scholarly journals Remdesivir Treatment for COVID 19 in Pregnant Patients with Moderate to Severe Symptoms: Serial Case Report

2021 ◽  
Vol 13 (2) ◽  
pp. 437-443
Author(s):  
Yudianto Budi Saroyo ◽  
Amanda Rumondang ◽  
Irene Sinta Febriana ◽  
Achmad Kemal Harzif ◽  
Rima Irwinda
Keyword(s):  
Adverse Effects ◽  
Adverse Events ◽  
Pregnant Women ◽  
Clinical Symptoms ◽  
Recovery Period ◽  
Rapid Improvement ◽  
Major Health Problem ◽  
Hospitalization Period ◽  
Duration Of Hospitalization ◽  
Novel Coronavirus

Introduction: Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) infection that causes novel Coronavirus Disease 2019 (COVID-19) has become a major health problem worldwide and been declared a pandemic since March 2020 by WHO. One special population that poses a challenge is pregnant women with COVID-19. There have not been many studies related to COVID-19 in pregnancy. In this study, we present five serial cases of Remdesivir treatment for COVID-19 in pregnant women with moderate to severe symptoms. Case Illustration: We briefly describe five serial cases being treated with Remdesivir therapy during hospitalization. Four cases were delivered by cesarean section, and one was delivered vaginally in gestation week 37. All cases showed a shortened duration of hospitalization, rapid improvement in clinical symptoms, and no adverse events were observed in mothers, fetuses, and neonates. Discussion: Remdesivir, an inhibitor RNA Polymerase, has been used in COVID-19 treatment and is known to shorten recovery time in nonpregnant women. Some studies have shown no adverse effects on Remdesivir for pregnant women. Based on randomized control trial (RCT) during the Ebola epidemic, Remdesivir was safe to use for pregnant women. All cases showed reduced hospitalization time and better clinical outcomes without maternal, fetal, or neonatal adverse events. Conclusion: Remdesivir protocol for pregnant women with moderate to severe symptoms of COVID-19 has resulted in better clinical improvement with a shorter recovery period and no adverse effects during the hospitalization period. Further studies and RCT are warranted to evaluate the biosafety and effects of Remdesivir in pregnant women.

scholarly journals Efficacy and safety of chloroquine or hydroxychloroquine in moderate type of COVID-19: a prospective open-label randomized controlled study

2020 ◽  
Author(s):  
Lan Chen ◽  
Zhen-Yu Zhang ◽  
Jian-Guo Fu ◽  
Zhi-Peng Feng ◽  
Su-Zhen Zhang ◽  
...  
Keyword(s):  
Adverse Events ◽  
Oral Treatment ◽  
Drug Repurposing ◽  
Control Treatment ◽  
Controlled Study ◽  
Control Group ◽  
Open Label ◽  
Duration Of Hospitalization ◽  
Novel Coronavirus ◽  
And Control

ABSTRACTThe outbreak of novel coronavirus disease 2019 (COVID-19) has become a pandemic. Drug repurposing may represent a rapid way to fill the urgent need for effective treatment. We evaluated the clinical utility of chloroquine and hydroxychloroquine in treating COVID-19.Forty-eight patients with moderate COVID-19 were randomized to oral treatment with chloroquine (1000 mg QD on Day 1, then 500 mg QD for 9 days; n=18), hydroxychloroquine (200 mg BID for 10 days; n=18), or control treatment (n=12).Adverse events were mild, except for one case of Grade 2 ALT elevation. Adverse events were more commonly observed in the chloroquine group (44.44%) and the hydroxychloroquine group (50.00%) than in the control group (16.67%). The chloroquine group achieved shorter time to clinical recovery (TTCR) than the control group (P=0.019). There was a trend toward reduced TTCR in the hydroxychloroquine group (P=0.049). The time to reach viral RNA negativity was significantly faster in the chloroquine group and the hydroxychloroquine group than in the control group (P=0.006 and P=0.010, respectively). The median numbers of days to reach RNA negativity in the chloroquine, hydroxychloroquine, and control groups was 2.5 (IQR: 2.0-3.8) days, 2.0 (IQR: 2.0-3.5) days, and 7.0 (IQR: 3.0-10.0) days, respectively. The chloroquine and hydroxychloroquine groups also showed trends toward improvement in the duration of hospitalization and findings on lung computerized tomography (CT). This study provides evidence that (hydroxy)chloroquine may be used effectively in treating moderate COVID-19 and supports larger trials.

scholarly journals COVID-19 and Impact on Pregnant Women

2021 ◽  
pp. 55-61
Author(s):  
Deepali Rajnalwar ◽  
Swaroopa Chakole
Keyword(s):  
Viral Infection ◽  
Pregnant Women ◽  
Clinical Outcomes ◽  
Clinical Symptoms ◽  
Preterm Births ◽  
Vulnerable Groups ◽  
Post Vaccination ◽  
The World ◽  
Novel Coronavirus ◽  
Second Wave

Background: Coronavirus disease 2019 or COVID-19 is the viral infection pandemic that has spread all over the world. Although all people are prone to the infection almost equally, some of them after catching infection may produce more severe clinical symptoms. These are called vulnerable groups and pregnant women are one of them. Summary: Pregnant women were thought to be not affected by the COVID-19 pandemic in the first wave, but recent observations from the second wave which harbors the mutated versions of novel coronavirus, said to be more virulent and lethal, suggests that pregnant women are not only vulnerable to catching the infection but they can show severe clinical outcomes. Also case fatalities, preterm births are also high among COVID-19 infected pregnant women. Conclusion: More vaccination among pregnant women is needed to safeguard them as the severity of the symptoms is lowered post-vaccination. To solidify more results, more comprehensive and frequent studies are needed so that correlation can be established.

scholarly journals Mechanical Ventilation in Pregnancy Due to COVID-19: A Cohort of Three Cases

2020 ◽  
Vol 37 (10) ◽  
pp. 1066-1069 ◽  
Author(s):  
Elizabeth Lucarelli ◽  
Claudia Behn ◽  
Susan Lashley ◽  
Dorothy Smok ◽  
Carlos Benito ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Adverse Effects ◽  
Pregnant Women ◽  
Mechanically Ventilated ◽  
Key Points ◽  
Novel Coronavirus ◽  
In Pregnancy

We describe our experience with three pregnant women with novel coronavirus disease 2019 (COVID-19) who required mechanical ventilation. Recent data suggest a mortality of 88% in nonpregnant patients with COVID-19 who require intubation and mechanical ventilation. The three women we report were intubated and mechanically ventilated during pregnancy due to respiratory failure and pneumonia resulting from COVID-19. After several days of ventilation, all three were successfully weaned off mechanical ventilation and extubated, and are continuing their pregnancies with no demonstrable adverse effects. Our experience suggests that the mortality in pregnant women with COVID-19 requiring mechanical ventilation is not necessarily as high as in nonpregnant patients with COVID-19. Key Points

scholarly journals Bilateral foot drop after COVID-19-related acute respiratory distress syndrome: A case report

2021 ◽  
Vol 67 (3) ◽  
pp. 378-381
Author(s):  
Rana Terlemez ◽  
Tuğçe Özekli Mısırlıoğlu ◽  
Deniz Palamar ◽  
Dilara Okutan ◽  
Kenan Akgün
Keyword(s):  
Daily Living ◽  
Distress Syndrome ◽  
Recovery Period ◽  
Foot Drop ◽  
The Novel ◽  
Locomotor System ◽  
Hospitalization Period ◽  
Novel Coronavirus ◽  
Prolonged Immobilization

In these days of the pandemic, we have faced with the locomotor system problems following severe acute respiratory syndrome-coro- navirus 2 (SARS-CoV-2) infection. While some of these problems are related to the disease itself, some of them are associated with the prolonged immobilization during the infection. Long-term intensive care unit admissions of patients may also lead to various types of neuropathies, extending the recovery period. The real burden of the novel coronavirus-2019 (COVID-19) is still unclear. In particular, after a prolonged hospitalization period, the duration of rehabilitation may be longer to gain independence in daily living activities. In this report, we present a different aspect of the COVID-19 with bilateral foot drop in a 53-year-old female patient. To the best of our knowledge, this case is the first report of both peroneal and sciatic nerve damage following COVID-19.

scholarly journals Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection During Pregnancy In China: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Ming-Zhu Yin ◽  
Li-juan Zhang ◽  
Guang-Tong Deng ◽  
Chao-Fei Han ◽  
Min-Xue Shen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Amniotic Fluid ◽  
Pregnant Women ◽  
Vertical Transmission ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Clinical Symptoms ◽  
Prognostic Index ◽  
Anal Swab ◽  
Novel Coronavirus

SummaryBackgroundSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been identified as the cause of the ongoing worldwide epidemic of Coronavirus Disease 2019 (COVID-19) in China and worldwide. However, there were few studies about the effects of SARS-CoV-2 infection on pregnant women.MethodsIn this retrospective cohort study, we enrolled 31 pregnant women and 35 non-pregnant women from Jan 28 to Feb 28, 2020 to evaluate the effects of SARS-CoV-2 infection during pregnancy. Inflammatory indices were used to assess the severity of COVID-19. Evidence of vertical transmission was determined by laboratory confirmation of SARS-CoV-2 in amniotic fluid, placenta, neonatal throat and anal swab and breastmilk samples.FindingsCompared with non-pregnant women, pregnant women had a significantly lower proportion of fever (54·8% vs. 87·5%, p= 0.006), a shorter average interval from onset to hospitalization (7·80 ±7·0d vs. 13·2 ± 8·2d, p= 0.005), and a higher proportion of severe or critical COVID-19 (32·3% vs. 11·4%, p=0.039). Neutrophil-to-lymphocyte ratio (NLR) and systematic immune-inflammation-based prognostic index (SII) were significantly higher on admission in severe/critical pneumonia group than moderate pneumonia group. We could not detect the presence of SARS-CoV-2 by RT-PCR in amniotic fluid, placenta, neonatal throat and anal swab and breastmilk samples.InterpretationThe clinical symptoms of COVID-19 in pregnant women were insidious and atypical, compared with those in non-pregnant patients. SII and NLR could be a useful marker to evaluate the severity of COVID-19. There was no evidence of vertical transmission during pregnancy with SARS-CoV-2 infection.FundingNational Natural Science Foundation of China and Research Funds for the Central Universities.Research in contextEvidence before this studyWe searched PubMed, Embase and Web of science for articles published up to March 1st, 2020, using the keywords (“novel coronavirus” OR “2019 novel coronavirus” OR “2019-nCoV” OR COVID-19 OR SARS-CoV-2) AND (pregnancy OR “maternal infection” OR “fetal infection”) AND “Cohort studies”.We identified no published cohort studies on pregnant women with the 2019 novel coronavirus disease (COVID-19) infection.Added value of this studyFor this retrospective cohort study, we reviewed clinical records, laboratory findings, and chest CT scans from 31 pregnant women and 35 non-pregnant women from Jan 28 to Feb 28, 2020 to evaluate the effects of SARS-CoV-2 infection during pregnancy. Inflammatory indices were used to assess the severity of COVID-19. Evidence of vertical transmission was determined by laboratory confirmation of SARS-CoV-2 in amniotic fluid, placenta, neonatal throat and anal swab and breastmilk samples. Compared with non-pregnant women, pregnant women had a significantly lower proportion of fever (54·8% vs. 87·5%, p= 0.006), a shorter average interval from onset to hospitalization (7·80 ±7·0d vs. 13·2 ± 8·2d, p= 0.005), and a higher proportion of severe or critical COVID-19 (32·3% vs. 11·4%, p=0.039). Neutrophil-to-lymphocyte ratio (NLR) and systematic immune-inflammation-based prognostic index (SII) were significantly higher on admission in severe/critical pneumonia group than moderate pneumonia group. Amniotic fluid, placenta, neonatal throat and anal swab and breastmilk samples were tested for SARS-CoV-2 by RT-PCR and all results were negative.Implications of all the available evidenceThe clinical symptoms of COVID-19 in pregnant women were insidious and atypical, compared with those in non-pregnant patients. SII and NLR could be a useful marker to evaluate the severity of COVID-19. There was no evidence of vertical transmission during pregnancy with SARS-CoV-2 infection.

Statin-induced adverse effects – facts and genes

2013 ◽  
Vol 154 (3) ◽  
pp. 83-92
Author(s):  
Mariann Harangi ◽  
Noémi Zsíros ◽  
Lilla Juhász ◽  
György Paragh
Keyword(s):  
Risk Factors ◽  
Single Nucleotide Polymorphisms ◽  
Adverse Effects ◽  
Adverse Events ◽  
Statin Therapy ◽  
Significant Proportion ◽  
Gene Mutations ◽  
Nucleotide Polymorphisms ◽  
Serious Adverse Events ◽  
Single Nucleotide

Statin therapy is considered to be safe and rarely associated with serious adverse events. However, a significant proportion of patients on statin therapy show some degree of intolerance which can lead to decreased adherence to statin therapy. The authors summarize the symptoms, signs and frequencies of the most common statin-induced adverse effects and their most important risk factors including some single nucleotide polymorphisms and gene mutations. Also, they review the available approaches to detect and manage the statin-intolerant patients. Orv. Hetil., 2013, 154, 83–92.

Naldemedine: Peripherally Acting Opioid Receptor Antagonist for Treating Opioid-induced Adverse Effects

2020 ◽  
Vol 20 (31) ◽  
pp. 2830-2842
Author(s):  
Masanao Inagaki ◽  
Toshiyuki Kanemasa ◽  
Takaaki Yokota
Keyword(s):  
Adverse Effects ◽  
Adverse Events ◽  
Severe Pain ◽  
Lead Compound ◽  
Inhibitory Effects ◽  
Pharmacokinetic Profiles ◽  
Structure Activity ◽  
The Usa ◽  
Relationship Study ◽  
The Eu

Opioids are widely used for pain management in moderate-to-severe pain. However, opioids are associated with adverse events, such as constipation and emesis/vomiting. To reduce these undesired effects, a structure–activity relationship study of morphinan derivatives was conducted, and a promising lead compound with inhibitory effects on opioid receptors was obtained. Further improvement in the potency and pharmacokinetic profiles of the lead compound led to the discovery of naldemedine, which showed anti-constipation and anti-emetic effects against these adverse events that were induced by morphine without influencing morphine’s analgesic effect. Naldemedine was launched in Japan and the USA in 2017 and in the EU in 2019, for treating opioid-induced constipation.

Novel Coronavirus Disease (COVID-19): A Narrative Review Based on Current Status

2020 ◽  
Vol 18 ◽  
Author(s):  
Rina Das ◽  
Dinesh Kumar Mehta ◽  
Meenakshi Dhanawat
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Clinical Symptoms ◽  
Virus Disease ◽  
Relevant Literature ◽  
World Health ◽  
Current Status ◽  
Future Research ◽  
Treatment And Prevention ◽  
First Case ◽  
Novel Coronavirus

Abstract:: A novel virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), appeared and expanded globally by the end of year in 2019 from Wuhan, China, causing severe acute respiratory syndrome. During its initial stage, the disease was called the novel coronavirus (2019-nCoV). It was named COVID-19 by the World Health Organization (WHO) on 11 February 2020. The WHO declared worldwide the SARS-CoV-2 virus a pandemic on March 2020. On 30 January 2020 the first case of Corona Virus Disease 2019 (COVID-19) was reported in India. Now in current situation the virus is floating in almost every part of the province and rest of the globe. -: On the basis of novel published evidences, we efficiently summarized the reported work with reference to COVID-19 epidemiology, pathogen, clinical symptoms, treatment and prevention. Using several worldwide electronic scientific databases such as Pubmed, Medline, Embase, Science direct, Scopus, etc were utilized for extensive investigation of relevant literature. -: This review is written in the hope of encouraging the people successfully with the key learning points from the underway efforts to perceive and manage SARS-CoV-2, suggesting sailent points for expanding future research.

Impact of Novel Coronavirus (COVID-19) on Pregnant Women: A Review

Coronaviruses ◽  
2020 ◽  
Vol 01 ◽  
Author(s):  
Saima Habeeb ◽  
Manju Chugani
Keyword(s):  
Pregnant Women ◽  
Vertical Transmission ◽  
Respiratory Infections ◽  
Age Groups ◽  
Well Being ◽  
Fetal Outcome ◽  
Global Public Health ◽  
Coronavirus Infection ◽  
Novel Coronavirus ◽  
The Impact

: The novel coronavirus infection (COVID‐19) is a global public health emergency.Since its outbreak in Wuhan, China in December 2019, the infection has spread at an alarming rate across the globe and humans have been locked down to their countries, cities and homes. As of now, the virus has affected over 20million people globally and has inflicted over 7 lac deaths. Nevertheless, the recovery rate is improving with each passing day and over 14 million people have recuperated so far. The statistics indicate that nobody is immune to the disease as the virus continues to spread among all age groups; newborns to the elders, and all compartmentsincluding pregnant women. However, pregnant women may be more susceptible to this infection as they are, in general, highly vulnerable to respiratory infections. There is no evidence for vertical transmission of the COVID-19 virus among pregnant women, but an increased prevalence of preterm deliveries. Besides this, the COVID-19 may alter immune response at the maternal-fetal interface and affect the well-being of mothers as well as infants. Unfortunately, there is limited evidence available in the open literature regarding coronavirus infection during pregnancy and it now appears that certain pregnant women have infected during the present 2019-nCoV pandemic. In this short communication, we study the impact of the COVID-19 infection on vertical transmission and fetal outcome among pregnant women.

scholarly journals Overt and subclinical hypothyroidism among Bangladeshi pregnant women and its effect on fetomaternal outcome

2015 ◽  
Vol 40 (2) ◽  
pp. 52-57 ◽  
Author(s):  
M Sharmeen ◽  
PA Shamsunnahar ◽  
TR Laita ◽  
SB Chowdhury
Keyword(s):  
Adverse Effects ◽  
Pregnant Women ◽  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
Perinatal Outcomes ◽  
Fetal Outcome ◽  
Thyroid Stimulating Hormone ◽  
Overt Hypothyroidism ◽  
Adequate Treatment ◽  
In Pregnancy

Objectives: Thyroid disorders are among the common endocrine problems in pregnant women. It is now well established that not only overt but subclinical thyroid dysfunction also has adverse effects on maternal and fetal outcome. There are few data from Bangladesh about the prevalence of thyroid dysfunction in pregnancy. With this background, this study aims to find out thyroid dysfunction (both overt and subclinical hypothyroidism) in pregnancy and its impact on obstetrical outcome.Methods: We studied the evaluation of 50 admitted pregnancies corresponding to 29 women with subclinical hypothyroidism and rest 21 was overt hypothyroidism. Detailed history and examination were performed. Apart from routine obstetrical investigations, Thyroid Stimulating Hormone (TSH) estimation was done. Their obstetrical and perinatal outcomes were noted.Results: Overt hypothyroidism was significantly (p<0.05) higher in 25 to 44 years age group. However two and three abortions were significantly (p<0.05) higher in overt hypothyroidism patients. In sub clinical hypothyroidism 86.2% conceived firstly within 2 years and 66.7% in overt hypothyroidism patients conceived firstly in between 3 to 5 years after marriage. Overt hypothyroids were prone to have pregnancy-induced hypertension 42.9%, intrauterine growth restriction (P=0.001) and gestational diabetes (38.1%) as compared to subclinical cases. Neonatal complications were significantly more in overt hypothyroidism group. Mean TSH level was significantly (p<0.05) higher in overt hypothyroidism patients but mean FT4 level was almost similar in both groups. Majority of the patient underwent caesarean section in both groups due to associated medical and obstetrical complications. None of the babies showed hypothyroidism by cord blood tests. In this analysis our results showed that overt hypothyroidism among Bangladeshi pregnant women are associated with more maternal complication & adverse parental outcome than subclinical hypothyroidism. The adequate treatment of hypothyroidism during gestation minimizes risks and generally, makes it possible for pregnancies to be carried to term without complications. Significant adverse effects on maternal and fetal outcome were seen emphasizing the importance of routine antenatal thyroid screening.Bangladesh Med Res Counc Bull 2014; 40 (2): 52-57

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