day of hospitalization was also higher in the case group receiving HDIVC (p = 0.014). The median length of hospitalization in the case group was significantly longer than the control group (8.5 days vs. 6.5 days) (p = 0.028). There was no significant difference in SpO2 levels at discharge time, the length of intensive care unit (ICU) stay, and mortality between the two groups. CONCLUSIONS: We did not find significantly better outcomes in the group who were treated with HDIVC in addition to the main treatment regimen at discharge. Trial registration irct.ir (IRCT20200411047025N1), April 14, 2020.


Asunto(s)
Antivirales/uso terapéutico , Ácido Ascórbico/administración & dosificación , /tratamiento farmacológico , Antivirales/administración & dosificación , Ácido Ascórbico/uso terapéutico , Temperatura Corporal , Femenino , Humanos , Hidroxicloroquina/uso terapéutico , Unidades de Cuidados Intensivos , Tiempo de Internación , Lopinavir/uso terapéutico , Masculino , Persona de Mediana Edad , Oxígeno/sangre , /virología , Ritonavir/uso terapéutico , Resultado del Tratamiento
2.
Pharmacol Res Perspect ; 9(1): e00705, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33421347

RESUMEN

Drug-drug interaction (DDI) is a common clinical problem that has occurred as a result of the concomitant use of multiple drugs. DDI may occur in patients under treatment with medications used for coronavirus disease 2019 (COVID-19; i.e., chloroquine, lopinavir/ritonavir, ribavirin, tocilizumab, and remdesivir) and increase the risk of serious adverse reactions such as QT-prolongation, retinopathy, increased risk of infection, and hepatotoxicity. This review focuses on summarizing DDIs for candidate medications used for COVID-19 in order to minimize the adverse reactions.


Asunto(s)
Antivirales/uso terapéutico , /tratamiento farmacológico , Animales , Anticuerpos Monoclonales Humanizados/uso terapéutico , Cloroquina/uso terapéutico , Interacciones Farmacológicas , Humanos , Lopinavir/uso terapéutico , Ribavirina/uso terapéutico , Ritonavir/uso terapéutico
3.
Virology ; 555: 10-18, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33421743

RESUMEN

Novel coronavirus (SARS-CoV-2), turned out to be a global pandemic with unstoppable morbidity and mortality rate. However, till date there is no effective treatment found against SARS-CoV-2. We report on the major in-depth molecular and docking analysis by using antiretroviral (Lopinavir and ritonavir), antimalarial (Hydroxychloroquine), antibiotics (Azithromycin), and dietary supplements (Vitamin C and E) to provide new insight into drug repurposing molecular events involved in SARS-CoV-2. We constructed three drug-target-pathways-disease networks to predict the targets and drugs interactions as well as important pathways involved in SARS-CoV-2. The results suggested that by using the combination of Lopinavir, Ritonavir along with Hydroxychloroquine and Vitamin C may turned out to be the effective line of treatment for SARS-CoV-2 as it shows the involvement of PARP-1, MAPK-8, EGFR, PRKCB, PTGS-2, and BCL-2. Gene ontology biological process analysis further confirmed multiple viral infection-related processes (P < 0.001), including viral life cycle, modulation by virus, C-C chemokine receptor activity, and platelet activation. KEGG pathway analysis involves multiple pathways (P < 0.05), including FoxO, GnRH, ErbB, Neurotrophin, Toll-like receptor, IL-17, TNF, Insulin, HIF-1, JAK-STAT, Estrogen, NF-kappa, Chemokine, VEGF, and Thyroid hormone signaling pathway in SARS-CoV-2. Docking study was carried out to predict the molecular mechanism Thus, the potential drug combinations could reduce viral infectivity, viral replication, and abnormal host inflammatory responses and may be useful for multi-target drugs against SARS-CoV-2.


Asunto(s)
Antivirales/farmacología , Reposicionamiento de Medicamentos , /efectos de los fármacos , Antivirales/metabolismo , Antivirales/uso terapéutico , Ácido Ascórbico/metabolismo , Ácido Ascórbico/farmacología , Ácido Ascórbico/uso terapéutico , Desarrollo de Medicamentos , Quimioterapia Combinada , Humanos , Hidroxicloroquina/metabolismo , Hidroxicloroquina/farmacología , Hidroxicloroquina/uso terapéutico , Lopinavir/metabolismo , Lopinavir/farmacología , Lopinavir/uso terapéutico , Simulación del Acoplamiento Molecular , Simulación de Dinámica Molecular , Unión Proteica , Mapeo de Interacción de Proteínas , Mapas de Interacción de Proteínas , Ritonavir/metabolismo , Ritonavir/farmacología , Ritonavir/uso terapéutico , /fisiología , Transducción de Señal , Replicación Viral/efectos de los fármacos
4.
Ann Palliat Med ; 10(1): 707-720, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33440983

RESUMEN

The whole world is battling through coronavirus disease 2019 (COVID-19) which is a fatal pandemic. In the early 2020, the World Health Organization (WHO) declared it as a global health emergency without definitive treatments and preventive approaches. In the absence of definitive therapeutic agents, this thorough review summarizes and outlines the potency and safety of all molecules and therapeutics which may have potential antiviral effects. A number of molecules and therapeutics licensed or being tested for some other conditions were found effective in different in vitro studies as well as in many small sample-sized clinical trials and independent case studies. However, in those clinical trials, there were some limitations which need to be overcome to find the most promising antiviral against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In conclusion, many of above-mentioned antivirals seems to have some therapeutic effects but none of them have been shown to have a strong evidence for their proper recommendation and approval in the treatment of COVID-19. Constantly evolving new evidences, exclusive adult data, language barrier, and type of study (observational, retrospective, small-sized clinical trials, or independent case series) resulted to the several limitations of this review. The need for multicentered, large sample-sized, randomized, placebo-controlled trials on COVID-19 patients to reach a proper conclusion on the most promising antiviral agent is warranted.


Asunto(s)
Antivirales/uso terapéutico , /terapia , Adenosina Monofosfato/análogos & derivados , Adenosina Monofosfato/farmacología , Adenosina Monofosfato/uso terapéutico , Alanina/análogos & derivados , Alanina/farmacología , Alanina/uso terapéutico , Amidas/farmacología , Amidas/uso terapéutico , Anticuerpos Monoclonales Humanizados/farmacología , Anticuerpos Monoclonales Humanizados/uso terapéutico , Azetidinas/farmacología , Azetidinas/uso terapéutico , Cloroquina/farmacología , Cloroquina/uso terapéutico , Combinación de Medicamentos , Humanos , Hidroxicloroquina/farmacología , Hidroxicloroquina/uso terapéutico , Inmunización Pasiva , Indoles/farmacología , Indoles/uso terapéutico , Interferones/farmacología , Interferones/uso terapéutico , Ivermectina/farmacología , Ivermectina/uso terapéutico , Lopinavir/farmacología , Lopinavir/uso terapéutico , Oseltamivir/farmacología , Oseltamivir/uso terapéutico , Purinas/farmacología , Purinas/uso terapéutico , Pirazinas/farmacología , Pirazinas/uso terapéutico , Pirazoles/farmacología , Pirazoles/uso terapéutico , Ribavirina/farmacología , Ribavirina/uso terapéutico , Ritonavir/farmacología , Ritonavir/uso terapéutico , Sulfonamidas/farmacología , Sulfonamidas/uso terapéutico , Tiazoles/farmacología , Tiazoles/uso terapéutico
5.
Int Immunopharmacol ; 92: 107329, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33412395

RESUMEN

Interferon Beta-1a (IFN-ß1-a), an immunomodulatory mediator with antiviral effects, has shown in vivo and in vitro activities especially on coronavirus including SARS-CoV-2. COVID-19 defined as the disease caused by infection with SARS-CoV-2. The virus has been illustrated inhibits the production of IFN-ß1-a from inflammatory cells. We conducted a retrospective study of all adult confirmed COVID-19 hospitalized patients who received combination of three doses of 12 million international units of IFN-ß1-a and Lopinavir 400 mg and Ritonavir 100 mg every 12 h (case group) for 14 days besides standard care and age- and sex- matched COVID-19 patients with receiving lopinavir/ritonavir (control group) at Masih Daneshvari Hospital as a designated hospital for COVID-19 between Feb 19 and Apr 30, 2020. Multivariate analysis was done to determine the impact of IFN-ß1-a on outcome and all-cause mortality. 152 cases in IFN-ß1-a group and 304 cases as control group were included. IFN-ß1-a group stayed at hospital longer and required noninvasive ventilation more than control group (13 vs. 6 days, p = 0.001) and (34% vs. 24%, p = 0.04), respectively. During treatment, 57 (12.5%) patients died. The death rate in case and control groups was 11% and 13% respectively. In multivariate analysis, not receiving IFN-ß1-a (HR 5.12, 95% CI: 2.77-9.45), comorbidity (HR 2.28, 95% CI: 1.13-4.60) and noninvasive ventilation (HR 2.77, 95% CI: 1.56-4.93) remained significantly associated with all-cause mortality. In this study, risk of death decreased by using IFN-ß1-a in COVID-19 patients. More clinical study will be necessary to measure efficacy of IFN-ß1-a in COVID-19 treatment.


Asunto(s)
Antivirales/uso terapéutico , Inhibidores de la Proteasa del VIH/uso terapéutico , Interferón beta/uso terapéutico , Lopinavir/uso terapéutico , Ritonavir/uso terapéutico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Combinación de Medicamentos , Femenino , Humanos , Interferón beta/administración & dosificación , Lopinavir/administración & dosificación , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Ritonavir/administración & dosificación , Adulto Joven
6.
Eur Rev Med Pharmacol Sci ; 25(1): 549-555, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33506948

RESUMEN

OBJECTIVE: Because of the limited treatment options available, oral lopinavir/ritonavir (LPR) was used for treating coronavirus disease (COVID-19) in pediatric patients. This study aimed to assess the efficacy and safety of LPR in COVID-19 pediatric patients with mild symptoms. PATIENTS AND METHODS: This retrospective multicenter analysis included hospitalized children with mild COVID-19 who received LPR at one of 13 hospitals in China from January 1, 2020, to June 1, 2020. Patients treated with LPR were matched with patients not treated with LPR (1:4) according to age, sex, and length of symptom onset and hospitalization. Descriptive statistics and non-parametric tests were applied to compare differences between groups. Kaplan-Meier probability curves and Cox regression models were used to analyze nasal swab turning negative time (recovery time) and hospital discharge days. RESULTS: In total, 23 patients treated with LPR were matched with 92 untreated controls. The median age of patients was 6 years, and 56.52% of them were male. All patients were discharged from the hospital after being cured. The treatment group had a longer nasal swab turning negative time (hazard ratio [HR] 5.33; 95% CI: 1.94-14.67; p = 0.001) than the control group. LPR treatment was also associated with a longer hospitalization time (HR 2.01; 95% CI: 1.24-3.29; p = 0.005). After adjusting for the influence of LPR treatment, adverse drug reaction events were associated with a longer nasopharyngeal swab negative time (HR 4.67; 95% CI 1.35-16.11; p = 0.015). CONCLUSIONS: For children with mild COVID-19, LPR is inferior to conventional treatment in reducing virus shedding time and hospitalization duration and is associated with increased adverse reactions.


Asunto(s)
Antivirales/uso terapéutico , Lopinavir/uso terapéutico , Ritonavir/uso terapéutico , Administración Oral , Antivirales/administración & dosificación , Antivirales/efectos adversos , Niño , China , Quimioterapia Combinada , Femenino , Hospitalización , Humanos , Lopinavir/administración & dosificación , Lopinavir/efectos adversos , Masculino , Estudios Retrospectivos , Ritonavir/administración & dosificación , Ritonavir/efectos adversos
7.
J Infect Chemother ; 27(2): 390-392, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33402301

RESUMEN

Favipiravir is an antiviral drug that is expected to have a therapeutic effect on SARS-CoV2 infection. Teratogenicity and hyperuricemia are known as the main side effects of favipiravir, but little is known about other side effects. This report describes a case of cholestatic liver injury induced by favipiravir. A 73-year-old Japanese with a history of alcoholic hepatitis was infected with SARS-CoV2. Drug therapy was instituted with lopinavir/ritonavir combined with interferon ß-1b. However, his condition worsened despite additional support with continuous hemodiafiltration and veno-venous extracorporeal membrane oxygenation. We suspected complications of bacterial pneumonia and started favipiravir in addition to antimicrobial therapy. Favipiravir was administered at 6000 mg/day on the first day and 2400 mg/day for the second and subsequent days for 14 days. After the initiation of antibiotics, transaminase and total bilirubin were elevated, suggesting a transient cholestasic liver dysfunction. The liver dysfunction in this case may have been triggered by antibacterial treatment, and high dose of favipiravir may have promoted the deterioration of liver function. Monitoring of liver function is vital and close attention should be paid when using favipiravir at high doses or in patients with impaired liver function.


Asunto(s)
Amidas/efectos adversos , Antivirales/efectos adversos , Enfermedad Hepática Inducida por Sustancias y Drogas/etiología , Colestasis/etiología , Pirazinas/efectos adversos , Anciano , Amidas/uso terapéutico , Antivirales/uso terapéutico , Quimioterapia Combinada , Oxigenación por Membrana Extracorpórea , Humanos , Lopinavir/uso terapéutico , Masculino , Pirazinas/uso terapéutico , Ritonavir/uso terapéutico
8.
Trials ; 22(1): 59, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-33451350

RESUMEN

BACKGROUND: Several drugs are being repurposed for the treatment of the coronavirus disease 2019 (COVID-19) pandemic based on in vitro or early clinical findings. As these drugs are being used in varied regimens and dosages, it is important to enable synthesis of existing safety data from clinical trials. However, availability of safety information is limited by a lack of timely reporting of overall clinical trial results on public registries or through academic publication. We aimed to analyse the evidence gap in this data by conducting a rapid review of results posting on ClinicalTrials.gov and in academic publications to quantify the number of trials missing results for drugs potentially being repurposed for COVID-19. METHODS: ClinicalTrials.gov was searched for 19 drugs that have been identified as potential treatments for COVID-19. Relevant clinical trials for any prior indication were listed by identifier (NCT number) and checked for results and for timely result reporting (within 395 days of the primary completion date). Additionally, PubMed and Google Scholar were searched to identify publications of results not listed on the registry. A second, blinded search of 10% of trials was conducted to assess reviewer concordance. RESULTS: Of 3754 completed trials, 1516 (40.4%) did not post results on ClinicalTrials.gov or in the academic literature. Tabular results were available on ClinicalTrials.gov for 1172 (31.2%) completed trials. A further 1066 (28.4%) had published results in the academic literature, but did not report results on ClinicalTrials.gov . Key drugs missing clinical trial results include hydroxychloroquine (37.0% completed trials unreported), favipiravir (77.8%) and lopinavir (40.5%). CONCLUSIONS: There is an important evidence gap for the safety of drugs being repurposed for COVID-19. This uncertainty could cause unnecessary additional morbidity and mortality during the pandemic. We recommend caution in experimental drug use for non-severe disease and urge clinical trial sponsors to report missing results retrospectively.


Asunto(s)
Antivirales/uso terapéutico , Ensayos Clínicos como Asunto , Inhibidores Enzimáticos/uso terapéutico , Sistema de Registros , Informe de Investigación , Amidas/uso terapéutico , Combinación de Medicamentos , Reposicionamiento de Medicamentos , Medicina Basada en la Evidencia , Humanos , Hidroxicloroquina/uso terapéutico , Lopinavir/uso terapéutico , PubMed , Pirazinas/uso terapéutico , Proyectos de Investigación , Ritonavir/uso terapéutico
9.
Medicine (Baltimore) ; 100(2): e23923, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-33466134

RESUMEN

ABSTRACT: Coronavirus disease 2019 (COVID-19) is an emerging disease caused by severe acute respiratory syndrome coronavirus 2; no specific effective medication to treat the disease has been identified to date. We aimed to investigate the administered medications and intervention times for patients who completely recovered from COVID-19.This single-center, retrospective, observational study included 55 patients with COVID-19 who were transferred to Shenyang Sixth People's Hospital between January 20 and March 15, 2020. Data on demographics, symptoms, laboratory indicators, treatment processes, and clinical outcomes were collected. Administered drugs and intervention times were compared in 47 and 8 patients with mild and severe symptoms, respectively.All 55 patients recovered. Fifty-three patients (96.36%) received antiviral therapy, including 45 in the mild group (median treatment: 14 days; 17 received umifenovir) and all 8 severe-group patients (median treatment: 17.5 days; 4 received lopinavir/ritonavir). Twenty-nine patients (52.72%) were administered antibiotics, including 21 in the mild group (median treatment: 13.5 days; 15 received moxifloxacin) and all 8 in the severe group (median treatment: 9 days; 2 received linezolid). Moreover, 7 patients (12.72%) were treated with glucocorticoids and 9 (16.36%) with immunomodulators.Given the 100% recovery rate, early administration of antiviral drugs can be considered. Umifenovir may benefit patients with mild symptoms, while lopinavir/ritonavir may benefit those with severe symptoms. Prophylactic administration of common antibiotics may reduce the risk of co-infection. The use of glucocorticoids is usually not necessary. Randomized, double-blind, and controlled trials remain necessary for more accurate conclusions.


Asunto(s)
/tratamiento farmacológico , Antibacterianos/uso terapéutico , Antivirales/uso terapéutico , China , Femenino , Glucocorticoides/uso terapéutico , Humanos , Factores Inmunológicos/uso terapéutico , Indoles/uso terapéutico , Linezolid/uso terapéutico , Lopinavir/uso terapéutico , Masculino , Persona de Mediana Edad , Moxifloxacino/uso terapéutico , Estudios Retrospectivos , Ritonavir/uso terapéutico
10.
Ann Intern Med ; 174(1): JC3, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33395331

RESUMEN

SOURCE CITATION: RECOVERY Collaborative Group. Lopinavir-ritonavir in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. Lancet. 2020;396:1345-52. 33031764.


Asunto(s)
Antivirales/uso terapéutico , Hospitalización , Lopinavir/uso terapéutico , Ritonavir/uso terapéutico , Administración Oral , Anciano , Antivirales/administración & dosificación , Combinación de Medicamentos , Femenino , Humanos , Lopinavir/administración & dosificación , Masculino , Estudios Multicéntricos como Asunto , Ensayos Clínicos Controlados Aleatorios como Asunto , Ritonavir/administración & dosificación , Reino Unido
12.
Nefrología (Madrid) ; 41(1): 1-90, ene. 2021. tab, graf
Artículo en Español | IBECS | ID: ibc-194912

RESUMEN

ANTECEDENTES Y OBJETIVO: En diciembre de 2019 surgió en Wuhan, China, la COVID-19, causada por el virus SARS-CoV-2 y declarada pandemia global por la Organización Mundial de la Salud en marzo de 2020. Es una infección respiratoria con complicaciones a nivel cardiaco, hematológico, digestivo, neurológico y renal. El fracaso renal agudo (FRA) en pacientes hospitalizados por COVID-19 se presenta en el 0,5-25% y es un factor de mal pronóstico. Los mecanismos de afectación renal no están completamente aclarados. Presentamos la evolución clínica de pacientes ingresados por COVID-19 con FRA que requirieron atención por Nefrología en un hospital terciario de la Comunidad de Madrid, España. MÉTODOS: Este es un estudio observacional prospectivo de todos los casos que ingresaron por COVID-19 entre el 6 de marzo y el 12 de mayo de 2020 y requirieron atención por Nefrología. Se recogieron datos clínicos y analíticos de características basales, y la evolución de la COVID-19 y del FRA. RESULTADOS: Se analizaron 41 pacientes con una edad media de 66,8 años (DE 2,1), el 90,2% varones, y con enfermedad renal crónica previa en el 36,6%. El 56,1% presentaron neumonía grave o síndrome de distrés respiratorio agudo y el 31,7% requirió ingreso en UCI. El FRA fue de etiología prerrenal en el 61%, necrosis tubular aguda en contexto de sepsis en el 24,4%, glomerular en el 7,3% y por toxicidad tubular en el 7,3%. Se registró proteinuria en el 88,9% y hematuria en el 79,4%. El 48,8% de los pacientes requirió terapia de sustitución renal. La mediana de estancia fue de 12 días (RIC 9-23), y el 22% fallecieron. Los pacientes que desarrollaron FRA durante el ingreso presentaron valores más altos de proteína C reactiva, LDH y dímero-D, una afectación pulmonar más grave, más necesidad de ingreso en UCI, más tratamiento con lopinavir/ritonavir y fármacos biológicos, y mayor necesidad de terapia de sustitución renal. CONCLUSIONES: La hipovolemia y la deshidratación son una causa frecuente de FRA en pacientes con COVID-19. Aquellos que desarrollan FRA intrahospitalario presentan un perfil de peor pronóstico respiratorio, analítico y renal. Creemos que la monitorización de marcadores renales, así como el manejo individualizado de la volemia, pueden ser determinantes para prevenir el FRA


BACKGROUND AND AIM: In December 2019, a coronavirus 2019 (COVID-19) outbreak, caused by SARS-CoV-2, took place in Wuhan, China, and was declared a global pandemic in March 2020 by the World Health Organization. It is a prominently respiratory infection, with potential cardiological, hematological, gastrointestinal and renal complications. Acute kidney injury (AKI) is found in 0.5-25% of hospitalized COVID-19 patients and constitutes a negative prognostic factor. Renal damage mechanisms are not completely clear. We report the clinical evolution of hospitalized COVID-19 patients who presented with AKI requiring attention from the Nephrology team in a tertiary hospital in Madrid, Spain. METHODS: This is an observational prospective study including all COVID-19 cases that required hospitalization and Nephrology management from March 6th to May 12th 2020. We collected clinical and analytical data of baseline characteristics, COVID-19 and AKI evolutions. RESULTS: We analyzed 41 patients with a mean age of 66.8 years (SD 2.1), 90.2% males, and with a history of chronic kidney disease in 36.6%. A percentage of 56.1 presented with severe pneumonia or acute respiratory distress syndrome, and 31.7% required intensive care. AKI etiology was prerenal in 61%, acute tubular necrosis in the context of sepsis in 24.4%, glomerular in 7.3% and tubular toxicity in 7.3% of the cases. We reported proteinuria in 88.9% and hematuria in 79.4% of patients. A percentage of 48.8 required renal replacement therapy. Median length of stay was 12 days (IQR 9-23) and 22% of the population died. Patients who developed AKI during hospital stay presented with higher C-reactive protein, LDH and D-dimer values, more severe pulmonary damage, more frequent ICU admission, treatment with lopinavir/ritonavir and biological drugs and renal replacement therapy requirement. CONCLUSIONS: Hypovolemia and dehydration are a frequent cause of AKI among COVID-19 patients. Those who develop AKI during hospitalization display worse prognostic factors in terms of pulmonary damage, renal damage, and analytical findings. We believe that monitorization of renal markers, as well as individualized fluid management, can play a key role in AKI prevention


Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Anciano , Lesión Renal Aguda/terapia , Betacoronavirus , Infecciones por Coronavirus/complicaciones , Neumonía Viral/complicaciones , Pandemias , Hospitalización , Infecciones por Coronavirus/diagnóstico , Neumonía Viral/diagnóstico , Estudios Prospectivos , Lesión Renal Aguda/tratamiento farmacológico , Lopinavir/uso terapéutico , Ritonavir/uso terapéutico , Diálisis Renal/métodos , Hidroxicloroquina/uso terapéutico , Azitromicina/uso terapéutico , Corticoesteroides/uso terapéutico
13.
Intern Med ; 60(3): 479-485, 2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-33361672

RESUMEN

An outbreak of coronavirus disease 2019 (COVID-19) that began in Wuhan, China, has spread rapidly to many countries. We herein report four cases of COVID-19 confirmed in Japan among passengers of the cruise ship Diamond Princess and describe the clinical features, clinical course, and progression of chest computed tomographic images, chest radiographs, and treatment. Although these four patients had symptoms that included a fever, malaise, runny nose, and cough, one patient had no symptoms on admission. Two of the four patients needed mechanical ventilation due to respiratory deterioration. One of the patients who required mechanical ventilation was transferred to a higher-level medical institution. Except for that patient, the other three patients were able to return home under their own power. Every patient took lopinavir/ritonavir, which was considered the most effective treatment at the time. We used it after receiving approval from the ethics committee in our hospital. In this case report, we emphasize that some patients need to be carefully monitored, even if their respiratory condition is stable at the initial presentation, as their respiratory status may deteriorate rapidly within a few days after oxygen administration begins.


Asunto(s)
/transmisión , Navíos , Anciano , Anciano de 80 o más Años , /terapia , Inhibidores del Citocromo P-450 CYP3A/uso terapéutico , Humanos , Japón , Lopinavir/uso terapéutico , Pulmón/diagnóstico por imagen , Pulmón/patología , Masculino , Radiografía Torácica , Respiración Artificial , Ritonavir/uso terapéutico , /aislamiento & purificación
14.
Int J Antimicrob Agents ; 57(2): 106265, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33338559

RESUMEN

Severe COVID-19 (coronavirus disease 2019) is associated with elevated inflammatory markers, consistent with cytokine release syndrome (CRS). Tocilizumab is an interleukin-6 (IL-6) inhibitor effective in treating CRS secondary to chimeric antigen receptor T-cell (CAR T-cell) therapy. The efficacy of tocilizumab in treating COVID-19 is unknown. This was a retrospective cohort study conducted at two hospitals in northern New Jersey (USA). All patients treated with tocilizumab for confirmed or suspected COVID-19 between 10 March 2020 and 9 April 2020 at the study sites were included. The primary endpoint was clinical improvement on Day 7 after treatment as assessed by respiratory status. Univariate analysis compared data between those who improved and those who did not. A total of 45 severe and critically ill patients treated with tocilizumab for COVID-19 were evaluated. Of the 45 patients, 11 (24.4%), 22 (48.9%) and 12 (26.7%) patients improved, had no change or worsened by Day 7 after treatment, respectively. Lower white blood cell count and lactate dehydrogenase at the time of drug administration as well as shorter time from supplemental oxygen initiation to dosing were significantly associated with clinical improvement in the univariate analysis. In conclusion, tocilizumab administration was associated with a low rate of clinical improvement within 7 days in this cohort of severe and critically ill patients with COVID-19.


Asunto(s)
Anticuerpos Monoclonales Humanizados/uso terapéutico , Antivirales/uso terapéutico , /tratamiento farmacológico , /etiología , Enfermedad Crítica , Femenino , Humanos , Hidroxicloroquina/uso terapéutico , Lopinavir/uso terapéutico , Masculino , Persona de Mediana Edad , Oxígeno/administración & dosificación , Oxígeno/uso terapéutico , Estudios Retrospectivos , Ritonavir/uso terapéutico , Factores de Tiempo , Resultado del Tratamiento
15.
Vector Borne Zoonotic Dis ; 21(2): 78-85, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33325821

RESUMEN

The outbreak of coronavirus disease 2019 (COVID-19) which emerged in Wuhan city of China has now spread to 214 countries and territories around the world and two international conveyances (the Diamond Princess cruise ship harbored in Yokohama, Japan and the Holland America's MS Zaandam cruise ship) as of October 11, 2020. The disease has been named as a coronavirus disease (COVID-19) and the virus causing the disease is known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). There are currently about 36,754,395 confirmed COVID-19-infected cases and 1,064,838 confirmed deaths as of October 11, 2020. The study is intended to understand the origin, transmission and impact of the coronavirus disease (COVID-19). The virus has not been encountered by humans previously and is therefore known as a novel. SARS-CoV-2 is spreading to new areas and has become a serious challenge for the scientific community in particular and the whole world population in general. The focus of the study is based on the transmission, epidemiology, genetic makeup, and possible remedies to control and contain the disease. It also includes the global impact of SARS-CoV-2 on health care and the world economy. The present review summarizes the current knowledge highlighting the symptoms, epidemiology, transmission, pathogenesis, phylogenetic analysis, and future directions to control the spread of this fatal disease.


Asunto(s)
/epidemiología , /transmisión , Combinación de Medicamentos , Humanos , Inmunización Pasiva , Lopinavir/uso terapéutico , Pandemias , Filogenia , Ritonavir/uso terapéutico , /clasificación
16.
Clin Med (Lond) ; 21(1): e80-e83, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33355217

RESUMEN

AIM: The inconsistent effects of lopinavir-ritonavir (LPV/r) on COVID-19 seem to be caused by the therapeutic window. In the present study, we aim to present the effects of early LPV/r treatment on patients with severe COVID-19. METHODS: The demographics, characteristics, treatments, SARS-CoV-2 test results and outcomes of 19 patients with severe COVID-19 treated with LPV/r within 12 days of onset of symptoms were retrospectively assessed. RESULTS: Within 3 days of admission, three (15.79%) patients received noninvasive ventilation, and 16 (84.21%) patients received high-flow oxygen support. The median duration between the onset of symptoms and initiating LPV/r therapy was 9 (range 2-12) days. The median course of LPV/r treatment was 11 (range 7-17) days. One of the 19 patients (5.26%) died. Of the 18 patients discharged, the median hospital stay was 17 (range 11-45) days. At day 6 after LPV/r therapy was initiated, 68.42% of patients were virologically cured, increasing to 84.22% at day 12. CONCLUSION: In this cohort of patients with severe COVID-19 who were treated with LPV/r within 12 days of the onset of symptoms, clinical improvement was observed in 18/19 patients (94.74%). Randomised controlled trials are urgently needed to further evaluate this strategy.


Asunto(s)
/tratamiento farmacológico , Lopinavir/uso terapéutico , Ritonavir/uso terapéutico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Inhibidores del Citocromo P-450 CYP3A/uso terapéutico , Combinación de Medicamentos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Estudios Retrospectivos , Resultado del Tratamiento , Adulto Joven
17.
Virus Res ; 294: 198262, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33333102

RESUMEN

Coronavirus disease 19 (COVID-19) has posed serious threats to the general population. To relieve the crisis, a comparison of drug effects against COVID-19 is instructive. Between January 27, 2020 and March 21, 2020, a total of 333 patients treated with arbidol, corticosteroids, hydroxychloroquine, lopinavir/ritonavir, or oseltamivir monotherapy, having definite outcomes and serological antibody detection results, were retrospectively analyzed. The hydroxychloroquine group had a significantly reduced duration of hospital stay than the arbidol and corticosteroids groups. The oseltamivir group had a significantly shorter length of hospital stay than the arbidol, corticosteroids, and lopinavir/ritonavir groups. The hydroxychloroquine group had a significantly higher IgM titer than the other four groups and exhibited significantly higher IgG levels than the arbidol, lopinavir/ritonavir, and oseltamivir groups. Our findings indicated that hydroxychloroquine might have the potential for efficient COVID-19 management, while oseltamivir should be prudently considered in combination therapy.


Asunto(s)
/tratamiento farmacológico , Corticoesteroides/uso terapéutico , Adulto , Anciano , Anciano de 80 o más Años , Anticuerpos Antivirales/sangre , /patología , Combinación de Medicamentos , Femenino , Humanos , Hidroxicloroquina/uso terapéutico , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Indoles/uso terapéutico , Tiempo de Internación , Lopinavir/uso terapéutico , Masculino , Persona de Mediana Edad , Oseltamivir/uso terapéutico , Estudios Retrospectivos , Ritonavir/uso terapéutico , /aislamiento & purificación , Adulto Joven
19.
Eur J Pharmacol ; 893: 173813, 2021 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-33345848

RESUMEN

Coronavirus disease-2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), poses an enormous challenge to the medical system, especially the lack of safe and effective COVID-19 treatment methods, forcing people to look for drugs that may have therapeutic effects as soon as possible. Some old drugs have shown clinical benefits after a few small clinical trials that attracted great attention. Clinically, however, many drugs, including those currently used in COVID-19, such as chloroquine, hydroxychloroquine, azithromycin, and lopinavir/ritonavir, may cause cardiotoxicity by acting on cardiac potassium channels, especially hERG channel through their off-target effects. The blocking of the hERG channel prolongs QT intervals on electrocardiograms; thus, it might induce severe ventricular arrhythmias and even sudden cardiac death. Therefore, while focusing on the efficacy of COVID-19 drugs, the fact that they block hERG channels to cause arrhythmias cannot be ignored. To develop safer and more effective drugs, it is necessary to understand the interactions between drugs and the hERG channel and the molecular mechanism behind this high affinity. In this review, we focus on the biochemical and molecular mechanistic aspects of drug-related blockade of the hERG channel to provide insights into QT prolongation caused by off-label use of related drugs in COVID-19, and hope to weigh the risks and benefits when using these drugs.


Asunto(s)
Azitromicina/efectos adversos , Azitromicina/uso terapéutico , /tratamiento farmacológico , Cloroquina/efectos adversos , Cloroquina/uso terapéutico , Canal de Potasio ERG1/efectos de los fármacos , Hidroxicloroquina/efectos adversos , Hidroxicloroquina/uso terapéutico , Síndrome de QT Prolongado/inducido químicamente , Lopinavir/efectos adversos , Lopinavir/uso terapéutico , Ritonavir/efectos adversos , Ritonavir/uso terapéutico , Combinación de Medicamentos , Humanos , Síndrome de QT Prolongado/epidemiología , Uso Fuera de lo Indicado
20.
J Infect Chemother ; 27(1): 99-102, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33023821

RESUMEN

We present three patients affected by pulmonary squamous cell carcinoma, metastatic esophageal cancer and advanced non-Hodgkin lymphoma, who incurred in coronavirus 2019 (COVID-19) infection during the early phase of epidemic wave in Italy. All patients presented with fever. Social contact with subject positive for COVID-19 was declared in only one of the three cases. In all cases, laboratory findings showed lymphopenia and elevated C-reactive protein (CRP). Chest x-ray and computed tomography showed bilateral ground-glass opacities, shadowing, interstitial abnormalities, and "crazy paving" pattern which evolved with superimposition of consolidations in one patient. All patients received antiviral therapy based on ritonavir and lopinavir, associated with hydroxychloroquine. Despite treatment, two patients with advanced cancers died after 39 and 17 days of hospitalization, while the patient with lung cancer was dismissed at home, in good conditions.


Asunto(s)
Infecciones por Coronavirus/tratamiento farmacológico , Hidroxicloroquina/uso terapéutico , Lopinavir/uso terapéutico , Neoplasias/complicaciones , Neumonía Viral/tratamiento farmacológico , Ritonavir/uso terapéutico , Anciano , Antibacterianos/uso terapéutico , Antivirales/uso terapéutico , Betacoronavirus , Carcinoma de Células Escamosas/complicaciones , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/tratamiento farmacológico , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/diagnóstico , Brotes de Enfermedades , Quimioterapia Combinada , Neoplasias Esofágicas/complicaciones , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/tratamiento farmacológico , Resultado Fatal , Humanos , Italia , Neoplasias Pulmonares/complicaciones , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/tratamiento farmacológico , Linfoma no Hodgkin/complicaciones , Linfoma no Hodgkin/diagnóstico , Linfoma no Hodgkin/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Neoplasias/diagnóstico , Neoplasias/tratamiento farmacológico , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico , Tomografía Computarizada por Rayos X , Resultado del Tratamiento
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