The aim of the study is to assess the efficacy and safety of the Favipiravir (Areplivir) drug, compared to the standard etiotropic therapy in the patients hospitalized with COVID-19.Material and methods. The research was conducted as a part of an open, randomized, multicenter comparative study of the efficacy and safety of Areplivir, 200 mg film-coated tablets (“PROMOMED RUS” LLC, Russia), in the patients hospitalized with COVID-19. The dosing regimen of Favipiravir was 1600 mg twice a day on the 1st day and 600 mg twice a day on days 2–14. Thirty nine patients were enrolled into the study with a laboratory-established diagnosis of a new type of Coronavirus infection caused by SARS-CoV-2 (confirmed) of moderate severity, with pneumonia. The group of comparison (22 patients) received standard etiotropic therapy, prescribed in accordance with the current version of the temporary guidelines for the diagnosis and treatment of COVID-19, represented mainly by Hydroxychloroquine with the dosage regimen of 800 mg on the 1st day, then 400 mg on days 2–7, and Azithromycin 500 mg once a day for 5 days. The main group (17 patients) received Favipiravir (Areplivir) as etiotropiс therapy.Results. In the main group, the time period until fever disappeared was found to be 1.36 days shorter than in the group of comparison (p<0.05); there was a higher rate of the reduction of inflammatory changes in the lungs according to the computer tomography data (38.4% vs 14.9%, p<0.05). By the end of the treatment, there was also a lower lactate level in the blood (27.1%, p<0.05) than in the patients of the group of comparison. The evaluation of the drug efficacy ассording to the Categorical Ordinal Scale of Clinical Improvement and measurements of oxygen saturation in the blood, manifested similar positive dynamics in the patients treated ассording to various etiotropic therapy regimens. By the end of the treatment, the RNA SARS-CoV-2 tests were also negative in all the patients. As for the overall frequency of adverse events (AEs), no relevant distinctions were found between the groups. A greater part of AEs was related to hepatotoxicity, with a predominantly clinically relevant increase in alanine aminotransferase (ALT). A clinically relevant prolongation of the corrected QT interval on the standard ECG was found to occur in the standard-therapy group on day 5, while no serious AEs were registered in the main group. No serious adverse reactions were registered in patients of the main group.Conclusion. The efficacy of the Favipiravir (Areplivir) therapy for the novel coronavirus infection has proved to be superior to the efficacy of the standard etiotropic therapy in a number of aspects. Basing on the obtained findings, Favipiravir (Areplivir) drug can be recommended for treating patients with the novel coronavirus infection of moderate severity.
Nephropathia Epidemica (NE), endemic to several Volga regions of Russia, including the Republic of Tatarstan (RT) and the Republic of Mordovia (RM), is a mild form of hemorrhagic fever with renal syndrome caused by infection with rodent-borne orthohantaviruses. Although NE cases have been reported for decades, little is known about the hantavirus strains associated with human infection in these regions. There is also limited understanding of the pathogenesis of NE in the RT and the RM. To address these knowledge gaps, we conducted comparative analyses of patients with NE in the RT and the RM. Clinical symptoms were more severe in patients with NE from the RM with longer observed duration of fever symptoms and hospitalization. Analysis of patient sera showed changes in the levels of numerous cytokines, chemokines, and matrix metalloproteases (MMPs) in patients with NE from both the RT and the RM, suggesting leukocyte activation, extracellular matrix degradation, and leukocyte chemotaxis. Interestingly, levels of several cytokines were distinctly different between patients NE from the RT when compared with those from the RM. These differences were not related to the genetic variation of orthohantaviruses circulating in those regions, as sequence analysis showed that Puumala virus (PUUV) was the causative agent of NE in these regions. Additionally, only the “Russia” (RUS) genetic lineage of PUUV was detected in the serum samples of patients with NE from both the RT and the RM. We therefore conclude that differences in serum cytokine, chemokine, and MMP levels between the RT and the RM are related to environmental factors and lifestyle differences that influence individual immune responses to orthohantavirus infection.
Аллахвердиев Сурхай Рагим оглы-академик Российской Академии Естествознания, профессор кафедры лесной индустрии, Бартынский государственный университет, профессор кафедры экологии и природопользования, ФГБОУ ВО «Московский педагогический государственный университет», доктор биологических наук, профессор (Бартын, Турция) Булгаков Алексей Григорьевич-профессор Института строительного дела, Дрезденский технический университет, доктор технических наук, профессор (Дрезден, Германия) Дианов Евгений Михайлович-академик Российской академии наук, директор ФГБУН «Научный центр волоконной оптики Российской академии наук», доктор физико-математических наук, профессор, ORCID: 0000-0002-5017-2287 (Москва, Россия) Димитров Валерий Петрович-декан факультета приборостроения и технического регулирования, ФГБОУ ВО «Донской государственный технический университет», доктор технических наук, профессор, ORCID: 0000-0003-1439-1674 (Ростов-на-Дону, Россия) Ерофеев Владимир Трофимович-академик Российской академии архитектуры и строительных наук, декан архитектурно-строительного факультета, ФГБОУ ВО «МГУ им. Н. П. Огарёва», доктор технических наук, профессор (Саранск, Россия) Железникова Ольга Евгеньевна-директор Института электроники и светотехники, ФГБОУ ВО «МГУ им. Н. П. Огарёва», кандидат технических наук, доцент (Саранск, Россия) Игумнов Леонид Александрович-директор Научно-исследовательского института механики, заведующий кафедрой теоретической, компьютерной и экспериментальной механики, ФГАОУ ВО «Нижегородский государственный университет им. Н. И. Лобачевского», доктор физико-математических наук, профессор (Нижний Новгород, Россия) Кечемайкин Владимир Николаевич-директор Рузаевского института машиностроения, ФГБОУ ВО «МГУ им. Н. П. Огарёва», кандидат экономических наук (Саранск, Россия) Котин Александр Владимирович-заведующий кафедрой механизации переработки сельскохозяйственной продукции, ФГБОУ ВО «МГУ им. Н. П. Огарёва», доктор технических наук, профессор, ORCID: 0000-0003-0078-1866 (Саранск, Россия) Кусмарцев Федор Васильевич-декан физического факультета, Университет Лафборо, кандидат физико-математических наук (Лафборо, Великобритания) Маргулис Виктор Александрович-заведующий кафедрой теоретической физики, ФГБОУ ВО «МГУ им. Н. П. Огарёва», доктор физико-математических наук, профессор,
Изучена гепатотропная активность ремаксола и эссенциале Н при хронических вирусных гепатитах (ХВГ) В и С: 45 больных получали препарат ремаксол (внутривенно капельно, 400 мл в сутки, 10 дней), 45 пациентов – эссенциале Н (внутривенно струйно, 5 мл в сутки, 10 дней). Эффективность препаратов оценивали по клинической симптоматике, активности АлАТ и АсАТ, уровню билирубина, щелочной фосфатазы, молекул средней массы (МСМ), общей и эффективной концентрации альбумина (ЭКА). Ремаксол при ХВГ оказывал гепатотропный эффект, сравнимый с эссенциале Н, но более эффективно купировал астеновегетативный, диспепсический, холестатический и интоксикационный синдром, что подтверждалось достоверно низкими значениями МСМ и высокими показателями ЭКА. Включение ремаксола в схему лечения больных ХВГ следует считать патогенетически обоснованным, клинически оправданным и перспективным.
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