Infectious Disease Reports

5 pages, 973 KiB

Open AccessCase Report

Generalized Tetanus in a Canadian Farmer Following Orthopedic Surgery

by Utkarsh Chauhan, Anukul Ghimire, Milan Raval, Curtiss Boyington, Adrienne Haponiuk, Gregory Koller, Jeffrey Korzan and Elaine Yacyshyn

Infect. Dis. Rep. 2022, 14(2), 273-277; https://doi.org/10.3390/idr14020033 - 13 Apr 2022

Viewed by 3060

Abstract

Tetanus is extremely rare in developed countries. We report the first documented case of tetanus in the province of Alberta since 2016: a farmer that developed trismus, shoulder stiffness, and fevers eight days following orthopedic surgery. Tetanus immunoglobulin elicited rapid recovery. We highlight [...] Read more.

Tetanus is extremely rare in developed countries. We report the first documented case of tetanus in the province of Alberta since 2016: a farmer that developed trismus, shoulder stiffness, and fevers eight days following orthopedic surgery. Tetanus immunoglobulin elicited rapid recovery. We highlight risk factors, pathogenesis, epidemiology, and diagnostic challenges. Full article

(This article belongs to the Special Issue Feature Papers in Infectious Diseases)

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7 pages, 502 KiB

Open AccessArticle

Evaluating the Use of Dalbavancin for Off-Label Indications

by Katherine Taylor, John Williamson, Vera Luther, Tyler Stone, James Johnson, Zachary Gruss, Courtney Russ-Friedman, Chris Ohl and James Beardsley

Infect. Dis. Rep. 2022, 14(2), 266-272; https://doi.org/10.3390/idr14020032 - 11 Apr 2022

Cited by 13 | Viewed by 3522

Abstract

(1) Background: Dalbavancin is a long-acting lipoglycopeptide antibiotic approved for skin and soft-tissue infections. Post-marketing experience suggests dalbavancin is being used for off-label indications that normally require long-term intravenous (IV) antibiotics; however, data assessing this off-label usage are limited. The purpose of this [...] Read more.

(1) Background: Dalbavancin is a long-acting lipoglycopeptide antibiotic approved for skin and soft-tissue infections. Post-marketing experience suggests dalbavancin is being used for off-label indications that normally require long-term intravenous (IV) antibiotics; however, data assessing this off-label usage are limited. The purpose of this study was to evaluate the real-world efficacy, safety, and financial impact of off-label dalbavancin use. (2) Methods: This is a retrospective, observational study conducted within a 4-hospital health system. Adult patients who received dalbavancin from January 2018 to January 2021 for an off-label indication were included. The primary outcome was clinical success at 90 days. Secondary outcomes included safety (nephrotoxicity and hepatotoxicity). A pharmacoeconomic analysis was performed by comparing the cost of dalbavancin to the anticipated cost of patient stay if standard IV therapy was given. (3) Results: Forty-eight patients met study criteria. Indications included osteomyelitis (54%), endocarditis (23%), bacteremia (15%), and prosthetic joint infection (8%). The predominant organism was S. aureus (60%), with 42% caused by methicillin-resistant S. aureus. Overall, 41 (85%) patients achieved clinical success at 90 days, including 85% with osteomyelitis, 82% with endocarditis, and 86% with bacteremia. There were no instances of nephrotoxicity or hepatotoxicity. Estimated cost avoidance per patient was USD 5313 and USD 1683 if traditional IV therapy would have been completed in the hospital and skilled nursing facility, respectively. (4) Conclusion: Dalbavancin was associated with a relatively high success rate for the treatment of off-label indications and may be a cost-effective alternative to traditional IV antibiotic therapy. Full article

(This article belongs to the Special Issue Feature Papers in Infectious Diseases)

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8 pages, 1493 KiB

Open AccessCommunication

First Molecular Identification of Three Clinical Isolates of Fungi Causing Mucormycosis in Honduras

by Bryan Ortiz, Isis Laínez-Arteaga, Celeste Galindo-Morales, Lilia Acevedo-Almendárez, Kateryn Aguilar, Diana Valladares, Miriam López and Gustavo Fontecha

Infect. Dis. Rep. 2022, 14(2), 258-265; https://doi.org/10.3390/idr14020031 - 7 Apr 2022

Cited by 3 | Viewed by 3110

Abstract

Mucormycoses are rare but serious opportunistic fungal infections caused by filamentous organisms of the order Mucorales. Here we report the first molecular identification of Rhizopus oryzae (heterotypic synonym Rhizopus arrhizus), R. delemar, and Apophysomyces ossiformis as the etiological agents of [...] Read more.

Mucormycoses are rare but serious opportunistic fungal infections caused by filamentous organisms of the order Mucorales. Here we report the first molecular identification of Rhizopus oryzae (heterotypic synonym Rhizopus arrhizus), R. delemar, and Apophysomyces ossiformis as the etiological agents of three cases of severe mucormycosis in Honduras. Conventional microbiological cultures were carried out, and DNA was extracted from both clinical samples and axenic cultures. The ITS ribosomal region was amplified and sequenced. Molecular tools are suitable strategies for diagnosing and identifying Mucorales in tissues and cultures, especially in middle-income countries lacking routine diagnostic strategies. Full article

(This article belongs to the Section Fungal Infections)

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8 pages, 1785 KiB

Open AccessArticle

Aluminium Gauze Reduces SARS-CoV-2 Viral Load in Non-Woven Masks Worn by Patients with COVID-19

by Yuto Yasuda, Satoru Mutsuo, Motoaki Hamada, Kazuo Murai, Yutaka Hirayama, Kiyoshi Uemasu, Soichi Arasawa, Daisuke Iwashima and Ken-ichi Takahashi

Infect. Dis. Rep. 2022, 14(2), 250-257; https://doi.org/10.3390/idr14020030 - 6 Apr 2022

Cited by 2 | Viewed by 2705

Abstract

Background: Aluminium reduces severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) survival in experimental settings. It is unknown whether adding an aluminium gauze to a mask reduces the SARS-CoV-2 RNA load in the mask and whether SARS-CoV-2 is detectable in the breath that permeates [...] Read more.

Background: Aluminium reduces severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) survival in experimental settings. It is unknown whether adding an aluminium gauze to a mask reduces the SARS-CoV-2 RNA load in the mask and whether SARS-CoV-2 is detectable in the breath that permeates through such a mask in clinical settings. Methods: Patients admitted to Kishiwada City Hospital, Osaka, Japan, between July 2021 and September 2021 were enrolled in the study. Non-woven masks comprising filters with 99% viral filtration efficacy and aluminium and cotton gauzes attached to plastic collection cases were developed. All participants wore the experimental mask models for three hours. Results: Twenty-nine patients who wore the final model masks were analysed in this study. The Ct values of the nucleocapsid gene and envelope gene of SARS-CoV-2 were significantly higher in the aluminium gauze than in the cotton gauze. SARS-CoV-2 RNA was detected in the masks of 8 out of 12 vaccinated patients (66.7%). Although breath condensates were collected behind both aluminium and cotton gauzes, SARS-CoV-2 RNA was not detected in these condensates. Conclusions: Our study indicated that non-woven masks with an aluminium gauze may obstruct SARS-CoV-2 transmission in clinical settings better than non-woven masks with cotton gauzes. Full article

(This article belongs to the Special Issue Feature Papers in Infectious Diseases)

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7 pages, 1144 KiB

Open AccessCommunication

Conservation and Enhanced Binding of SARS-CoV-2 Omicron Spike Protein to Coreceptor Neuropilin-1 Predicted by Docking Analysis

by Piyush Baindara, Dinata Roy, Santi M. Mandal and Adam G. Schrum

Infect. Dis. Rep. 2022, 14(2), 243-249; https://doi.org/10.3390/idr14020029 - 29 Mar 2022

Cited by 19 | Viewed by 3606

Abstract

The Omicron variant of SARS-CoV-2 bears peptide sequence alterations that correlate with a higher infectivity than was observed in the original SARS-CoV-2 isolated from Wuhan, China. We analyzed the CendR motif of spike protein and performed in silico molecular docking with neuropilin-1 (Nrp1), [...] Read more.

The Omicron variant of SARS-CoV-2 bears peptide sequence alterations that correlate with a higher infectivity than was observed in the original SARS-CoV-2 isolated from Wuhan, China. We analyzed the CendR motif of spike protein and performed in silico molecular docking with neuropilin-1 (Nrp1), a receptor–ligand interaction known to support infection by the original variant. Our analysis predicts conserved and slightly increased energetic favorability of binding for Omicron CendR:Nrp1. We propose that the viral spike:Nrp1 coreceptor pathway may contribute to the infectivity of the Omicron variant of SARS-CoV-2. Full article

(This article belongs to the Section Viral Infections)

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15 pages, 402 KiB

Open AccessCase Report

Pulmonary Kaposi Sarcoma without Respiratory Symptoms and Skin Lesions in an HIV-Naïve Patient: A Case Report and Literature Review

by Cristina Micali, Ylenia Russotto, Alessio Facciolà, Andrea Marino, Benedetto Maurizio Celesia, Eugenia Pistarà, Grazia Caci, Giuseppe Nunnari, Giovanni Francesco Pellicanò and Emmanuele Venanzi Rullo

Infect. Dis. Rep. 2022, 14(2), 228-242; https://doi.org/10.3390/idr14020028 - 25 Mar 2022

Cited by 12 | Viewed by 3235

Abstract

Kaposi sarcoma (KS) is a multifocal lympho-angioproliferative, mesenchymal low-grade tumor associated with a γ2-herpesvirus, named Kaposi sarcoma-associated virus or human herpesvirus (KSHV/HHV8). The lung is considered a usual anatomical location of KS, despite being infrequent, often in association with extensive mucocutaneous lesions and [...] Read more.

Kaposi sarcoma (KS) is a multifocal lympho-angioproliferative, mesenchymal low-grade tumor associated with a γ2-herpesvirus, named Kaposi sarcoma-associated virus or human herpesvirus (KSHV/HHV8). The lung is considered a usual anatomical location of KS, despite being infrequent, often in association with extensive mucocutaneous lesions and very uncommonly as an isolated event. We report a case of a pulmonary KS (pKS) in a human immunodeficiency virus (HIV) naïve patient, which was atypical due to a lack of cutaneous involvement and an absence of respiratory symptoms. The pKS was initially identified as a tumoral suspected nodular lesion and only after immunohistochemical analysis was it characterized as KS. Furthermore, the diagnosis of pKS led to the discovery of the HIV-seropositive status of the patient, previously unknown. Our report underlines the importance of considering pKS even without skin lesions and as a first manifestation of HIV infection. We also reviewed literature on the current knowledge about pKS in people living with HIV (PLWH) to underline how one of the most common HIV/acquired immunodeficiency syndrome (AIDS) associated tumors can have a challenging localization and be difficult to recognize. Full article

(This article belongs to the Section Viral Infections)

8 pages, 246 KiB

Open AccessArticle

From Undetectable Equals Untransmittable (U=U) to Breastfeeding: Is the Jump Short?

by Tullio Prestileo, Sanfilippo Adriana, Di Marco Lorenza and Antonina Argo

Infect. Dis. Rep. 2022, 14(2), 220-227; https://doi.org/10.3390/idr14020027 - 25 Mar 2022

Cited by 19 | Viewed by 2824

Abstract

Background: Vertical transmission of HIV infection may occur during pregnancy, at childbirth or through breastfeeding. Recommendations on the safety of breastfeeding of HIV-infected women on effective antiretroviral treatment are not univocal among international guidelines (WHO 2010, EACS 2017, DHHS 2017), leaving space for [...] Read more.

Background: Vertical transmission of HIV infection may occur during pregnancy, at childbirth or through breastfeeding. Recommendations on the safety of breastfeeding of HIV-infected women on effective antiretroviral treatment are not univocal among international guidelines (WHO 2010, EACS 2017, DHHS 2017), leaving space for variability at the patient’s level. Methods: We collected clinical, laboratory and outcome data from 13 HIV-infected pregnant women who, between March 2017 and June 2021, elected to breastfeed their children against specific medical advice. All mothers were on antiretroviral therapy with darunavir or raltegravir plus emtricitabine/tenofovir disoproxil and remained HIV-RNA undetectable and >400 cells/mmc CD4+ lymphocytes during pregnancy and breastfeeding. Prophylactic antiretroviral therapy (zidovudine for 4 weeks) was started immediately after birth in all newborns. The mean duration of breastfeeding was 5.4 months. Newborns were tested for HIV-RNA multiple times: at birth, 1, 3, and 6 months after birth, and 1, 3 and 6 months after the end of breastfeeding. Results: None of the infants were infected by HIV. Conclusions: Our experience, gathered in the setting of freedom of choice on the patient’s side, while insufficient to address the eventual safety of breastfeeding in HIV-infected mothers since the represented cohort is numerically irrelevant, supports the extension of the U=U (Undetectable Equals Untransmittable) paradigm to this setting. Since breastfeeding is often requested by women with HIV planning pregnancy, more extensive comparative studies should be performed. Full article

(This article belongs to the Section Infection Prevention and Control)

7 pages, 547 KiB

Open AccessArticle

Risk Factors Associated with Poor Outcome in Patients with Infective Endocarditis: An Italian Single-Center Experience

by Claudio Ucciferri, Antonio Auricchio, Carmine Cutone, Alessandro Di Gasbarro, Jacopo Vecchiet and Katia Falasca

Infect. Dis. Rep. 2022, 14(2), 213-219; https://doi.org/10.3390/idr14020026 - 21 Mar 2022

Cited by 4 | Viewed by 2863

Abstract

Background: Nowadays, infective endocarditis (IE) is still burdened by a high mortality. In the absence of an adequate prognostic stratification system, it is important to assess new predictors of poor outcomes. The aim of our study is to evaluate which factors were associated [...] Read more.

Background: Nowadays, infective endocarditis (IE) is still burdened by a high mortality. In the absence of an adequate prognostic stratification system, it is important to assess new predictors of poor outcomes. The aim of our study is to evaluate which factors were associated with higher mortality in IE patients. Methods: A retrospective cohort study enrolled patients with an IE diagnosis at the Infectious Diseases Clinic of the University ‘G. D’Annunzio’, Chieti, Italy from January 2013 to December 2019. For each patient, demographic, anamnestic and clinical information, embolic phenomena, laboratory and microbiologic data, treatment, and outcomes were collected and analyzed. A correlation analysis was performed. Results: Sixty-eight patients with EI were studied; among them, the mortality was 17.6%, 20.6%, and 23.5%, intra-hospital, at 1 month from discharge and at 6 months from discharge, respectively. Mortality was significantly correlated with age, estimated glomerular filtration rate, and procalcitonin values when considering either basal values (r = 0.266, p = 0.029), or values at 48–72 h from the start of an antibiotic therapy (r = 0.222; p < 0.05), cerebral embolization for 6-month mortality (r = 0.284; p = 0.019), and inadequate antibiotic therapy (r = 0.232, p < 0.05). Conclusions: Procalcitonin values, at EI diagnosis and at 48–72 h after starting antibiotics, are prognostic factors useful for stratifying patient risk, and for setting up a personalized treatment. Of note, cerebral embolization and an inappropriate empirical treatment were associated with a higher mortality in the short- and long-term. Full article

(This article belongs to the Section Bacterial Diseases)

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8 pages, 677 KiB

Open AccessCase Report

Pandoraea pnomenusa Superinfection in a Patient with SARS-CoV-2 Pneumonia: First Case in the Literature

by Diego Alejandro Cubides-Diaz, Natalia Muñoz Angulo, Daniel Augusto Martin Arsanios, Ana Lucia Ovalle Monroy, Daniel Ricardo Perdomo-Rodriguez and Maria Paula Del-Portillo

Infect. Dis. Rep. 2022, 14(2), 205-212; https://doi.org/10.3390/idr14020025 - 18 Mar 2022

Cited by 4 | Viewed by 3223

Abstract

Pandoraea pnomenusa is a Gram-negative bacterium of the Pandoraea genus and is mainly associated with the colonization of structurally abnormal airways. During the COVID-19 pandemic, many microorganisms have been associated with coinfection and superinfection in SARS-CoV-2 pneumonia, but so far, no coinfection or [...] Read more.

Pandoraea pnomenusa is a Gram-negative bacterium of the Pandoraea genus and is mainly associated with the colonization of structurally abnormal airways. During the COVID-19 pandemic, many microorganisms have been associated with coinfection and superinfection in SARS-CoV-2 pneumonia, but so far, no coinfection or superinfection by P. pnomenusa has been reported. We present the first case describing this association in a previously healthy patient. Clinical manifestations, treatment, and outcomes are shown. Full article

(This article belongs to the Section Bacterial Diseases)

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7 pages, 587 KiB

Open AccessArticle

Acute Stroke Care during COVID-19: National Data

by Grzegorz Miękisiak, Samuel D. Pettersson, Dariusz Szarek, Piotr Morasiewicz, Justyna Fercho, Stanisław Adamski, Lech Kipiński and Tomasz Szmuda

Infect. Dis. Rep. 2022, 14(2), 198-204; https://doi.org/10.3390/idr14020024 - 16 Mar 2022

Cited by 5 | Viewed by 3003

Abstract

(1) Background: The pandemic of COVID-19 and subsequent lockdown strategies had a profound impact on many aspects of everyday life. During this time the world faced the unprecedented crisis of healthcare disrupting timely care delivery. This study was designed to evaluate the impact [...] Read more.

(1) Background: The pandemic of COVID-19 and subsequent lockdown strategies had a profound impact on many aspects of everyday life. During this time the world faced the unprecedented crisis of healthcare disrupting timely care delivery. This study was designed to evaluate the impact of the pandemic on the acute treatment of stroke in Poland. (2) Methods: The national data on hospitalizations with stroke as a primary diagnosis were obtained from the National Health Fund of Poland. Poisson regression was used to determine the significance of the change in hospital admissions. The differences between proportions were analyzed using the “N-1” Chi-squared test. (3) Results: During the COVID-19 period, the number of hospitalizations dropped by 8.28% with a monthly nadir of 22.02 in April. On a monthly scale during 2020, the greatest decrease was 22.02%. The thrombolysis ratio was also affected, with the highest monthly drop of 15.51% in November. The overall number of in-hospital deaths did not change. (4) Conclusions: The pandemic caused a serious disruption of the acute care of stroke. There is no evidence that the quality of care was seriously compromised. Full article

(This article belongs to the Special Issue Feature Papers in Infectious Diseases)

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14 pages, 885 KiB

Open AccessReview

COVID-19 and the Endocrine System: A Review of the Current Information and Misinformation

by Samir Ahmed Mirza, Abdul Ahad Ehsan Sheikh, Michaela Barbera, Zainab Ijaz, Muhammad Ali Javaid, Rahul Shekhar, Suman Pal and Abu Baker Sheikh

Infect. Dis. Rep. 2022, 14(2), 184-197; https://doi.org/10.3390/idr14020023 - 11 Mar 2022

Cited by 33 | Viewed by 9754

Abstract

Coronavirus disease 2019 (COVID-19) infection primarily involves the respiratory system but has many noteworthy extra pulmonary manifestations as well. We write this review to highlight the basis of some pathophysiological mechanisms of COVID-19 infection-induced endocrine dysfunction. Different scientific databases and institutional websites were [...] Read more.

Coronavirus disease 2019 (COVID-19) infection primarily involves the respiratory system but has many noteworthy extra pulmonary manifestations as well. We write this review to highlight the basis of some pathophysiological mechanisms of COVID-19 infection-induced endocrine dysfunction. Different scientific databases and institutional websites were searched to collect and consolidate the most up-to-date data relating to COVID-19 infection and endocrine systems. Hypopituitarism, central diabetes insipidus, SIADH, thyroid abnormalities, hyperglycemia, adrenal insufficiency, orchitis and alteration in sperm morphology have been reported in case reports of patients with COVID-19 infection. Data focusing on COVID-19 vaccination was also searched to summarize the effect, if any, on the endocrine system. Endocrinopathies noted post COVID-19 vaccination, including cases of adrenal hemorrhage, new onset Type II Diabetes Mellitus and subacute thyroiditis, are also discussed in this review. This review calls attention to the misinformation relating to COVID-19 vaccination with supposed endocrine effects such as infertility and problems with pregnancy. Rebutting these misconceptions can help increase compliance and maximize COVID-19 vaccination to the public. Full article

(This article belongs to the Section Viral Infections)

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8 pages, 1463 KiB

Open AccessSystematic Review

Examining the Efficacy of Antimicrobial Therapy in Preventing the Development of Postinfectious Glomerulonephritis: A Systematic Review and Meta-Analysis

by Emily Bateman, Sara Mansour, Euchariachristy Okafor, Kedzie Arrington, Bo-Young Hong and Jorge Cervantes

Infect. Dis. Rep. 2022, 14(2), 176-183; https://doi.org/10.3390/idr14020022 - 7 Mar 2022

Cited by 6 | Viewed by 6306

Abstract

Postinfectious glomerulonephritis (PIGN) is an immune-mediated acute glomerulonephritis classically seen weeks after infection with Streptococcus pyogenes, although other infectious etiologies have emerged. While it has become increasingly rare in industrialized regions, it continues to affect children in developing countries. There has been [...] Read more.

Postinfectious glomerulonephritis (PIGN) is an immune-mediated acute glomerulonephritis classically seen weeks after infection with Streptococcus pyogenes, although other infectious etiologies have emerged. While it has become increasingly rare in industrialized regions, it continues to affect children in developing countries. There has been debate as to why incidence rates are declining, including the possibility of improved initial treatment of bacterial infections. The ability of antimicrobial therapy in preventing PIGN as infectious sequelae, however, has not been comprehensively assessed. As varying evidence from published studies exists, the objective of this meta-analysis is to determine if antimicrobial therapy utilized to treat an initial infection has an effect in reducing the development of PIGN in humans. EMBASE, MEDLINE, and CENTRAL were searched using a comprehensive terminology strategy. From an initial search that returned 337 publications, 9 articles were included for analysis. Eight studies showed an incidence of PIGN after antimicrobial use ranging from 0.05% to 10% with a mean standardized difference (MSD) of 0.03 (0.01–0.06). Three studies showed an occurrence of PIGN without antibiotic use ranging from 1% to 13% with an MSD of 0.06 (−0.09–0.21). Our findings suggest that antimicrobial treatment for the initial infection may help diminish the development of PIGN. Although Streptococcus pyogenes infections are generally treated aggressively to prevent rheumatic fever, these findings may help further support the early treatment of bacterial infections to prevent postinfectious sequelae, especially as we consider other infectious etiologies of PIGN antimicrobial resistance. Full article

(This article belongs to the Section Bacterial Diseases)

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7 pages, 1224 KiB

Open AccessCase Report

Alveolar Proteinosis Secondary to M. tuberculosis, in a Patient with Transient CD4 Lymphocytopenia Due to Cryptococcus neoformans Infection: First Case in the Literature

by Daniel Augusto Martin Arsanios, Diego Alejandro Cubides-Díaz, Natalia Muñoz-Angulo, Maria Alejandra Perez-Hernandez, Marlyn Zamora Posada, Mónica Briceño Torres and Carlos Mauricio Calderón Vargas

Infect. Dis. Rep. 2022, 14(2), 169-175; https://doi.org/10.3390/idr14020021 - 4 Mar 2022

Viewed by 2721

Abstract

Transient CD4 lymphocytopenia is defined as the transitory presence of CD4+ T lymphocyte fewer than 300 cells/mm³ or less than 20% of T cells without HIV infection. It can occur due to multiple causes; however, it is rare for it to occur [...] Read more.

Transient CD4 lymphocytopenia is defined as the transitory presence of CD4+ T lymphocyte fewer than 300 cells/mm³ or less than 20% of T cells without HIV infection. It can occur due to multiple causes; however, it is rare for it to occur due to opportunistic infections. Few cases have been described in the literature where antimicrobial treatment normalizes the CD4 count, being more frequent in Mycobacterium tuberculosis infections. To date, this phenomenon has not been described in Cryptococcus neoformans infections. This would be the first reported case according to our knowledge, of a patient who normalizes CD4 count after antifungal treatment, later developing alveolar proteinosis due to M. Tuberculosis. Full article

(This article belongs to the Section Tuberculosis and Mycobacteriosis)

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9 pages, 628 KiB

Open AccessArticle

Efficacy and Safety of Ivermectin and Hydroxychloroquine in Patients with Severe COVID-19: A Randomized Controlled Trial

by Jose Lenin Beltran Gonzalez, Mario González Gámez, Emanuel Antonio Mendoza Enciso, Ramiro Josue Esparza Maldonado, Daniel Hernández Palacios, Samuel Dueñas Campos, Itzel Ovalle Robles, Mariana Jocelyn Macías Guzmán, Andrea Lucia García Díaz, César Mauricio Gutiérrez Peña, Lucila Martinez Medina, Victor Antonio Monroy Colin and Jose Manuel Arreola Guerra

Infect. Dis. Rep. 2022, 14(2), 160-168; https://doi.org/10.3390/idr14020020 - 3 Mar 2022

Cited by 23 | Viewed by 11387

Abstract

During the first year of the COVID-19 pandemic, unauthorized drugs were widely used. Ivermectin and hydroxychloroquine are drugs that inhibit viral replication in vitro and that have been used in several medical centers. This clinical trial analyzes their efficacy in hospitalized patients with [...] Read more.

During the first year of the COVID-19 pandemic, unauthorized drugs were widely used. Ivermectin and hydroxychloroquine are drugs that inhibit viral replication in vitro and that have been used in several medical centers. This clinical trial analyzes their efficacy in hospitalized patients with moderate COVID-19. Methods: This a controlled, clinical, randomized, double-blind trial that included hospitalized patients with COVID-19-induced pneumonia, without severe respiratory failure. Patients were randomized to one of three groups: Group 1—hydroxychloroquine, 400 mg every 12 h on the first day and, subsequently, 200 mg every 12 h for 4 days; Group 2—ivermectin, 12 mg or 18 mg, according to patient weight; and Group 3—placebo. At inclusion, blood samples for arterial blood gases and biochemical markers were obtained. The primary outcome was established as the length of stay due to patient improvement and the rate of respiratory deterioration or death. Results: During the month of August 2020, the admission of patients requiring hospitalization mostly encompassed cases with severe respiratory failure, so we ended the recruitment process and analyzed the data that was available at the time. One hundred and six (106) patients with an average age of 53 yrs (±16.9) were included, with a greater proportion of males (n = 66, 62.2%). Seventy-two percent (72%) (n = 76) had an associated comorbidity. Ninety percent (90%) of patients were discharged due to improvement (n = 96). The average duration of hospitalization was 6 days (IQR, 3–10). No difference in hospitalization duration was found between the treatment groups (Group1: 7 vs. Group 2: 6 vs. Group 3: 5, p = 0.43) nor in respiratory deterioration or death (Group 1: 18% vs. Group 2: 22.2% vs. Group 3: 24.3%, p = 0.83). Conclusions: In non-critical hospitalized patients with COVID-19 pneumonia, neither ivermectin nor hydroxychloroquine decreases the number of in-hospital days, respiratory deterioration, or deaths. Full article

(This article belongs to the Section Viral Infections)

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