Systemic corticosteroids for the treatment of COVID-19

Cochrane library, Journal Year: 2021, Volume and Issue: 2021(8)

Published: Aug. 16, 2021

Language: Английский

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Effect of Early Treatment with Ivermectin among Patients with Covid-19

New England Journal of Medicine, Journal Year: 2022, Volume and Issue: 386(18), P. 1721 - 1731

Published: March 30, 2022

The efficacy of ivermectin in preventing hospitalization or extended observation an emergency setting among outpatients with acutely symptomatic coronavirus disease 2019 (Covid-19), the caused by severe acute respiratory syndrome 2 (SARS-CoV-2), is unclear.We conducted a double-blind, randomized, placebo-controlled, adaptive platform trial involving SARS-CoV-2-positive adults recruited from 12 public health clinics Brazil. Patients who had symptoms Covid-19 for up to 7 days and at least one risk factor progression were randomly assigned receive (400 μg per kilogram body weight) once daily 3 placebo. (The also involved other interventions that are not reported here.) primary composite outcome was due within 28 after randomization department visit clinical worsening (defined as participant remaining under >6 hours) randomization.A total 3515 patients (679 patients), placebo (679), another intervention (2157). Overall, 100 (14.7%) group primary-outcome event, compared 111 (16.3%) (relative risk, 0.90; 95% Bayesian credible interval, 0.70 1.16). Of 211 events, 171 (81.0%) hospital admissions. Findings similar analysis modified intention-to-treat included only received dose 0.89; 0.69 1.15) per-protocol 100% adherence regimen 0.94; 0.67 1.35). There no significant effects use on secondary outcomes adverse events.Treatment did result lower incidence medical admission prolonged early diagnosis Covid-19. (Funded FastGrants Rainwater Charitable Foundation; TOGETHER ClinicalTrials.gov number, NCT04727424.).

Language: Английский

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Remdesivir for the treatment of COVID-19

Cochrane library, Journal Year: 2021, Volume and Issue: 2021(8)

Published: Aug. 5, 2021

Language: Английский

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Ultralarge Virtual Screening Identifies SARS-CoV-2 Main Protease Inhibitors with Broad-Spectrum Activity against Coronaviruses

Journal of the American Chemical Society, Journal Year: 2022, Volume and Issue: 144(7), P. 2905 - 2920

Published: Feb. 10, 2022

Drugs targeting SARS-CoV-2 could have saved millions of lives during the COVID-19 pandemic, and it is now crucial to develop inhibitors coronavirus replication in preparation for future outbreaks. We explored two virtual screening strategies find main protease ultralarge chemical libraries. First, structure-based docking was used screen a diverse library 235 million compounds against active site. One hundred top-ranked were tested binding enzymatic assays. Second, fragment discovered by crystallographic optimized guided elaborated molecules experimental testing 93 compounds. Three identified first screen, five selected elaborations showed inhibitory effects. Crystal structures target-inhibitor complexes confirmed predictions hit-to-lead optimization, resulting noncovalent inhibitor with nanomolar affinity, promising vitro pharmacokinetic profile, broad-spectrum antiviral effect infected cells.

Language: Английский

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A Comprehensive Review of Viral Characteristics, Transmission, Pathophysiology, Immune Response, and Management of SARS-CoV-2 and COVID-19 as a Basis for Controlling the Pandemic

Frontiers in Immunology, Journal Year: 2021, Volume and Issue: 12

Published: Feb. 26, 2021

COVID-19 emerged from China in December 2019 and during 2020 spread to every continent including Antarctica. The coronavirus, SARS-CoV-2, has been identified as the causative pathogen, its stretched capacities of healthcare systems negatively affected global economy. This review provides an update on virus, genome, risks associated with emergence variants, mode transmission, immune response, children elderly, advances made contain, prevent manage disease. Although our knowledge mechanics virus transmission response substantially demystified, concerns over reinfection, susceptibility elderly whether asymptomatic promote remain unanswered. There are also uncertainties about pathophysiology why there variations clinical presentations some patients suffer long lasting symptoms—“ haulers .” To date, no significantly effective curative drugs for COVID-19, especially after failure hydroxychloroquine trials produce positive results. RNA polymerase inhibitor, remdesivir, facilitates recovery severely infected cases but, unlike anti-inflammatory drug, dexamethasone, does not reduce mortality. However, vaccine development witnessed substantial progress several being approved countries around globe.

Language: Английский

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Comparative efficacy and safety of monoclonal antibodies and aspirin desensitization for chronic rhinosinusitis with nasal polyposis: A systematic review and network meta-analysis

Journal of Allergy and Clinical Immunology, Journal Year: 2021, Volume and Issue: 149(4), P. 1286 - 1295

Published: Sept. 17, 2021

Chronic rhinosinusitis with nasal polyposis (CRSwNP) is an inflammatory condition of the upper airways. Optimal management unclear.We compared effects mAbs and aspirin desensitization (ASA-D) for treatment CRSwNP.We searched Medline, Embase, Cochrane Central Register Controlled Trials, International Clinical Trials Registry Platform, US Food Drug Administration, European Medicines Agency databases from inception to August 4, 2021, randomized controlled trials comparing ASA-D CRSwNP. We conducted network meta-analysis sinusitis symptoms, heath-related quality life, rescue oral corticosteroids surgery, endoscopic radiologic scores, adverse events. used Grades Recommendation Assessment, Development Evaluation (GRADE) approach assess certainty evidence. PROSPERO CRD42020177334.Twenty-nine evaluating 8 treatments (n = 3461) were included in meta-analysis. Compared placebo, moderate high evidence showed that health-related life (SNOT-22) improved dupilumab (mean difference [MD] -19.91 [95% confidence interval (CI) -22.50, -17.32]), omalizumab (MD -16.09 CI -19.88, -12.30]), mepolizumab -12.89 -16.58, -9.19], -10.61 -14.51, -6.71]), benralizumab -7.68 -12.09, -3.27]). The risk polyp surgery likely decreased (risk [RD] -16.35% -18.13, -13.48]), (RD -7.40% -11.04, -2.43]), -12.33% -15.56, -7.22]), -16.00% -19.79, 0.21]; all certainty). Comparisons among agents show ranks most beneficial 7 outcomes, 2 7, 1 7.Multiple biologics credibly improve patient-important clinically important differences agents; uniquely outcomes studied.

Language: Английский

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Rheumatic disease and COVID-19: epidemiology and outcomes

Nature Reviews Rheumatology, Journal Year: 2020, Volume and Issue: 17(2), P. 71 - 72

Published: Dec. 18, 2020

Language: Английский

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Interleukin-6 blocking agents for treating COVID-19: a living systematic review

Cochrane library, Journal Year: 2021, Volume and Issue: 2021(3)

Published: March 18, 2021

Language: Английский

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Methylprednisolone in adults hospitalized with COVID-19 pneumonia

Wiener klinische Wochenschrift, Journal Year: 2021, Volume and Issue: 133(7-8), P. 303 - 311

Published: Feb. 3, 2021

To determine whether a 6-day course of methylprednisolone (MP) improves outcome in patients with severe SARS-CoV‑2 (Corona Virus Disease 2019 [COVID-19]).

Language: Английский

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Impact of the COVID-19 pandemic on publication dynamics and non-COVID-19 research production

BMC Medical Research Methodology, Journal Year: 2021, Volume and Issue: 21(1)

Published: Nov. 22, 2021

Abstract Background The COVID-19 pandemic has severely affected health systems and medical research worldwide but its impact on the global publication dynamics non-COVID-19 not been measured. We hypothesized that may have impacted scientific production of research. Methods conducted a comprehensive meta-research studies (original articles, letters case reports) published between 01/01/2019 01/01/2021 in 10 high-impact infectious disease journals (New England Journal Medicine, Lancet, American Medical Association, Nature British Journal, Annals Internal Lancet Global Health, Public Infectious Disease Clinical Disease). For each publication, we recorded date, type, number authors, whether was related to COVID-19, based series, patients included study if report or series. estimated with locally scatterplot smoothing method. A Natural Language Processing algorithm designed calculate authors for publication. simulated could during by extrapolating 2019 2020, comparing expected observed studies. Results Among 22,525 assessed, 6319 met inclusion criteria, which 1022 (16.2%) were dramatic increase publications general from February April 2020 weekly median 4.0 (IQR: 2.8–5.5) 19.5 15.8–24.8) ( p < 0.001), followed afterwards pattern stability 10.0 6.0–14.0) until December = 0.045 comparison April). Two prototypical editorial strategies found: 1) maintained volume while integrating thus increased their overall production, 2) decreased publications. using simulation models COVID associated 18% decrease also found significant change type as compared illustrated original (47.9% vs 71.3% publications, 0.001). Last, showed higher especially reports 9.0 6.0–13.0) 3.0–6.0) Conclusion In this gathering journals, shown rise accompanied substantial Meta-research registration https://osf.io/9vtzp/ .

Language: Английский

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