Early intervention with azelastine nasal spray may reduce viral load in SARS-CoV-2 infected patients.

With the changing epidemiology of COVID-19 and its impact on our daily lives, there is still an unmet need of COVID-19 therapies treating early infections to prevent progression. The current study was a randomized, parallel, double-blind, placebo-controlled trial. Ninety SARS-CoV-2 positive patients were randomized into 3 groups receiving placebo, 0.02% or 0.1% azelastine nasal spray for 11 days, during which viral loads were assessed by quantitative PCR. Investigators assessed patients' status throughout the trial including safety follow-ups (days 16 and 60). Symptoms were documented in patient diaries. Initial viral loads were log10 6.85 ± 1.31 (mean ± SD) copies/mL (ORF 1a/b gene). After treatment, virus load was reduced in all groups (p < 0.0001) but was greater in the 0.1% group compared to placebo (p = 0.007). In a subset of patients (initial Ct < 25) viral load was strongly reduced on day 4 in the 0.1% group compared to placebo (p = 0.005). Negative PCR results appeared earlier and more frequently in the azelastine treated groups: being 18.52% and 21.43% in the 0.1% and 0.02% groups, respectively, compared to 0% for placebo on day 8. Comparable numbers of adverse events occurred in all treatment groups with no safety concerns. The shown effects of azelastine nasal spray may thus be suggestive of azelastine's potential as an antiviral treatment.Trial registration: The study was registered in the German Clinical Trial Register (DRKS-ID: DRKS00024520; Date of Registration in DRKS: 12/02/2021). EudraCT number: 2020-005544-34.

Pharmacometric Modeling of the Impact of Azelastine Nasal Spray on SARS-CoV-2 Viral Load and Related Symptoms in COVID-19 Patients.

The histamine-1 receptor antagonist azelastine was recently found to impact SARS-CoV-2 viral kinetics in a Phase 2 clinical trial (CARVIN). Thus, we investigated the relationship between intranasal azelastine administrations and viral load, as well as symptom severity in COVID-19 patients and analyzed the impact of covariates using non-linear mixed-effects modeling. For this, we developed a pharmacokinetic (PK) model for the oral and intranasal administration of azelastine. A one-compartment model with parallel absorption after intranasal administration described the PK best, covering both the intranasal and the gastro-intestinal absorption pathways. For virus kinetic and symptoms modeling, viral load and symptom records were gathered from the CARVIN study that included data of 82 COVID-19 patients receiving placebo or intranasal azelastine. The effect of azelastine on viral load was described by a dose-effect model targeting the virus elimination rate. An extension of the model revealed a relationship between COVID-19 symptoms severity and the number of infected cells. The analysis revealed that the intranasal administration of azelastine led to a faster decline in viral load and symptoms severity compared to placebo. Moreover, older patients showed a slower decline in viral load compared to younger patients and male patients experienced higher peak viral loads than females.

Eye Infection with SARS-CoV-2 as a Route to Systemic Immunization?

Infectious diseases of the conjunctiva and cornea usually leave behind both broad local and systemic immunity. Case reports of SARS-CoV-2-positive conjunctivitis with subsequent systemic immunity suggest a new route of immunization preventing the primary infection of the airways. MATERIAL AND METHODS: A total of 24 Syrian field hamsters were treated. In systematic animal experiments, we infected the eyes of n = 8 animals (group 1) and the airways of another n = 8 animals (group 2) with SARS-CoV-2 (Wuhan type); n = 8 hamsters served as controls (group 3). The weight development of the animals was recorded. After two weeks of observation of disease symptoms, all animals were re-exposed to SARS-CoV-2 in the respiratory tract (challenge) to determine whether immunity to the virus had been achieved. RESULTS: The epi-ocularly infected animals (group 1) showed no clinically visible disease during the ocular infection phase. At most, there was a slightly reduced weight gain compared to the control group (group 3), while the respiratory infected animals (group 2) all lost weight, became lethargic, and slowly recovered after two weeks. After the challenge, none of the animals in groups 1 and 2 became ill again. The animals in the negative control (group 3) all became ill. Cytotoxic antibodies were detectable in the blood of the infected groups before and after challenge, with higher titers in the epi-ocularly infected animals. CONCLUSION: By epi-ocular infection with SARS-CoV-2, the development of systemic immunity with formation of cytotoxic antibodies without severe general disease could be observed in the experimental animals, which did not induce any more disease upon a second infection in the respiratory tract. Therefore, it can be concluded that a purely epi-ocular infection with SARS-CoV2 only induces a weak disease pattern followed by systemic immunity.

The requirements for low-temperature plasma ionization support miniaturization of the ion source.

Ambient ionization mass spectrometry (AI-MS), the ionization of samples under ambient conditions, enables fast and simple analysis of samples without or with little sample preparation. Due to their simple construction and low resource consumption, plasma-based ionization methods in particular are considered ideal for use in mobile analytical devices. However, systematic investigations that have attempted to identify the optimal configuration of a plasma source to achieve the sensitive detection of target molecules are still rare. We therefore used a low-temperature plasma ionization (LTPI) source based on dielectric barrier discharge with helium employed as the process gas to identify the factors that most strongly influence the signal intensity in the mass spectrometry of species formed by plasma ionization. In this study, we investigated several construction-related parameters of the plasma source and found that a low wall thickness of the dielectric, a small outlet spacing, and a short distance between the plasma source and the MS inlet are needed to achieve optimal signal intensity with a process-gas flow rate of as little as 10 mL/min. In conclusion, this type of ion source is especially well suited for downscaling, which is usually required in mobile devices. Our results provide valuable insights into the LTPI mechanism; they reveal the potential to further improve its implementation and standardization for mobile mass spectrometry as well as our understanding of the requirements and selectivity of this technique. Graphical abstract Optimized parameters of a dielectric barrier discharge plasma for ionization in mass spectrometry. The electrode size, shape, and arrangement, the thickness of the dielectric, and distances between the plasma source, sample, and MS inlet are marked in red. The process gas (helium) flow is shown in black.

Influence of low- and high-frequency electrical heating on biodegrading microorganisms in soil: soil respiration.

The influence of electrical heating on microbiological processes in soil has been studied to evaluate the potential for enhancing biodegradation of pollutants by controlling the temperature. A frequency of 50 Hz (power line frequency) was applied for resistive heating. Dielectric heating was realized using a frequency of 13.56 MHz (radio frequency). Both techniques were compared with conventional heating in a water bath. For experiments in laboratory and full scale, a model soil and a contaminated original soil were used. It was shown that under conditions capable for heating soil to 35 degrees C or even 60 degrees C, soil respiration as a measure for microbial activity was not hindered by electrical heating when temperature and moisture content were comparable with conventional heating. The variations of soil respiration were reversible upon temperature changes. Under certain conditions, periodical fluctuations of microbiological activity were observed. Several possible explanations including chronobiology are discussed without being able to provide an unambiguous interpretation for this effect.

Influence of low- and high-frequency heating on biodegrading microorganisms in soil: microbial degradation.

The influence of low-frequency (50 Hz) resistive and high-frequency (13.56 MHz, radio-frequency) dielectric heating in comparison to conventional heating on the microbial degradation of pollutants in soil was studied. The investigation of the biodegradation of model substances (benzoic acid, acetic acid, glucose, sodium acetate) added to a standard soil showed no significant influence of the electrical heating methods when compared with samples heated to the same temperature in a water bath. Therefore, a hindrance of the microbial degradation could be excluded as it was done for soil respiration in a previous study. This finding is especially relevant for the application of these electrical heating methods for thermally enhanced soil bioremediation as an option for making in situ or ex situ clean-up processes more efficient.

Ambivalent role of water in thermodesorption of hydrocarbons from contaminated soil.

Thermodesorption studies with soil samples from a former filling station for light crude oil contaminated with mineral oil hydrocarbons (mainly benzene, toluene, ethylbenzene, xylenes, naphthalene, alkylnaphthalenes, and C(10) to C(14) alkanes) have revealed an ambivalent influence of water on desorption rates. Particularly, the influences of soil moisture content, humidity of the purge gas, temperature, and content of soil organic matter (SOM) were studied. At low temperature, purge gas humidity strongly affected the mobility of hydrocarbons in the soil organic matter (SOM) leading to an enhanced release of contaminants at higher moisture contents. Heating resulted in a decrease of thermodesorption when connected with desiccation of soil, in spite of the strong temperature impact on the vapor pressure of contaminants. At high water content of the SOM, the transfer of the pollutant molecules into the gas phase was found to be markedly hindered by the formation of water films or pore-filling by bulk water, both acting as diffusion barriers.

Influence of in situ steam formation by radio frequency heating on thermodesorption of hydrocarbons from contaminated soil.

Thermal desorption of a wide spectrum of organic contaminants, initiated by radio frequency (RF) heating, was studied at laboratory and pilot-plant scales for an artificially contaminated soil and for an originally contaminated soil from an industrial site. Up to 100 °C, moderate desorption rates were observed for light aromatics such as toluene, chlorobenzene, and ethylbenzene. Desorption of the less volatile contaminants was greatly enhanced above 100 °C, when fast evaporation of soil-water produced steam for hydrocarbon stripping (steam-distillation, desorption rates increased by more than 1 order of magnitude). For hydrocarbons with low water solubility (e.g., aliphatic hydrocarbons), the temperature increase above 100 °C after desiccation of soil again led to a significant increase of the removal rates, thus showing the impact of hydrocarbon partial pressure. RF heating was shown to be an appropriate option for thermally enhanced soil vapor extraction, leading to efficient cleaning of contaminated soils.