What to expect from different drugs used in the treatment of COVID-19: A study on applications and in vivo and in vitro results
EUROPEAN JOURNAL OF PHARMACOLOGY
Authors: Marcolino, Vanessa Aparecida; Pimentel, Tatiana Colombo; Barao, Carlos Eduardo
The end of 2019 was marked by the emergence of a new type of coronavirus (SARS-CoV-2), which has killed more than 240,000 people around the world so far. Several clinical studies are being performed to test possible drugs in response to the COVID-19 outbreak; however, there is still no treatment that is completely effective. Our goal in this paper is to bring together the results of main studies carried out with different drugs in order to help spread the knowledge about possible treatments for COVID-19 that have been suggested so far.
Monitoring of viral load by RT-PCR caused decision making to continue ECMO therapy for a patient with COVID-19
JOURNAL OF INFECTION AND CHEMOTHERAPY
Authors: Sakamaki, Ippei; Morinaga, Yoshitomo; Tani, Hideki; Takegoshi, Yusuke; Fukui, Yasutaka; Kawasuji, Hitoshi; Ueno, Akitoshi; Miyajima, Yuki; Wakasugi, Masahiro; Kawagishi, Toshiomi; Kuwano, Hroyuki; Hatano, Tomoya; Shibuya, Tadaki; Okudera, Hiroshi; Yamamoto, Yoshihiro
Most patients with coronavirus disease 2019 (COVID-19) have just only mild symptoms, but about 5% are very severe. Although extracorporeal membranous oxygenation (ECMO) is sometimes used in critically patients with COVID-19, ECMO is only an adjunct, not the main treatment. If the patient's condition deteriorates and it is determined to be irreversible, it is necessary to decide to stop ECMO. A 54-year-old man was admitted on day 6 of onset with a chief complaint of high fever and cough. Computed tomography (CT) showed a ground glass opacity in both lungs, and reverse transcription-polymerase chain reaction (RT-PCR) diagnosed COVID-19. He was admitted to the hospital and started to receive oxygen and favipiravir. After that, his respiratory condition deteriorated, and he was intubated and ventilated on day 9 of onset, and ECMO was introduced on day 12. Two days after the introduction of ECMO, C-reactive protein (CRP) increased, chest X-p showed no improvement in pneumonia, and PaO2/FiO2 decreased again. As D-dimer rose and found a blood clot in the ECMO circuit, we had to decide whether to replace the circuit and continue with ECMO or stop ECMO. At this time, the viral load by RTPCR was drastically reduced to about 1/1750. We decided to continue ECMO therapy and replaced the circuit. The patient's respiratory status subsequently improved and ECMO was stopped on day 21 of onset. In conclusion, viral load measurement by RT-PCR may be one of the indicators for promoting the treatment of severe COVID-19 patients. (c) 2020 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.