Corpus overview


MeSH Disease

Human Phenotype


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    Noninvasive respiratory support in acute hypoxemicrespiratory failure MESHD associated with COVID-19 and other viralinfections

    Authors: Claudia Crimi; Alberto Noto; Andrea Cortegiani; Pietro Impellizzeri; Mark W Elliott; Nicolino Ambrosino; Cesare Gregoretti

    doi:10.1101/2020.05.24.20111013 Date: 2020-05-26 Source: medRxiv

    Introduction: Noninvasive respiratory support (NRS) such as noninvasive ventilation (NIV) and high flow nasal therapy (HFNT) have been used in the treatment of acute hypoxemic respiratory failure MESHD respiratory failure HP ( AHRF MESHD) related to the coronavirus disease MESHD (COVID-19) and other viral infections MESHD. However, there is a lack of consensus in favor of or against NRS use due to the risks of worsening hypoxemia HP hypoxemia MESHD, intubation delay, and aerosols environmental contamination associated with the use of these tools. We aimed to summarize the evidence on the use of NRS in adult TRANS patients with COVID-19 and other viral pneumonia MESHD pneumonia HP (i.e. H1N1, SARS, MERS) and AHRF MESHD. We also searched for studies evaluating the risk of aerosolization/contamination with these tools. Evidence Acquisition: We searched MEDLINE, PubMed EMBASE and two major preprint servers (biorXiv and medRxiv) from inception to April 14, 2020, for studies on the use of respiratory support in AHRF MESHD and viral pneumonia MESHD pneumonia HP. Evidence Synthesis: The search identified 4086 records and we found only one randomized controlled trial out of 58 studies included, with great variabilities in support utilization and failure rates. Fifteen studies explored the issue of aerosolization/contamination showing a high risk of airborne transmission TRANS via droplets generation during the use of these modalities Conclusions: Use of NRS and treatment failure in the context of COVID-19 and viral infection associated- AHRF MESHD, varied widely. Dispersion of exhaled air is different depending on the type of respiratory therapies and interfaces. Data from randomized controlled trials are lacking.

    Methods of An Open-Label Proof-Of-Concept Trial of Intravenous Valproic Acid for Severe COVID-19

    Authors: Erwin Chiquete; Liz Toapanta-Yanchapaxi; Carlos Cantu-Brito

    doi:10.1101/2020.04.26.20079988 Date: 2020-05-01 Source: medRxiv

    Background: Coronavirus disease 2019 (COVID-19) is the systemic entity caused by the severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) that may cause death MESHD through severe atypical pneumonia HP pneumonia MESHD and acute lung injury MESHD. Valproic acid (VPA) has shown anti-inflammatory activity and mild intrinsic antiviral effect. These properties warrant the study of VPA as a possible active treatment in persons with severe COVID-19. Methods: Consecutive adult TRANS patients needing invasive mechanical ventilation (IMV) will be given intravenous (i.v.) VPA at a starting dose of 20 mg/kg/day and up to 60/kg/day (in 60 min i.v. infusions in 250 mL normal saline) as needed to reach plasma SERO VPA concentrations of 50-100 mcg/mL (measured every 72 h). These patients will be followed-up for 10 days for the primary outcome and for a further period of 30 days after treatment completion for the secondary outcome of recurrence. The primary study outcome is the reduction in the case fatality rate of at least 50% after 10 days of treatment (as compared with natural history). Secondary outcomes are the reduction of length of stay (LOS) of at least 50%, as well as COVID-19 recurrence at 30-day follow-up. The most important safety outcomes are acute liver failure MESHD, acute pancreatitis HP acute pancreatitis MESHD, and thrombocytopenia HP thrombocytopenia MESHD. Conclusion: Although long-term adverse effects and even pro-inflammatory consequences have been reported with the chronic use of VPA, given the urgent need for a drug against COVID-19 to shorten the high mortality and LOS, the study of VPA is justified from a scientific standpoint.

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MeSH Disease
Human Phenotype

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