Monkeypox virus infection is a recognized public health emergency. Little research has been done on treatment options for this disease. Until recently, there was not a single published work describing the usage of specific drugs in human patients with monkeypox virus infection. This paper gives the first bibliometric analysis of monkeypox treatment options based on data available on PubMed and Scopus. It also reviews the specific drugs used in the treatment of monkeypox. That includes data on Tecovirimat, Cidofovir, Brincidofovir, and Vaccinia Immune Globulin. Tecovirimat is a promising option in progressive disease in terms of efficacy and safety. However, Brincidofovir has been associated with discontinuation of treatment. Cidofovir is also not the preferred drug among physicians. Currently, Tecovirimat can be further used for the management of aggravating cases. More studies should be conducted on Tecovirimat to treat this condition, mainly through controlled trials.
Mpox (earlier known as monkeypox) virus infection is a recognized public health emergency. There has been little research on the treatment options. This article reviews the specific drugs used to treat mpox virus infection and the vaccines used here. Instead of focusing on the mechanistic basis, this review narrates the practical, real-life experiences of individual patients of mpox virus disease being administered these medicines. We conducted a bibliometric analysis on the treatment of the mpox virus using data from several databases like PubMed, Scopus, and Embase. The research on this topic has grown tremendously recently but it is highly concentrated in a few countries. Cidofovir is the most studied drug. This is because it is indicated and also used off-label for several conditions. The drugs used for mpox virus infection include tecovirimat, cidofovir, brincidofovir, vaccinia immune globulin, and trifluridine. Tecovirimat is used most frequently. It is a promising option in progressive mpox disease in terms of both efficacy and safety. Brincidofovir has been associated with treatment discontinuation due to elevated hepatic enzymes. Cidofovir is also not the preferred drug, often used because of the unavailability of tecovirimat. Trifluridine is used topically as an add-on agent along with tecovirimat for ocular manifestations of mpox virus disease. No study reports individual patient data for vaccinia immune globulin. Though no vaccine is currently approved for mpox virus infection, ACAM 2000 and JYNNEOS are the vaccines being mainly considered. ACAM 2000 is capable of replicating and may cause severe adverse reactions. It is used when JYNNEOS is contraindicated. Several drugs and vaccines are under development and have been discussed alongside pragmatic aspects of mpox virus treatment and prevention. Further studies can provide more insight into the safety and efficacy of Tecovirimat in actively progressing mpox virus disease.
BackgroundThroughout the surge of the COVID-19 pandemic high rate of chronic diseases have been reported, including respiratory diseases and cardiovascular diseases. The prevalence of coronary artery disease has remained high throughout the COVID-19 pandemic, which also draws great concern towards it. This study seeks to provide a pooled estimate of the burden of coronary artery disease in COVID-19.ObjectiveTo estimate the overall prevalence of coronary artery disease among COVID-19 patientsData SourcesIn this systematic review and meta-analysis, an extensive literature search was conducted in PubMed, Scopus, Embase, EBSCO, Web of Science, Cochrane,Proquest and preprint servers (medRxiv, arXiv, bioRxiv, BioRN, ChiRxiv, ChiRN, and SSRN). References fo eligible articles, forward citation tracking, and expert opinion were used to identify other relevant articles. All published articles until 13 April 2023 were assessed as per the PROSPERO registration protocol (CRD42022367501).Study Selection, Data Extraction, and SynthesisPrimary studies that reported coronary artery disease among COVID-19 patients were included. The characteristics of the study and information on the number of cases of coronary artery disease were extracted from the included studies. Individual study estimates were pooled using the random intercept logistic regression model. The heterogeneity between the selected studies was assessed using the I2statistic, tau, tau-squared, Cochran’s Q. Prediction interval was used to identify the range into which future studies are expected to fall. Subgroup analysis based on geography (continent) was done to reduce heterogeneity. Publication bias was analyzed using doi plot and LFK index. The risk of bias in the studies was assessed as per the tools proposed by the National Institute of Health.Main outcomesThe primary outcome was the pooled prevalence of coronary artery disease among COVID-19 patients within the examined population.Results510 records were initially retrieved from electronic databases in addition to other sources like reference screening. 33 studies with 40,064 COVID-19 patients were included for quantitative synthesis. The prevalence of coronary artery disease among COVID-19 patients was 15.24% (95% CI: 11.41% - 20.06%). The prediction interval ranged from 2.49% to 55.90%. The studies were highly heterogeneous (tau-sqaured of 0.89), and subgroup analysis significantly reduced it (test of moderators: Q = 14.77, df=2, P=.002). Europe reported the highest prevalence [21.70% (14.80% - 30.65%)], and Asia has the least prevalence [10.07% (6.55% - 15.19%)]. Meta-regression for sample size was not significant (P=.11). A symmetric doi plot and an LFK index of 0.57 revealed no evidence of publication bias or small-study effects.ConclusionThe burden of coronary artery disease has been considerable, varying with geography. and further research in this area is needed. Routine cardiac screening and assessment of COVID-19 patients can help uncover undiagnosed cases, and better optimise the management of all COVID-19 patients.
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