Emelt szintű szervtámogató és életfenntartó kezelések kritikus állapotú COVID–19-fertőzött betegeken

Berhés, Mariann; Fábián, Ákos; László, István; Végh, Tamás; Molnár, Csilla; Fülesdi, Béla; Koszta, György

doi:10.1556/650.2020.31813

Cited by 10 publications

(15 citation statements)

References 16 publications

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“…In critically ill COVID-19 patients, a cytokine storm, along with unmanageable hypoxemia, can lead to multi-organ failure. 25 The cytokine profile with COVID-19 consists of increased IL-2, IL-7, G-CSF, CXCL10, CCL2, CCL3, and TNF-α, 26 ferritin, IL-1β, S100 proteins, 27 and IL-6. 28 A clinical trial in the United Kingdom published their results while our study was ongoing on the beneficial effect of using of low dose dexamethasone treatment in reducing the 28-day mortality rate by 17%.…”

Section: Discussionmentioning

confidence: 99%

“…Meduri et al using an ex vivo model of systemic inflammation reported that naïve peripheral blood leukocytes when exposed to prolonged methylprednisolone treatment of un-resolving ARDS exhibited a progressive increase in cytoplasmic binding of glucocorticoid receptor to NFκB, and a concomitant reduction in NFκB DNA binding and transcription of cytokines such as tumor necrosis factor-α and interleukin-1β. 22,25 A recent unpublished study demonstrates that SARS-CoV-2 proteins interact with lung associated proteins more than other organs. 31 The same study demonstrates that SARS-CoV-2 interacts with multiple innate immune pathways, 31 which suggests that the lung is very susceptible to SARS-CoV-2 and targeting the cytokine storm during COVID-19 and steroid treatment may be beneficial.…”

Section: Discussionmentioning

confidence: 99%

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Early Experience With Methylprednisolone on SARS-CoV-2 Infection in the African American Population, a Retrospective Analysis

Saggi

Nath

Culas

et al. 2020

Clin Med Insights Circ Respir Pulm Med

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Background: Coronavirus disease-19 (COVID-19) is associated with acute kidney injury (AKI) and acute respiratory distress syndrome (ARDS) with high mortality rates. In African American (AA) populations, COVID-19 presentations and outcomes are more severe. NIH and Interim WHO guidelines had suggested against the use of corticosteroids unless in clinical trials until the recent publication of the RECOVERY trial. Here, we analyzed the treatment effect of methylprednisolone on patients with AKI and ARDS during the initial 2 months of COVID-19 and detail the learning effect within our institution. Methods: Between March 1 and April 30, 2020, 75 AA patients met our inclusion criteria for ARDS and AKI, of which 37 had received corticosteroids. Twenty-eight-day mortality, improvement in PaO2/FiO2 ratio, and renal function were analyzed. The impact of methylprednisolone treatment was assessed with multivariable methods. Results: Survival in the methylprednisolone group reached 51% at 21 days compared to 29% in the non-corticosteroid group ( P < .001). Methylprednisolone improved the likelihood of renal function improvement. PaO2/FiO2 ratio in the methylprednisolone group improved by 73% compared to 45% in the non-corticosteroid group ( P = .01). Age, gender, BMI, preexisting conditions, and other treatment factors did not show any impact on renal or PaO2/FiO2 ratio improvement. The use of anticoagulants, the month of treatment, and AKI during hospitalization also influenced outcomes. Conclusion: In AA COVID-19 positive patients with ARDS and AKI, IV methylprednisolone lowered the incidence of mortality and improved the likelihood of renal and lung function recovery. Further investigation with a randomized control trial of corticosteroids is warranted.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Early Experience With Methylprednisolone on SARS-CoV-2 Infection in the African American Population, a Retrospective Analysis

Saggi

Nath

Culas

et al. 2020

Clin Med Insights Circ Respir Pulm Med

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“…NO inhalation is beneficial for most patients with severe ARDS 240 . Inhalation of NO triggers the relaxation of smooth muscles in pulmonary blood vessels, leading to increased blood flow and adequate ventilation in the lungs 241 . NO showed inhibition of the synthesis of viral RNA and proteins 242 .…”

Section: Small-molecule Sars-cov-2 Inhibitors Targeting Host Proteinsmentioning

confidence: 99%

“…NO showed inhibition of the synthesis of viral RNA and proteins 242 . Therefore, NO inhalation may be an effective method for the treatment of patients with severe COVID-19 169 , 241 .…”

Section: Small-molecule Sars-cov-2 Inhibitors Targeting Host Proteinsmentioning

confidence: 99%

Recent advances in developing small-molecule inhibitors against SARS-CoV-2

Xiang

Wang

et al. 2022

Acta Pharmaceutica Sinica B

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The COVID-19 pandemic caused by the novel SARS-CoV-2 virus has caused havoc across the entire world. Even though several COVID-19 vaccines are currently in distribution worldwide, with others in the pipeline, treatment modalities lag behind. Accordingly, researchers have been working hard to understand the nature of the virus, its mutant strains, and the pathogenesis of the disease in order to uncover possible drug targets and effective therapeutic agents. As the research continues, we now know the genome structure, epidemiological and clinical features, and pathogenic mechanism of SARS-CoV-2. Here, we summarized the potential therapeutic targets involved in the life cycle of the virus. On the basis of these targets, small-molecule prophylactic and therapeutic agents have been or are being developed for prevention and treatment of SARS-CoV-2 infection.

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“…По сути, развивается своеобразный «физико-химический пневмонит», который резко утяжеляет состояние пациента и снижает эффективность искусственной вентиляции легких [79,144]. В этом случае более эффективна экстракорпоральная мембранная оксигенация (ЭКМО) крови [67,74], как это рекомендовано для пациентов с ОРДС при тяжелых формах гриппа А [12], дополненная ингаляциями оксида азота [42] и/или Гелиокса [7,97]. Перспективным препаратом для преодоления негативных последствий пневмонита мог бы стать Перфторан [18,25].…”

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COVID-19: etiology, clinical picture, treatment

Shchelkanov

Колобухина

Бургасова

et al. 2020

Russian Journal of Infection and Immunity

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Whereas the XX century marked the history of acute respiratory disease investigation as a period for generating in-depth system of combating influenza viruses (Articulavirales: Orthomyxoviridae, Alpha-/Betainfluenzavirus) (based on environmental and virological monitoring of influenza A virus in its natural reservoir — aquatic and semi-aquatic birds — to supervising epidemic influenza), a similar system is necessary to build up in the XXI century with regard to especially dangerous betacoronaviruses (Nidovirales: Coronaviridae, Betacoronavirus): Severe acute respiratory syndrome-related coronavirus (SARS-CoV) (subgenus Sarbecovirus), Severe acute respiratory syndrome-related coronavirus 2 (SARSCoV-2) (Sarbecovirus), Middle East respiratory syndrome-related coronavirus (MERS-CoV) (Merbecovirus). This became particularly evident after pandemic potential has been revealed in 2020 by the SARS-CoV-2. This review provides an insight into the historic timeline of discovering this virus, its current taxonomy, ecology, virion morphology, life cycle, molecular biology, pathogenesis and clinical picture of the etiologically related COVID-19 (Coronavirus disease 2019) as well as data available in the scientific literature on the anti-SARS-CoV-2-effectiveness of passive immunotherapy and most debated drugs used to treat COVID-19: Chloroquine, Hydroxychloroquine, Nitazoxanide, Ivermectin, Lopinavir and Ritonavir, Camostat mesilate, Remdesivir, Ribavirin, Tocilizumab, Anakinra, corticosteroids, and type I interferons. The pathogenesis of SARS-CoV-2 infection implicates decreased efficacy of artificial respiration, which, in this case might be replaced by more efficient extracorporeal membrane blood oxygenation supplemented with nitrogen oxide and/or Heliox inhalations.

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Emelt szintű szervtámogató és életfenntartó kezelések kritikus állapotú COVID–19-fertőzött betegeken

Cited by 10 publications

References 16 publications

Early Experience With Methylprednisolone on SARS-CoV-2 Infection in the African American Population, a Retrospective Analysis

Early Experience With Methylprednisolone on SARS-CoV-2 Infection in the African American Population, a Retrospective Analysis

Recent advances in developing small-molecule inhibitors against SARS-CoV-2

COVID-19: etiology, clinical picture, treatment

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