Combination of convalescent plasma therapy and repurposed drugs to treat severe COVID‐19 patient with multimorbidity

Das, Santa Kumar; Ranabhat, Kamal; Bhattarai, Suraj; Karki, Kshitij; Paneru, Hem Raj; Nepal, Bipin; Dumre, Shyam Prakash; Acharya, Subhash Prasad

doi:10.1002/ccr3.3964

Cited by 3 publications

(3 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Lack of standard protocols for screening and testing of COVID-19 suspects, lack of clear treatment guidelines, and dilemma about prognosis scoring of critical patients were found to be the major ethical challenges faced by the majority of physicians. A similar scenario was prevalent in India, South Africa, the UK, and globally (16,35,38). Particularly, it was unclear when to end the quarantine, isolation, or hospitalization requirements, not only for the patients but also for the exposed healthcare workers.…”

Section: Discussionmentioning

confidence: 91%

Participatory Approach to Develop Evidence-Based Clinical Ethics Guidelines for the Care of COVID-19 Patients: A Mixed Method Study From Nepal

Bhattarai¹,

Adhikari²,

Rayamajhee³

et al. 2022

Front. Public Health

Self Cite

View full text Add to dashboard Cite

During health emergencies such as the COVID-19 pandemic, healthcare workers face numerous ethical challenges while catering to the needs of patients in healthcare settings. Although the data recapitulating high-income countries ethics frameworks are available, the challenges faced by clinicians in resource-limited settings of low- and middle-income countries are not discussed widely due to a lack of baseline data or evidence. The Nepali healthcare system, which is chronically understaffed and underequipped, was severely affected by the COVID-19 pandemic in its capacity to manage health services and resources for needy patients, leading to ethical dilemmas and challenges during clinical practice. This study aimed to develop a standard guideline that would address syndemic ethical dilemmas during clinical care of COVID-19 patients who are unable to afford standard-of-care. A mixed method study was conducted between February and June of 2021 in 12 government designated COVID-19 treatment hospitals in central Nepal. The draft guideline was discussed among the key stakeholders in the pandemic response in Nepal. The major ethical dilemmas confronted by the study participants (50 healthcare professionals providing patient care at COVID-19 treatment hospitals) could be grouped into five major pillars of ethical clinical practice: rational allocation of medical resources, updated treatment protocols that guide clinical decisions, standard-of-care regardless of patient's economic status, effective communication among stakeholders for prompt patient care, and external factors such as political and bureaucratic interference affecting ethical practice. This living clinical ethics guideline, which has been developed based on the local evidence and case stories of frontline responders, is expected to inform the policymakers as well as the decision-makers positioned at the concerned government units. These ethics guidelines could be endorsed with revisions by the concerned regulatory authorities for the use during consequent waves of COVID-19 and other epidemics that may occur in the future. Other countries affected by the pandemic could conduct similar studies to explore ethical practices in the local clinical and public health context.

show abstract

Section: Discussionmentioning

confidence: 91%

Participatory Approach to Develop Evidence-Based Clinical Ethics Guidelines for the Care of COVID-19 Patients: A Mixed Method Study From Nepal

Bhattarai¹,

Adhikari²,

Rayamajhee³

et al. 2022

Front. Public Health

Self Cite

View full text Add to dashboard Cite

show abstract

“…Several case reports of successful concomitant use of Remdesivir and CP in treating patients with severe COVID-19 infections have been reported in literature [35][36][37][38]. A single clinical trial conducted in Nepal has evaluated treatment of COVID-19 in hospitalized patients with Remdesivir, CP or both.…”

Section: Discussionmentioning

confidence: 99%

Convalescent Plasma for COVID-19- is it Time to Say Goodbye? A Single-Center, Retrospective, Observational Study from Northern India

Setia

Dogra

Thangavel

et al. 2021

IBRR

View full text Add to dashboard Cite

Background: COVID-19 pandemic continues threatening the world with no effective treatment to tackle the menace. Till date, there is conflicting evidence on efficacy of CP in reducing COVID-19 related mortality. The objective of this study was to see disease progression and 7, 14 and 28-day mortality after CP therapy and analyze CP efficacy with/without Remdesivir. Materials and Methods: A retrospective single-centre observational study done from August 20, 2020, to 20 November 2020. Records of 294 COVID-19 patients with moderate to severe disease given CP therapy were analysed based on disease progression and length of hospital stay, further subcategorized on age, clinical profile, risk factors, ward/ICU, ventilatory support and co-administration of Remdesivir. Results: Lowest 7-day mortality rate was seen within age group 20-40 years (0%) and was highest in ≥61 years (24.3%). 87 patients on ventilatory support showed higher 28day mortality (48.28%) compared to non-ventilated (10.14%), (P<0.00001). Lesser 7-day mortality was seen in early CP therapy ≤3 days of admission (P=0.01). Patients requiring ICU admission showed higher 14 and 28-day mortality compared to ward P=0.001%). Median (IQR) length of hospital stay from CP transfusion was shorter, 4 (3 to 9) days in group 2 (CP only) compared to 7 (4 to 12) days in group1 (CP+Remdesivir ). Conclusion: CP therapy in ≤3 days of hospital admission in COVID-19 patients with moderate to severe infection not on ventilatory support showed reduction in mortality and length of hospital stay. Length of hospital stay was shorter in the CP-only group as compared to the CP+ Remdesivir group.

show abstract

“…In Nepal, convalescent plasma showed beneficial effects against COVID-19, but larger, randomized controlled trials are required to confirm its efficacy. 118 …”

Section: Treatment Options Against Sars-cov-2 Infection In Nepalmentioning

confidence: 99%

Understanding COVID-19 Situation in Nepal and Implications for SARS-CoV-2 Transmission and Management

Dawadi

Syangtan

Lama

et al. 2022

Environ�Health�Insights

View full text Add to dashboard Cite

Background: The pandemic of Coronavirus Disease 2019 (COVID-19), one of the most infectious diseases in the modern history, is caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) and has had a profound health and economic toll, globally. This paper identifies the overall health status associated with COVID-19 pandemic in all 7 provinces of Nepal, a developing country in South Asia, analyzing data from January 2020 to February 2022. It focuses on the SARS-CoV-2 prevalence, transmission through wastewater and other routes, diagnostics, treatment options, and alternative medicines, thereby offering key perspectives for its management. Materials and Methods: Studies regarding coronavirus spanning the 2017 to 2022 period were searched on the web, Nepalese database, and Web of Science. Refined criteria included SARS-CoV-2 in wastewater of Nepal or worldwide. Demographic data (sex, age-group, and geographic location) were also obtained from websites and relevant reports of the Ministry of Health and Population (MOHP) of Nepal, ranging from January 2020 to February 2022. Moreover, trends concerning lockdown, business, and border activities in Nepal between February 2020 and October 2020 were evaluated. The viral dissemination pathways, diagnosis, and available treatment options, including the Ayurvedic medicine, were also examined. Results: Aerosols generated during the hospital, industrial, recreational, and household activities were found to contribute to the propagation of SARS-CoV-2 into environmental wastewater, thereby putting the surrounding communities at risk of infection. When lockdown ended and businesses opened in October 2020, the number of active cases of COVID-19 increased exponentially. Bagmati Province had the highest number of cases (53.84%), while the remaining 6 provinces tallied 46.16%. Kathmandu district had the highest number of COVID-19 cases (138, 319 cases), while Manang district had the smallest number of infections (81 cases). The male population was found to be predominantly infected (58.7%). The most affected age groups were the 31 to 40 years old males (25.92%) and the 21 to 30 years old females (26.85%). Conclusion: The pandemic impacted the public health and economic growth in our study duration. SARS-CoV-2 was prevalent in the wastewater of Nepal. The Terai districts and the megacities were mostly affected by SARS-CoV-2 infections. Working-age groups and males were identified as the highest risk groups. More investigations on the therapeutic and alternative cures are recommended. These findings may guide the researchers and professionals with handling the COVID-19 challenges in developing countries such as Nepal and better prepare for future pandemics.

show abstract

Combination of convalescent plasma therapy and repurposed drugs to treat severe COVID‐19 patient with multimorbidity

Abstract: Combination of convalescent plasma therapy and repurposed drugs such as dexamethasone and remdesivir could be beneficial for severe COVID‐19 patients with obesity and chronic diseases such as diabetes and hypertension.

Cited by 3 publications

References 17 publications

Participatory Approach to Develop Evidence-Based Clinical Ethics Guidelines for the Care of COVID-19 Patients: A Mixed Method Study From Nepal

Participatory Approach to Develop Evidence-Based Clinical Ethics Guidelines for the Care of COVID-19 Patients: A Mixed Method Study From Nepal

Convalescent Plasma for COVID-19- is it Time to Say Goodbye? A Single-Center, Retrospective, Observational Study from Northern India

Understanding COVID-19 Situation in Nepal and Implications for SARS-CoV-2 Transmission and Management

Contact Info

Product

Resources

About