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Africa
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Epidemiology and Pathogenesis of COVID-19
Published in Hanadi Talal Ahmedah, Muhammad Riaz, Sagheer Ahmed, Marius Alexandru Moga, The Covid-19 Pandemic, 2023
Sidrah Tariq Khan, Sagheer Ahmed
Drugs that have the ability to block the interaction between viral proteins and humanAce-2 receptors may result in areduction in viral load in infectedpatients and prove to be beneficial in treating the disease. Japan has approved the use of the antiviral drug Camostat mesylate, which is responsible for inhibiting serine protease enzymes such as TMPRSS2, which results in a reduction in viral entry into the host cell and also prevent the patient from reaching severe disease. Unfortunately, at present there is not enough clinical data to support the use of this drug in COVID-19 patients. In patients with milder disease, Umifenovir has been shown to be much more effective than ritonavir. However, the drug has not shown much promise when it comes to treating more severe COVID-19 cases. Previously, antimalarial drugs Chloroquine and hydroxychloroquine (HCQ) were being used to treat COVID-19 due to their ability to block viral entry via multiple mechanisms such as raising the endosomal PH making it more acidic and inhibition of receptor glycosylation thereby interfering with membrane fusion. However, due to their debilitating adverse effects, especially those related to the cardiovascular systems, the FDA has now unauthorized the use of these drugs in emergency cases.
Antiviral Nanomaterials as Potential Targets for Malaria Prevention and Treatment
Published in Devarajan Thangadurai, Saher Islam, Charles Oluwaseun Adetunji, Viral and Antiviral Nanomaterials, 2022
Kantrol Kumar Sahu, Sunita Minz, Madhulika Pradhan, Monika Kaurav, Krishna Yadav
After the application of chloroquine and hydroxychloroquine for the management of COVID-19, the repurposing of drugs is now emerging and pre-established drugs are been investigated for their other pharmacological utility. Compared to other infections, malaria is the most suffering cause of death in a large amount of populace. Around 228 million people on the globe suffer from malaria. It is the deadliest of viruses and uses human-cellular machinery for its growth, leaving an unhealthy human body behind. Numerous drugs have been used in the management of malaria, including chloroquine, hydroxychloroquine, doxycycline, quinine, atovaquone, and so forth. The inefficacy of vaccines and the limited option of therapeutics for the anticipation and management of malaria has forced the researchers to focus on other alternatives. Among existing classes of therapeutics, antiretroviral has proven to be a significant and potential candidate for their repurposing as an antimalarial. Despite the effectiveness of these drugs, limited drug choice, unpredictable and undesired side effects, and unconventional physico-chemical attributes limit their use, which could be compensated by the application of nanomaterial. The investigations included in this chapter have indicated the potential of antiviral drugs as antimalarial and their various aspects nanomaterials.
Renal diseases in pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
In pregnant women with active lupus nephritis, the maternal and perinatal outcomes are improved if a remission is achieved. Corticosteroids are the drugs of choice (51,53), given either as an increased oral form or intravenous methylprednisolone 500 mg daily for 3 days. Azathioprine can be used safely in pregnancy and during lactation (51,53). Hydroxychloroquine, often used to prevent flares, seems to be safe for use in pregnancy and should not be stopped in early pregnancy (51–53). Antiphospholipid-positive patients should be started on at least low-dose heparin to prevent thrombosis (52). The use of low-dose aspirin has been advocated for prevention of pre-eclampsia in patients at risk.
Hydroxychloroquine/chloroquine and the risk of acute kidney injury in COVID-19 patients: a systematic review and meta-analysis
Published in Renal Failure, 2022
Zheng-Ming Liao, Zhong-Min Zhang, Qi Liu
Table 1 presents the main characteristics of the included studies. Among the 21 included studies, 14 considered AKI outcomes, and seven analyzed increased creatinine levels. Of the 14 studies on AKI, six were RCTs, six were cohort studies, and two were nested case-control studies. For the seven studies on increased creatinine levels, six were RCTs, and one was a cohort study. For the 21 studies, 13 clearly specified the age range, with 12 focusing on adults and one focusing on children. The daily total dosage of hydroxychloroquine/chloroquine ranged from 200 mg to 1200 mg (available from 18 studies), with 13 studies providing 400 mg, two studies providing 200 mg, one study providing 600 mg, one study providing 800 mg, and one study providing 1200 mg. The follow-up for the safety outcomes ranged from 3 to 42 days, while three studies did not provide such information. Eight studies were conducted in Europe, seven in Asia, and six in America.
Drug repurposing strategies and key challenges for COVID-19 management
Published in Journal of Drug Targeting, 2022
Shubham Mule, Ajit Singh, Khaled Greish, Amirhossein Sahebkar, Prashant Kesharwani, Rahul Shukla
A randomised clinical trial was done to assess the therapeutic utility of hydroxychloroquine in COVID-19 infection in 31 infected individuals by administering 400 mg per day of hydroxychloroquine [158]. The study involved 62 patients, out of which 31 were without treatment with hydroxychloroquine. Out of the 31 individuals who were treated with hydroxychloroquine, around 80.6% exhibited improvement in the symptoms of pneumonia [158]. However, the side effects associated with hydroxychloroquine like liver abnormalities, gastric problems, muscle cramps and headache were observed. Azithromycin is administered along with hydroxychloroquine to achieve better clinical results and speedy recovery. Around 53 clinical trials were done by September 2020 to determine the utility of azithromycin in combination with other categories of drugs in COVID-19 management [154].
Immune Responses to the Novel Coronavirus-2: Friend or Foe?
Published in Immunological Investigations, 2021
Ata Mahmoodpoor, Nader D. Nader
Controversy still exists in using immunomodulating agents to treat COVID-19 disease. Among these remedies, chloroquine and its hydroxy form have been used in China initially and were adopted elsewhere. Hydroxychloroquine is an antimalarial agent that is commonly used in patients with auto immune diseases such as rheumatoid arthritis. The original recommendation was based on anecdotal observations of less severity and fatality in patients who were taking these medications for other indications. Due to the rapid spread of the disease, and the lack of other treatment alternatives, several clinicians empirically used hydroxychloroquine alone or in combination with a macrolide antibacterial, azithromycin, to treat COVID-19 disease without available robust controlled trials. Recent studies failed to show any anticipated benefits with use of hydroxychloroquine, as it failed to alter the course of the disease in terms of decreasing the severity of the resultant respiratory distress and the mortality rate (Rosenberg et al. 2020). On its defense, in all studies that examined the efficacy of hydroxychloroquine, the drug was started well after an exuberant cytokine/inflammatory response had already started. Therefore, there may still be some theoretical benefit in its early initiation to prevent the immune response from activation. Additionally, due to non-randomized design of this study, hydroxychloroquine was more likely to be administered to patients who suffered from other systemic co-morbidities.