SARS-CoV-2 infection and the COVID-19 pandemic: a call to action for therapy and interventions to resolve the crisis of hospitalization, death, and handle the aftermath

McCullough, Peter A.; Vijay, Kris

doi:10.31083/j.rcm.2021.01.301

Cited by 7 publications

(6 citation statements)

References 18 publications

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“…Alexander et al demonstrated that any one of a variety of medical regimens applied in nursing home residents was associated with an approximately 60% reduction in mortality compared with patients who received no medical therapy [ 51 ]. McCullough et al published a sequential, multi-drug regimen demonstrating that a combination of 4 to 6 pharmacological agents can reduce the risk of hospitalization and death by 85% [ 49 , 52 , 54 ]. This evidence is also supported by Derwand et al [ 55 ].…”

Section: Discussionmentioning

confidence: 99%

Retrospective Study of Outcomes and Hospitalization Rates of Patients in Italy with a Confirmed Diagnosis of Early COVID-19 and Treated at Home Within 3 Days or After 3 Days of Symptom Onset with Prescribed and Non-Prescribed Treatments Between November 2020 and August 2021

et al. 2021

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Background This retrospective study aimed to investigate outcomes and hospitalization rates in patients with a confirmed diagnosis of early COVID-19 treated at home with prescribed and non-prescribed treatments. Material/Methods The medical records of a cohort of 158 Italian patients with early COVID-19 treated at home were analyzed. Treatments consisted of indomethacin, low-dose aspirin, omeprazole, and a flavonoid-based food supplement, plus azithromycin, low-molecular-weight heparin, and betamethasone as needed. The association of treatment timeliness and of clinical variables with the duration of symptoms and with the risk of hospitalization was evaluated by logistic regression. Results Patients were divided into 2 groups: group 1 (n=85) was treated at the earliest possible time (<72 h from onset of symptoms), and group 2 (n=73) was treated >72 h after the onset of symptoms. Clinical severity at the beginning of treatment was similar in the 2 groups. In group 1, symptom duration was shorter than in group 2 (median 6.0 days vs 13.0 days, P <0.001) and no hospitalizations occurred, compared with 19.18% hospitalizations in group 2. One patient in group 1 developed chest X-ray alterations and 2 patients experienced an increase in D-dimer levels, compared with 30 and 22 patients, respectively, in group 2. The main factor determining the duration of symptoms and the risk of hospitalization was the delay in starting therapy ( P <0.001). Conclusions This real-world study of patients in the community showed that early diagnosis and early supportive patient management reduced the severity of COVID-19 and reduced the rate of hospitalization.

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Section: Discussionmentioning

confidence: 99%

Retrospective Study of Outcomes and Hospitalization Rates of Patients in Italy with a Confirmed Diagnosis of Early COVID-19 and Treated at Home Within 3 Days or After 3 Days of Symptom Onset with Prescribed and Non-Prescribed Treatments Between November 2020 and August 2021

et al. 2021

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“…Because this approach is associated with 85% reductions in hospitalization, differences in access to this therapy may account for some of the differences observed. 22 , 23 , 24 Fourth, the models did not control for other policies and measures, such as school closures, mobility restrictions, physical distancing recommendations, and vaccinations. It was assumed that these could not directly affect demand for hospitalization, but only indirectly via changes in the case count.…”

Section: Discussionmentioning

confidence: 99%

“…The present analysis does not account for, inter alia, utilization of early sequenced multidrug therapy for COVID‐19. Because this approach is associated with 85% reductions in hospitalization, differences in access to this therapy may account for some of the differences observed 22‐24 . Fourth, the models did not control for other policies and measures, such as school closures, mobility restrictions, physical distancing recommendations, and vaccinations.…”

Section: Discussionmentioning

confidence: 99%

Disparities in demand for COVID‐19 hospital care in the United States: Insights from a longitudinal hierarchical study

Messner

2022

Health Science Reports

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Background and aims This study examined disparities in hospitalization for COVID‐19 within the U.S. by racial and ethnic groups, health insurance status, and social support structure. Methods Using publicly available ecological case and contextual data from July 2020 to April 2021, a longitudinal hierarchical model for the 51 U.S. states was constructed. Results Racial/ethnic disparities were observed, such as that hospitalization rates were higher in states with a higher percentage of Black ( β = .002, P = .009) and American Indian or Alaska Native persons ( β = .003, P = .03). Conversely, lack of health insurance was related to a lower hospitalization rate ( β = −.005, P = .002), and so was a stronger social support system ( β = −.015, P = .05). Conclusion These differences suggest disparities in COVID‐19 incidence, symptom severity, and demand for hospital care. Understanding how they contribute to geographic differences in hospitalization can help guide public health decisions and resource allocation to address COVID‐19‐related health inequalities.

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“…In such patients, lacking a widely approved therapeutic strategy and pending evidence-based guidance, the health authorities suggest a “watchful waiting” or “monitoring” of clinical evolution and the use of symptomatic drugs, such as paracetamol or non-steroidal anti-inflammatory agents (NSAIDs), unless there are specific contraindications. However, lack of treatment in the first 72 h or limiting it to symptomatic medications could be risky in many patients, whose disease is destined to progress to more severe forms [ 1 – 4 ]. Indeed, many patients have a significant increase in D-dimer levels, an indicator of thrombosis, which correlates with a worse prognosis [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

A Review of the Potential Roles of Antioxidant and Anti-Inflammatory Pharmacological Approaches for the Management of Mild-to-Moderate Symptomatic COVID-19

2022

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In the past 2 years, the coronavirus disease 2019 (COVID-19) pandemic has driven investigational studies and controlled clinical trials on antiviral treatments and vaccines that have undergone regulatory approval. Now that the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its variants may become endemic over time, there remains a need to identify drugs that treat the symptoms of COVID-19 and prevent progression toward severe cases, hospitalization, and death. Understanding the molecular mechanisms of SARS-CoV-2 infection is extremely important for the development of effective therapies against COVID-19. This review outlines the key pathways involved in the host response to SARS-CoV-2 infection and discusses the potential role of antioxidant and anti-inflammatory pharmacological approaches for the management of early mild-to-moderate COVID-19, using the examples of combined indomethacin, low-dose aspirin, omeprazole, hesperidin, quercetin, and vitamin C. The pharmacological targets of these substances are described here for their possible synergism in counteracting SARS-CoV-2 replication and progression of the infection from the upper respiratory airways to the blood, avoiding vascular complications and cytokine and bradykinin storms.

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SARS-CoV-2 infection and the COVID-19 pandemic: a call to action for therapy and interventions to resolve the crisis of hospitalization, death, and handle the aftermath

Cited by 7 publications

References 18 publications

Retrospective Study of Outcomes and Hospitalization Rates of Patients in Italy with a Confirmed Diagnosis of Early COVID-19 and Treated at Home Within 3 Days or After 3 Days of Symptom Onset with Prescribed and Non-Prescribed Treatments Between November 2020 and August 2021

Retrospective Study of Outcomes and Hospitalization Rates of Patients in Italy with a Confirmed Diagnosis of Early COVID-19 and Treated at Home Within 3 Days or After 3 Days of Symptom Onset with Prescribed and Non-Prescribed Treatments Between November 2020 and August 2021

Disparities in demand for COVID‐19 hospital care in the United States: Insights from a longitudinal hierarchical study

A Review of the Potential Roles of Antioxidant and Anti-Inflammatory Pharmacological Approaches for the Management of Mild-to-Moderate Symptomatic COVID-19

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