Please enable JavaScript.
Coggle requires JavaScript to display documents.
The articles Assignment-2, COVID-19, Major: Medical surgeon …
The articles Assignment-2
Treatment of COVID-19 px with hydroxychloroquine and azithromycin
Structure of text
Introduction
COVID-19 is a pandemic with a global spread infection
It is demonstrated that HCQ and AZ inhibits SARS-CoV-2 in vitro
They already have reported good clinical and virological outcomes with 80 patients with HCQ and AZ
The article is about the success with 1061 COVID-19 px
Their outcomes were death and clinical worsening
Body
Materials & Methods
Patients and their selection depending on their treatment, comorbidities, age, medications and demographics
Clinical and radiological classification according the severity of symptoms and high risk category of the patient
Treatment and outcome depending on the clinical history of the patient and their risk-benefit ratio
Patients with failure in the treatment by death or ICU or hospitalization with poor virological outcome
Multivariable analysis were made with logistic models
HCQ and AZ prescription was made for patients with complete hospitalization or day-care hospital assessment of the benefit/harm ratio.
Results
1,061 patients in total
Mean age: 43.6 years
469px (65.7%) had pneumonia intermediate and severe
From 204px was successfully obtained isolation of virus
973 patients (91.7%) had good outcomes
46px with 10px to ICU, and 2px died
350px excluded of the study for comorbidities
Conclusions
Discussion
A very controversial issue is the use of HCQ and AZ as a treatment on patients with COVID-19
The treatment was associated with a low-rate of severe outcomes in the patients
The diagnosis is poorer when the patient has already advance signs of pneumonia
The early detection of positive cases gives a high-rate recovery to the patient
Strict attention should be paid to any contraindications
It must be evaluated in controlled trials
Main ideas
Key words
SARS-CoV-2
COVID-19
Hydroxychloroquine
Azithromycin
Purpose of the text
Research and scientific
The hydroxychloroquine and azithromycin are used in France as treatment of COVID-19
Three days treatment regimen to 1061 SARS-CoV-2 positive tested patients
973 px cure within 10 days
Poor outcome in 46 px and 8px died
2.3% reported adverse events
This treatment before COVID-19 complications is safe and has a low fatality rate
Resources
Academic affiliation
i. AP-HM, Aix Marseille Univ., hôpital Timone, Cardiologie, Rythmologie, Marseille, France
h. Department of Radiology and Cardiovascular Imaging, Aix-Marseille Univ., UMR 7339, CNRS, CRMBM-CEMEREM (Centre de Résonance Magnétique Biologique et Médicale-Centre d'Exploration Métaboliques par Résonance Magnétique),Marseille, France
g. AP-HM, Marseille, France
f. Centre d'Epidémiologie et de Santé Publique des Armées (CESPA), Marseille, France
e. AP-HM, hôpital Timone, service Pharmacie, Marseille, France
d. Aix Marseille Univ., Laboratoire de Pharmacie Clinique, Marseille, France
c. Aix Marseille Univ., IRD, AP-HM, SSA, VITROME, Marseille,France
b. Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France
a. IHU-Méditerranée Infection, Marseille, France
References
[1] Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020;395:1054–62
[2] Yao X, Ye F, Zhang M, Cui C, Huang B, Niu P, et al. In vitro antiviral activity and projection of optimized dosing design of hydroxychloroquine for the treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Clin Infect Dis 2020:5801998. pii:ciaa237.
[3] Liu J, Cao R, Xu M, Wang X, Zhang H, Hu H, et al. Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitro. Cell Discov 2020;6:16.
[4] Weston S, Coleman CM, Haupt R, Logue J, Matthews K, Frieman M. Broad anticoronaviral activity of FDA approved drugs against 1 SARS-CoV-2 in vitro and SARS-CoV in vivo. bioRxiv 2020.
https://doi.org/10.1101/2020.03.25.008482
.
[5] Touret F, Gilles R, Barral K, Nougairede A, Decroly E, De Lamballerie X, et al. In vitro screening of a FDA approved chemical library reveals potential inhibitors of SARSCoV-2 replication. bioRxiv 2020.
https://doi.org/10.1101/2020.04.03.023846
.
[6] Andreani J, Le BM, Duflot I, Jardot P, Rolland C, Boxberger M, et al. In vitro testing of combined hydroxychloroquine and azithromycin on SARS-CoV-2 shows synergistic effect. Microb Pathog 2020:104228.
[7] Chen Z, Hu J, Zhang Z, Jiang S, Han S, Yan D, et al. Efficacy of hydroxychloroquine in patients with COVID-19: results of a randomized clinical trial. medRxiv 2020.
https://doi.org/10.1101/2020.03.22.20040758
.
[8] Tang W, Cao Z, Han M, Wang Z, Chen J, Sun W, et al. Hydroxychloroquine in patients with COVID-19: an open-label, randomized, controlled trial. medRxiv 2020.
https://doi.org/10.1101/2020.04.10.20060558
.
[9] Ashraf MA, Shokouhi N, Shirali E, Davari-Tanha F, Memar O, Kamalipour A, et al. COVID-19 in Iran, a comprehensive investigation from exposure to treatment outcomes. medRxiv 2020.
https://doi.org/10.1101/2020.04.20.20072421
.
[10] Chen J, Liu D, Liu L, Liu P, Xu Q, Xia L, et al. A pilot study of hydroxychloroquine in the treatment of patients with common coronavirus disease-19 (COVID-19). J Zhejiang Univ (Med Sci) 2020;49. 0.
[11] Mahevas M, Tran VT, Roumier M, Chabrol A, Paule R, Guillaud C, et al. No evidence of clinical efficacy of hydroxychloroquine in patients hospitalised for COVID-19 infection and requiring oxygen: results of a study using routinely collected data to emulate a target trial. medRxiv 2020.
https://doi.org/10.1101/2020.04.10.20060699
[12] Magagnoli J, Narendran S, Pereira F, Cummings F, Hardin JW, Scott Sutton S, et al. Outcomes of hydroxychloroquine usage in United States veterans hospitalized with Covid-19. medRxiv 2020.
https://doi.org/10.1101/2020.04.16.20065920
[13] Gautret P, Lagier JC, Parola P, Hoang VT, Meddeb L, Mailhe M, et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. Int J Antimicrob Agents 2020:105949.
https://doi.org/10.1016/j.ijantimicag.2020.105949
. [Epub ahead of print].
[14] Gautret P, Lagier JC, Parola P, Hoang VT, Meddeb L, Sevestre J, et al. Clinical and microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up: an observational study. TravMed Infect Dis 2020 Apr 11:101663.
https://doi.org/10.1016/j.tmaid.2020
. 101663. [Epub ahead of print].
[15] Retallack H, Di LE, Arias C, Knopp KA, Laurie MT, Sandoval-Espinosa C, et al. Zika virus cell tropism in the developing human brain and inhibition by azithromycin. Proc Natl Acad Sci U S A 2016;113:14408–13.
[16] Madrid PB, Panchal RG, Warren TK, Shurtleff AC, Endsley AN, Green CE, et al. Evaluation of Ebola virus inhibitors for drug repurposing. ACS Infect Dis 2015;1:317–26.
[17] Bosseboeuf E, Aubry M, Nhan T, dde Pin JJ, Rolain JM, Raoult D, et al. Azithromycin inhibits the replication of Zika virus. J Antivir Antiretrovir 2018;10:6–11.
[18] Sermo Sermo. COVID-19 real time barometer. 2020
https://app.sermo.com/covid19-barometer?utm_campaign=wwwsermo_covid19
, Accessed date: 17 April 2020 Last accessed:.
[19] Amrane S, Tissot-Dupont H, Doudier B, Eldin C, Hocquart M, Mailhe M, et al. Rapid viral diagnosis and ambulatory management of suspected COVID-19 cases presenting at the infectious diseases referral hospital in Marseille, France, - January 31st to March 1st, 2020: a respiratory virus snapshot. Trav Med Infect Dis 2020 Mar 20:101632.
https://doi.org/10.1016/j.tmaid.2020.101632
. [Epub ahead of print].
[20] Liao X, Wang B, Kang Y. Novel coronavirus infection during the 2019-2020 epidemic: preparing intensive care units-the experience in Sichuan Province, China. Intensive Care Med 2020;46:357–60.
[21] Armstrong N, Richez M, Raoult D, Chabriere E. Simultaneous UHPLC-UV analysis of hydroxychloroquine, minocycline and doxycycline from serum samples for the therapeutic drug monitoring of Q fever and Whipple's disease. J Chromatogr B Analyt Technol Biomed Life Sci 2017;1060:166–72.
[22] Lagier JC, Fenollar F, Lepidi H, Giorgi R, Million M, Raoult D. Treatment of classic Whipple's disease: from in vitro results to clinical outcome. J Antimicrob Chemother 2014;69:219–27.
[23] La Scola B, Le Bideau M, Andreani J, Hoang VT, Grimaldier C, Colson P, et al. Viral RNA load as determined by cell culture as a management tool for discharge of SARS-CoV-2 patients from infectious disease wards. Eur J Clin Microbiol Infect Dis 2020.
https://doi.org/10.1007/s10096-020-03913-9
.
[24] Hadfield J, Megill C, Bell SM, Huddleston J, Potter B, Callender C, et al. Nextstrain: real-time tracking of pathogen evolution. Bioinformatics 2018;34:4121–3.
[25] Lane JCE, Weaver J, Kostka K, Duarte-Salles T, Abrahao MT, Alghoul H, et al. Safety of hydroxychloroquine, alone and in combination with azithromycin, in light of rapid wide-spread use for COVID-19: a multinational, network cohort and self-controlled case series study. medRxiv 2020.
https://doi.org/10.1101/2020.04.08
.
20054551
[26] Wu Z, McGoogan JM. Characteristics of and immportant lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese center for disease control and prevention. J Am Med Assoc 2020
Feb 24.
https://doi.org/10.1001/jama.2020.2648
. [Epub ahead of print].
[27] Dong L, Hu S, Gao J. Discovering drugs to treat coronavirus disease 2019 (COVID19). Drug Discov Ther 2020;14:58–60.
[28] Sung-sun K. Physicians work out treatment guidelines for coronavirus. Korea Biomedical Review 2020
http://m.koreabiomed.com/news/articleView.html?idxno=7428
.
Authors
Million, Matthieu
Lagier, Jean-C.
Gautret Philippe
Colson, Philippe
Fournier, Pierre-E.
Amrane, S.
Aubry, Camille
Doudier, B.
Esteves-V.,Vera
Mailhe, Morgane
Hocquart, Marie
Correard Florian
Giraud-G., A.
Roussel, Yanis
Berenger, Cyril
Cassir, Nadim
Tomei, C.
Ravaux, I.
Dhiver, C.
Zandotti, Christine
Eldin, C.
Tissot-D., H.
Honoré, S.
Stein, A.
Deharo, Jean-C.
Jacquier, A.
Chabrière, Eric
Obadia, Yolande
Rolain, Jean-Marc
Brouqui, P.
Fenollar, F.
Drancourt, M.
Levasseur, A.
La Scola, B.
Parola, P.
Raoult, Didier
DOI:
https://doi.org/10.1016/j.tmaid.2020.101738
Million, M., Lagier, J. C., Gautret, P., Colson, P., Fournier, P. E., Amrane, S., ... & Aubry, C. (2020). Full-length title: Early treatment of COVID-19 patients with hydroxychloroquine and azithromycin: A retrospective analysis of 1061 cases in Marseille, France. Travel medicine and infectious disease, 101738.
BiblioTec link:
https://0-www-sciencedirect-com.biblioteca-ils.tec.mx/science/article/pii/S1477893920302179?via%3Dihub
Graphs, charts, tables and figures
Table1: Reasons for exclusion of 350 px
Table 2: Baseline characteristics according to clinical and virological outcome of 1061 px
Table 3: Adverse events
Table 4: Multivariable logistic regressions
Table 5: Clinical data of 8px who died
Figure 1: Flowchart of px in the analysis
Figure 2: Phylogenetic tree of SARS-COV-2 genomes
Anticoagulant approach in COVID-19 px with cerebral venous thrombosis
Structure of text
Introduction
COVID-19 px with cerebral venous thrombosis are treated with anticoagulant
UFH and LMWH appears to be a stronger treatment and with better outcomes
It can be used in patients during the acute period
Body
Material & Methods
The selected patients presented acute cerebral venous thrombosis
They were randomly assigned to UFH or LMWH
They were in total 66 adults in the controlled trial
Results
LMWH has 6% of low-rate mortality
10% rate of new intracranial hemorrhage
UFH and LMWH were not statistically different
LMWH demonstrated significantly lesser ods compare to UFH of intracranial bleeding
88% with complete recovery in 3 months
LMWH have better outcome in a good recovery and lower mortality-rate
Conclusions
LMWH may work better than UFH in terms of safeness
Large trials may be needed to confirm
Unfractionated heparin suited in critically ill immediate surgery patients
UFH is safer in patients with renal failure and poor absorption obesity patients
Main ideas
Key words
COVID-19
Anticoagulant
Heparin
Cerebral venous thrombosis
Purpose of the text
Research and scientific
Neurological symptoms and COVID-19 can lead to cerebral enous thrombosis
Is more present in young adults
Low-molecular-weight heparin or LMWH can be used in COVID-19 patients
The LMWH improved thrombus regression, reduced rates of major hemorrhage and a reduction in mortality
Graphs, chart, tables and figures
It doesn't include
Resources
Authors
Chia Siang Kow (MPharm)
Abdullah Faiz Zaihan (BPharm)
Syed
Shahzad Hasan (PhD)
Academic Affiliations
School of Postgraduate Studies, International Medical University, Kuala Lumpur, Malaysia
Department of Pharmacy, Shah Alam Hospital, Selangor, Malaysia
Department of Pharmacy, University of Huddersfield, Huddersfield, United Kingdom.
Correspondence to: Kow Chia Siang, International Medical University, Kuala Lumpur, Malaysia
References
Klein DE, Libman R, Kirsch C, Arora R. Cerebral venous thrombosis: A typical presentation of
COVID-19 in the young. J Stroke Cerebrovasc Dis. 2020 Aug;29(8):104989.
Robertson L, Jones LE. Fixed dose subcutaneous low molecular weight heparins versus adjusted
dose unfractionated heparin for the initial treatment of venous thromboembolism. Cochrane
Database Syst Rev. 2017;2(2):CD001100.
Misra UK, Kalita J, Chandra S, Kumar B, Bansal V. Low molecular weight heparin versus
unfractionated heparin in cerebral venous sinus thrombosis: a randomized controlled trial. Eur J
Neurol. 2012;19(7):1030-1036.
Coutinho JM, Ferro JM, Canhão P, et al. Unfractionated or low-molecular weight heparin for the
treatment of cerebral venous thrombosis. Stroke. 2010;41(11):2575-2580.
Xu W, Gao L, Li T, Shao A, Zhang J. Efficacy and risks of anticoagulation for cerebral venous
thrombosis. Medicine (Baltimore). 2018;97(20):e10506.
Ferro JM, Bousser MG, Canhão P, et al. European Stroke Organization guideline for the diagnosis
and treatment of cerebral venous thrombosis - endorsed by the European Academy of
Neurology. Eur J Neurol. 2017;24(10):1203-1213.
Merli GJ, Groce JB. Pharmacological and clinical differences between low-molecular-weight
heparins: implications for prescribing practice and therapeutic interchange. P T. 2010;35(2):95-
105.
Masuhr F, Einhaupl K. Treatment of cerebral venous and sinus thrombus. In: Caso V, Angelli G,
Paciaroni M, editors. Handbook on Cerebral Venous Thrombosis. San Ramon, CA: Karger
Publishers; 2008. pp. 132–43.
DOI:
https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105222
Kow, C. S., Zaihan, A. F., & Hasan, S. S. (2020). Anticoagulant approach in COVID-19 patients with cerebral venous thrombosis. Journal of Stroke and Cerebrovascular Diseases.
BiblioTec link:
https://0-www-sciencedirect-com.biblioteca-ils.tec.mx/science/article/pii/S1052305720306406
COVID-19
Major: Medical surgeon
Abril Salguero Cabañas A00826992