Repurposing of Mycobacterium indicus pranii for the severe form of COVID‐19 patients in India: A cohort study

Abstract

Severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) induces the production of proinflammatory cytokines, which results in a cytokine storm, and immune‐modulators like Mycobacterium indicus pranii (MIP) might ameliorate coronavirus disease of 2019 (COVID‐19) related cytokine storm. Therefore, the present study evaluates whether MIP offers an advantage in the treatment of severe COVID‐19 patients infected with SARS‐CoV‐2. A prospective MIP cohort study was conducted in chest disease hospitals in Srinagar, Jammu and Kashmir, India. In the present prospective, randomized clinical study, critically severe COVID‐19 patients were divided into two groups, the MIP group (n = 105) and the best standard treatment (BST) group (n = 210). Procalcitonin, ferritin, high‐sensitive C‐reactive protein, D‐dimer levels, and interleukin levels on 5th‐day posttreatment were significantly reduced in the MIP group compared to the BST group. Compared to the BST group, 105 consecutive patients with severe COVID‐19 in the MIP group reported early weaning off ventilation, resolution of chest architecture (computed tomography [CT] scan), a significant increase in SpO2 levels, and decreased mortality with a hazard ratio: 0.234 (95% confidence interval: 0.264–2.31) (p = 0.001). MIP restored SpO2, immune/inflammatory response, normalized lung abnormalities (chest CT scan), and reduced mortality without any serious complications. However, there is a need for placebo‐controlled double‐blind and controlled clinical trials to confirm the efficacy.

Modulation of immune cum inflammatory pathway by earthworm granulation tissue extract in wound healing of diabetic rabbit model

“…For above statistical test level of statistical significance was set at P < 0.05. Statistical analysis was performed as per method of [ 38 ].…”

The critical impacts of cytokine storms in respiratory disorders

“…The perplexing etiology of COVID-19 is marked by significantly enhanced cytokine production which results both in considerable mortality and grave disease progression [ 6 ] The increased case fatality of the recent SARS-CoV-2 pandemic is attributed to uncontrolled and dysregulated cytokine production which results from severe Acute Respiratory Distress Syndrome (ARDS) symptoms, which further causes significantly higher mortality rate in these patients [ 7 ]. Studies across the globe have reported that activation of immune cells by various viruses that infect the pulmonary system promotes secretion of a diverse set of cytokines which enhances endothelial-vascular permeability and allows blood cells and fluid to migrate into the alveoli henceforth causing dyspnea and respiratory failure [ [7] , [8] , [9] , [10] , [11] , [12] ]. In addition to SARS-CoV-2 viruses that induce CS include SARS-CoV-1, H1N1 influenza, H5N1 influenza, Ebola infections, and Influenza Band Parainfluenza virus, [ 13 ].…”

“…Increased infiltration of immune cells inside pulmonary parenchyma. Hyper activation of inflammatory pathway, higher levels of Ferritin and C-Reactive Protein [ 17 , 18 , 19 ] 4) Bacteria Induced CS Increased levels of TNF-α, interluekins chemokines and G-CSF, [ 20 , 21 [51,185,190] 5) SARS-CoV-1 Elevated levels of IL-8, IL-1β, TNF-α, and IL-6 in alveolar lavage and blood plasma and significant Lymphopenia, higher levels of Ferritin and C-Reactive Protein [ 8 ,204] 6) MERS-CoV-1 Significantly higher levels of procalcitonin, and IL-6 being a prominent indicator of CS. The main differentiating factors includes absence of hyperferritinemia and absence of any significant elevation in C reactive protein levels [ [ 20 , [18] , [22] , [23] , [24] , [25] , [26] , [27] , [28] ], 202] 7) Macrophage Activation Syndrome Ferritin levels above the threshold level of 10,000 ng/mL.…”

Clinical Characterization and Outcomes of Patients with Hypercreatinemia Affected by COVID-19

“…The clinical disease affects the respiratory system and is characterized by acute respiratory distress syndrome. In addition to pulmonary involvement, SARS-CoV-2 has been isolated from cardiovascular, digestive, neurological and renal tissues [ 4 , 5 , 6 ]. The incidence of renal failure varies from 0.5% to 25% in hospitalized patients in the absence of medical emergencies related to a pandemic [ 7 , 8 ].…”