Objective: The objective of this update article is to report structural and functional neuroimaging studies exploring the potential role of cerebellum in the pathophysiology of psychiatric disorders. Method: A non-systematic literature review was conducted by means of Medline using the following terms as a parameter : "cerebellum", "cerebellar vermis", "schizophrenia", "bipolar disorder", "depression", "anxiety disorders", "dementia" and "attention
Background
The absence of specific antivirals to treat COVID-19 leads to the repositioning of candidates’ drugs. Nitazoxanide (NTZ) has a broad antiviral effect.
Methods
This was a randomized, double-blind pilot clinical trial comparing NTZ 600 mg BID versus Placebo for seven days among 50 individuals (25 each arm) with SARS-COV-2 RT-PCR+ (PCR) that were hospitalized with mild respiratory insufficiency from May 20
th
, 2020, to September 21
st
, 2020 (ClinicalTrials.gov NCT04348409). Clinical and virologic endpoints and inflammatory biomarkers were evaluated. A five-point scale for disease severity (SSD) was used.
Findings
Two patients died in the NTZ arm compared to 6 in the placebo arm (
p
= 0.564). NTZ was superior to placebo when considering SSD (
p
< 0001), the mean time for hospital discharge (6.6 vs. 14 days,
p
= 0.021), and negative PCR at day 21 (
p
= 0.035), whereas the placebo group presented more adverse events (
p
= 0.04). Among adverse events likely related to the study drug, 14 were detected in the NTZ group and 22 in placebo (
p
= 0.24). Among the 30 adverse events unlikely related, 21 occurred in the placebo group (
p
= 0.04). A decrease from baseline was higher in the NTZ group for
d
-Dimer (
p
= 0.001), US-RCP (
p
< 0.002), TNF (
p
< 0.038), IL-6 (
p
< 0.001), IL-8 (
p
= 0.014), HLA DR. on CD4
+
T
lymphocytes (
p
< 0.05), CD38 in CD4
+
and CD8
+
T
(both
p
< 0.05), and CD38 and HLA-DR. on CD4+ (
p
< 0.01)
Interpretation
Compared to placebo in clinical and virologic outcomes and improvement of inflammatory outcomes, the superiority of NTZ warrants further investigation of this drug for moderate COVID-19 in larger clinical trials. A higher incidence of adverse events in the placebo arm might be attributed to COVID-19 related symptoms.
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