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MeSH Disease

Human Phenotype

Transmission

Seroprevalence

There are no seroprevalence terms in the subcorpus

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    A Randomized Trial of Ivermectin-Doxycycline and Hydroxychloroquine-Azithromycin therapy on COVID19 patients.

    Authors: Abu Taiub Mohammed Mohiuddin Chowdhury; Mohammad Shahbaz; Md Rezaul Karim; Johirul Islam; Dan Guo; Shuixiang He

    doi:10.21203/rs.3.rs-38896/v1 Date: 2020-06-29 Source: ResearchSquare

    Background The worldwide COVID-19 pandemic was caused by a newly discovered Coronavirus. The treatment methods for COVID-19 are emerging and rapidly evolving. Existing drugs, including Ivermectin and Hydroxychloroquine, offer the hope of effective treatment in early disease MESHD. In this study, we investigated and compared outcomes of Ivermectin-Doxycycline vs. Hydroxychloroquine-Azithromycin combination therapy COVID19 patients with mild to moderate disease MESHD.Methods Patients with mild to moderate COVID-19 disease MESHD, tested positive by RT PCR for SARS-CoV-2 infection MESHD at Chakoria Upazilla Health Complex, Cox's Bazar, Bangladesh, were included in this study. Patients were divided randomly into two groups: Ivermectin 200µgm/kg single dose + Doxycycline 100 mg BID for 10days in group A, and Hydroxychloroquine 400 mg 1st day, then200mg BID for 9days + Azithromycin 500 mg daily for 5 days in group B. PCR for SARS-CoV-2 was repeated in all symptomatic patients on the second day onward without symptoms, or, for those who were asymptomatic TRANS (throughout the process), on the 5th day after taking medication and repeated every two days onward if the result is positive. Time to negative PCR and time to full symptomatic recovery was measured for each group.Results All subjects in the Ivermectin-Doxycycline group (group A) reached a negative PCR for SARS-CoV-2, at a mean of 8.93days, and all reached symptomatic recovery, at a mean of 5.93days, with 55.10% symptom-free by the 5th day. In the Hydroxychloroquine-Azithromcyin group (group B), 96.36% reached a negative PCR at a mean of 6.99days and were symptoms-free at 9.33days. Group A patients had symptoms that could have been caused by the medication in 31.67% of patients, including lethargy MESHD lethargy HP in 14(23.3%), nausea MESHD nausea HP in 11(18.3%), and occasional vertigo MESHD vertigo HP in 7(11.66%) of patients. In Group B, 46.43% had symptoms that could have been caused by the medication, including 13(23.21%) mild blurring of vision HP and headache MESHD headache HP; 22(39.2%) increased lethargy MESHD lethargy HP and dizziness MESHD, 10(17.85%) occasional palpitation HP, and 9(16.07%) nausea MESHD nausea and vomiting HP and vomiting MESHD.Conclusion The Ivermectin-Doxycycline combination showed a trend toward superiority to the Hydroxychloroquine-Azithromycin combination therapy in the case of patients with mild to moderate COVID19 disease MESHD, though the difference in time to becoming symptom-free and the difference in time to negative PCR was not statistically significant.

    Hydroxychloroquine Versus COVID-19: A Rapid Systematic Review and Meta-Analysis

    Authors: Amir Shamshirian; Amirhossein Hessami; Keyvan Heydari; Reza Alizadeh-Navaei; Mohammad Ali Ebrahimzadeh; George W YIP; Roya Ghasemian; Meghdad Sedaghat; Hananeh Baradaran; Soheil Mohammadi Yazdi; Elham Aboufazeli; Hamed Jafarpour; Ehsan Dadgostar; Behnaz Tirandazi; Keyvan Karimifar; Aida Eftekhari; Danial Shamshirian

    doi:10.1101/2020.04.14.20065276 Date: 2020-04-20 Source: medRxiv

    Background: Coronavirus Disease MESHD 2019 (COVID-19) has become a major global issue with rising the number of infected individuals and mortality in recent months. Among all therapeutic approaches, arguments have raised about hydroxychloroquine (HCQ) efficacy in the treatment of COVID-19. We carried out a systematic review and meta-analysis overcome the controversies regarding the effectiveness of hydroxychloroquine in the treatment of COVID-19. Methods: A systematic search was performed in PubMed, Scopus, Embase, Cochrane Library, Web of Science, Google Scholar and medRxiv pre-print database using all available MeSH terms for COVID-19 and hydroxychloroquine up to July 19, 2020. Studies focused on the effectiveness of HCQ with/without azithromycin (AZM) in confirmed COVID-19 patients were entered into the study. Two researchers have independently evaluated quality assessment of the studies and abstracted data for data extraction. Extracted data were analyzed using CMA v. 2.2.064. Heterogeneity was assessed using the I-squared (I2) test, and fixed/random-effects model was used when appropriate for pooling of studies. Results: Out of 26 studies entered into our systematic review, 21 studies including 14 comparative studies with control group and seven observational studies containing 103,486 participants have entered into the meta-analysis. The results of the meta-analysis on comparative studies indicated no significant clinical effectiveness (negative in RT-PCR evaluation) for HCQ regimen in the treatment of COVID-19 in comparison to control group (RR: 1.03, 95% CI, 0.79-1.34). The same result was observed for the combination of HCQ+azithromycin (RR: 1.26, 95% CI, 0.91-1.74). No significant differences were found for both HCQ (RR: 0.92, 95% CI, 0.72-1.16) and HCQ+AZM (RR: 1.72, 95% CI, 0.86-3.42) mortality rate; however, mortality was affected by age TRANS differences according to meta-regression analysis (P<0.000001). No substantial difference was observed for disease MESHD exacerbation (RR: 1.23, 95% CI, 0.65-2.30) between HCQ group and controls. Also, radiological findings significantly improved in the HCQ group (OR: 0.32, 95% CI, 0.11-0.98). Odds of known HCQ adverse effects ( diarrhea MESHD diarrhea HP, vomiting MESHD vomiting HP, blurred vision HP, rash, headache MESHD headache HP, etc.) occurred in the HCQ regimen group was approximately 3.5 times of control group (OR: 3.40, 95% CI, 1.65-6.98), but no substantial differences were found regarding intubation odds between HCQ group and control group (OR: 2.11, 95% CI, 0.31-14.03). Meta-analysis indicated no significant prophylactic effects for HCQ (OR: 0.40, 95% CI, 0.04-3.65) Conclusion: This systematic review and meta-analysis showed no clinical benefits regarding HCQ treatment with/without azithromycin for COVID-19 patients. Although mortality rate was not significantly different between cases and controls, frequency of adverse effects was substantially higher in HCQ regimen group. However, due to that most of the studies were non-randomized and results were not homogenous, selection bias was unavoidable and further large randomized clinical trials following comprehensive meta-analysis should be taken into account in order to achieve more reliable findings. Also, it is worth mentioning that if this work does not allow to quantify a "value" of the HCQ, it allows at least to know what is not the HCQ and that it would be prudent not to continue investing in this direction.

    Ocular manifestations and clinical characteristics of 534 cases of COVID-19 in China: A cross-sectional study

    Authors: Liwen Chen; Chaohua Deng; Xuhui Chen; Xian Zhang; Bo Chen; Huimin Yu; Yuanjun Qin; Ke Xiao; Hong Zhang; Xufang Sun

    doi:10.1101/2020.03.12.20034678 Date: 2020-03-16 Source: medRxiv

    Objective: The novel coronavirus disease MESHD (COVID-19) was first reported in Wuhan, China in December 2019 and is now pandemic all over the world. Previous study has reported several COVID-19 cases with conjunctivitis MESHD conjunctivitis HP. However, the complete profiling of COVID-19 related ocular symptoms and diseases MESHD are still missing. We aim to investigate the ocular manifestations and clinical characteristics of COVID-19 patients. Methods: A total of five hundred and thirty-four patients were recruited at Mobile Cabin Hospital and Tongji Hospital. We collected information on demographic characteristics, exposure history, ocular symptoms, systemic concomitant symptoms, eye drop medication, eye protections, radiologic findings, and SARS-CoV-2 detection in nasopharyngeal swabs by RT-PCR from questionnaires and electronic medical records. Results: The median age TRANS of patients was 40 and 50 years at Mobile Cabin Hospital and Tongji Hospital, respectively. Of 534 COVID-19 patients, 25 patients (4.68%) presented with conjunctival congestion and 3 patients had conjunctival congestion as the initial symptom. The average duration of conjunctival congestion was 4.9 {+/-} 2.6 days (mean [SD]), ranging from 2 to 10 days. Dry eye (112, 20.97%), blurred vision HP (68, 12.73%), and foreign body MESHD sensation (63, 11.80%) ranked as the top three COVID-19 related ocular symptoms. Notably, a total of 332 COVID-19 patients (62%) had a hand-eye contact history. We also found that some COVID-19 patients had a history of eye disease MESHD, including conjunctivitis MESHD conjunctivitis HP (33, 6.18%), dry eye (24, 4.49%), keratitis MESHD keratitis HP (14, 2.62%), cataract MESHD cataract HP (9, 1.69%), and diabetic retinopathy MESHD retinopathy HP (5, 0.94%). In consistent with previous studies, the most common clinical symptoms were fever MESHD fever HP, cough MESHD cough HP, and fatigue MESHD fatigue HP. Patients, 60.5% in Mobile Cabin Hospital and 67.5% in Tongji Hospital, respectively were confirmed with positive SARS-CoV-2 detection. Conclusions: Conjunctival congestion was one of the COVID-19 related ocular symptoms, which may have clinical diagnostic significance. It is essential to provide eye-care equipment and strengthen education on eye protection, as dirty hand-eye contact might be a high risk factor of COVID-19. Further detailed and comprehensive ophthalmological guidance is needed for COVID-19 control.

The ZB MED preprint Viewer preVIEW includes all COVID-19 related preprints from medRxiv and bioRxiv, from ChemRxiv, from ResearchSquare, from arXiv and from Preprints.org and is updated on a daily basis (7am CET/CEST).

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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