Letter to the editor: Possible role of topical povidone iodine in case of accidental ocular exposure to SARS-CoV-2

Sarma, Phulen; Kaur, Hardeep; Medhi, Bikash; Bhattacharyya, Anusuya

doi:10.1007/s00417-020-04864-9

Cited by 7 publications

(8 citation statements)

References 30 publications

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“…Among all, steroid therapy is showing some promise especially among severe and critical patients ( Sarma et al, 2020a ). Role of povidone iodine is also coming up as a prophylactic agent ( Khan et al, 2020 ; Sarma et al, 2020b , 2020c , p. 2). Other agents under evaluation are remdesivir ( Rezagholizadeh et al, 2021 ) folic acid ( Bhattacharyya et al, 2021 , p. 19; Hardeep Kaur et al, 2021 ) etc.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of dihydroorotate dehydrogenase (DHODH) inhibitors “leflunomide” and “teriflunomide” in Covid-19: A narrative review

Kaur

Sarma

Bhattacharyya

et al. 2021

European Journal of Pharmacology

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Dihydroorotate dehydrogenase (DHODH) is rate-limiting enzyme in biosynthesis of pyrimidone which catalyzes the oxidation of dihydro-orotate to orotate. Orotate is utilized in the biosynthesis of uridine-monophosphate. DHODH inhibitors have shown promise as antiviral agent against Cytomegalovirus, Ebola, Influenza, Epstein Barr and Picornavirus. Anti-SARS-CoV-2 action of DHODH inhibitors are also coming up. In this review, we have reviewed the safety and efficacy of approved DHODH inhibitors (leflunomide and teriflunomide) against COVID-19. In target-centered in silico studies, leflunomide showed favorable binding to active site of MPro and spike: ACE2 interface. In artificial-intelligence/machine-learning based studies, leflunomide was among the top 50 ligands targeting spike: ACE2 interaction. Leflunomide is also found to interact with differentially regulated pathways [identified by KEGG (Kyoto Encyclopedia of Genes and Genomes) and reactome pathway analysis of host transcriptome data] in cogena based drug-repurposing studies. Based on GSEA (gene set enrichment analysis ), leflunomide was found to target pathways enriched in COVID-19. In vitro , both leflunomide (EC50 41.49±8.8μmol/L) and teriflunomide (EC50 26μmol/L) showed SARS-CoV-2 inhibition. In clinical studies, leflunomide showed significant benefit in terms of decreasing the duration of viral shredding, duration of hospital stay and severity of infection. However, no advantage was seen while combining leflunomide and IFN alpha-2a among patients with prolonged post symptomatic viral shredding. Common adverse effects of leflunomide were hyperlipidemia, leucopenia, neutropenia and liver-function alteration. Leflunomide/teriflunomide may serve as an agent of importance to achieve faster virological clearance in COVID-19, however, findings needs to be validated in bigger sized placebo controlled studies.

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Section: Introductionmentioning

confidence: 99%

Efficacy and safety of dihydroorotate dehydrogenase (DHODH) inhibitors “leflunomide” and “teriflunomide” in Covid-19: A narrative review

Kaur

Sarma

Bhattacharyya

et al. 2021

European Journal of Pharmacology

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“…Regarding the clinical evaluations in outpatient services, avoiding the congestion of waiting rooms, reprogramming patients who were not urgently seen, disinfecting rooms with special disinfectant at each time interval, placing the UV lamp for 10-15 minutes were among the few useful measures in preventing the transmission of the infection. All patients in the emergency room presented for admission are recommended: epidemiological survey questionnaire, temperature monitoring, chest CT and COVID-19 emergency test (4, 6,7,8,9).…”

Section: Discussionmentioning

confidence: 99%

Ophthalmic pathology treated during Covid-19 at the Ophthalmology Clinic of “Sf. Spiridon” County Clinical Emergency Hospital in Iaşi, Romania

Bogdănici

2021

MSJ

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Within the current epidemiological context and due to the increased risk of infectivity, this article focuses on the practical activity of "Sf. Spiridon" Ophthalmology Clinic in Iaşi, during the emergency period (March 16 th -May 16 th , 2020), the evaluated ocular pathology and the approached strategy from the point of view of med ical and surgical vision. Material and methods: As an Emergency Hospital and Tertiary Center of Moldova, Romania "Sf. Spiridon" Hospital in Iaşi was the only hospital in the region that dealt with all the urgent ophthalmological pathology during COVID-19. The clinic worked due to the established protocol, the patient's circuit was changed, with the buffer zone for the suspicious COVID-19 patient, where the patient was hospitalized until the negative PCR result. All patients having a negative PCR test benefited from both medical and / or surgical treatment depending on the type of ocular pathology. Results: 619 patients were examined in the emergency room, of which 61 patients were hospitalized in Clinic I Ophthalmology, "Sf. Spiridon" Hospital in Iaşi, between March 16 and May 16, 2020. Most patients (59%) came from the neighboring counties (Suceava, Vaslui, Piatra Neamţ, Bacău) the rest being from Iaşi (41%). The age varied from 2 to 87 years, the average age being 51.72 ± 22.16. Most frequently, patients were hospitalized with retinal detachment (29.5%), trauma (24.6%) and corneal sclerosis (13.1%), most cases being surgical. The average length of stay was 6.3 days. The average time of surgery stages was 45 minutes. The condition at discharge was in 60% of cases improved and 30% cured. All patients tested negative for COVID-19 PCR. Visual acuity and IOP showed slightly higher / lower changes at discharge than a t the time of admission. Depending on the diagnosis, the average stay for the patients with retinal detachment was about 4 days, while for patients with glaucoma (13 days) or ulcer corneal (12 days), the long-term hospitalization exceeded 12 days. The multivariate analysis showed that about 10% of the number of days spent in hospital (dependent variable) can be e xplained by the diagnosis of hospitalization and the type of intervention. Correlated with the status of discharge, the number of days spent in hospital did not differ significantly. Conclusions: Most of the ophthalmological activity during the pandemic was surgical, due to the large number of trauma cases from neighboring counties, being the only non-COVID-19 hospital in the North-eastern region of Romania. Complying with the protocol suggested by

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“…Povidone iodine (PVP-I) is a time tested antimicrobial agent active against wide spectrum of bacteria and viruses (covers both enveloped as well as non-enveloped viruses including corona virus family) [ 19 ]. 1% povidone iodine is already in use for viral conjunctivitis, especially adenoviral conjunctivitis [ 30 – 33 ] and can also be used in COVID-19 associated conjunctivitis [ 18 , 19 ]. Povidone iodine sinus irrigations shows 43% post-treatment culture negativity result as compared to saline irrigation [ 34 ].…”

Section: Role Of Povidone Iodine In Covid-19mentioning

confidence: 99%

“…Povidone iodine (PVP-I) has been utilized as a time tested antimicrobial agent with broad spectrum coverage against various bacteria and viruses at a concentration as low as 0.6% in vitro and clinical study [ 18 , 19 ] and at concentration of 0.45% against SARS-CoV-2 [ 20 – 22 ].…”

Section: Introductionmentioning

confidence: 99%

Yogic Neti-Kriya Using Povidone Iodine: Can it have a Preventive Role Against SARS-CoV-2 Infection Gateway?

Sarma

Bhattacharyya

Prakash

et al. 2021

Indian J Otolaryngol Head Neck Surg

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During this COVID-19 pandemic, except steroid, none of the therapeutic measures have showed any evidence of efficacy. Traditionally jala-neti using lukewarm salted water remains a yogic way of maintaining upper airway hygiene. Saline irrigation decreases the concentration of inflammatory mediators (e.g. histamine, leukotriene etc.) in nasal secretions, reduces the severity and frequency of sinusitis, reduce need of antibiotic therapy and restores competency of nasal mucosa. Jala-neti is an integral part of six cleansing techniques of yogic kriyas practised in India since thousands of years. Jala-neti can clean the upper airways, prevents colonization of infectious agents, removes foreign bodies, prevents stasis of mucous and subsequently enhances the drainage of paranasal sinuses and maintain health. Regular practice of Jala neti improves nasal symptoms and overall health status of patients with sinusitis. Jala-neti sample can even be used for COVID-19 diagnosis. Povidone iodine (PVP-I) has been utilized as a time tested antimicrobial agent with broad spectrum coverage against wide range of bacteria and viruses. Anti-SARS-CoV-2 action of PVP-I was seen at a concentration as low as 0.45% . PVP-I is generally well tolerated upto 5%, however nasal ciliotoxicity is reported at this concentration, however, this toxicity is not reported with lower concentrations(1.25% and 0.5%). So, theoretically, by using neti-kriya with povidone iodine (0.5–1%) as irrigation solution can combine and enhance the protection against COVID-19 and this can be an important armor in the fight against COVID-19. However, this hypothesis needs to be validated in real life clinical trial scenario before implementing.

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Letter to the editor: Possible role of topical povidone iodine in case of accidental ocular exposure to SARS-CoV-2

Cited by 7 publications

References 30 publications

Efficacy and safety of dihydroorotate dehydrogenase (DHODH) inhibitors “leflunomide” and “teriflunomide” in Covid-19: A narrative review

Efficacy and safety of dihydroorotate dehydrogenase (DHODH) inhibitors “leflunomide” and “teriflunomide” in Covid-19: A narrative review

Ophthalmic pathology treated during Covid-19 at the Ophthalmology Clinic of “Sf. Spiridon” County Clinical Emergency Hospital in Iaşi, Romania

Yogic Neti-Kriya Using Povidone Iodine: Can it have a Preventive Role Against SARS-CoV-2 Infection Gateway?

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