The coronavirus disease 2019(COVID-19)mortality rate in 55 African countries is almost 4.5 times lower than in the coronavirus disease 2019(COVID-19)despite Africa having over 4.2 times more people.This mortality para...The coronavirus disease 2019(COVID-19)mortality rate in 55 African countries is almost 4.5 times lower than in the coronavirus disease 2019(COVID-19)despite Africa having over 4.2 times more people.This mortality paradox is also evident when comparing Nigeria,a heavily populated,poorly vaccinated and weakly mandated country to Israel,a small,highly vaccinated and strictly mandated country.Nigeria has almost 4 times lower COVID mortality than Israel.In this Field of Vision perspective,I explain how this paradox has evolved drawing upon my academic,clinical and social experience.Since April 2020,I’ve developed and been using the Egyptian immune-modulatory Kelleni’s protocol to manage COVID-19 patients including pediatric,geriatric,pregnant,immune-compromised and other individuals suffering from multiple comorbidities.It’s unfortunate that severe acute respiratory syndrome coronavirus 2 is still evolving accompanied by more deaths.However in Africa,we’ve been able to live without anxiety or mandates throughout the pandemic because we trust science and adopted early treatment using safe,and effective repurposed drugs that have saved the majority of COVID-19 patients.This article represents an African and Egyptian tale of honor.展开更多
Objective:To explore on the association between nucleic acid turning-negative-time and traditional Chinese medicine(TCM)symptoms in coronavirus disease 2019(COVID-19)patients with the Omicron variant.Method:For this r...Objective:To explore on the association between nucleic acid turning-negative-time and traditional Chinese medicine(TCM)symptoms in coronavirus disease 2019(COVID-19)patients with the Omicron variant.Method:For this retrospective cross-sectional study,we enrolled 189 patients with COVID-19(age 20-90 years)were included.multiple linear regression models were used to investigate the TCM symptoms affecting the nucleic acid turning-negative-time of COVID-19 patients,during the process of data analysis,taking with nucleic acid turning-negative-time as the dependent variable,and TCM symptoms as independent variables,and at the same time,sex,age,hypertension,diabetes,and coronary heart disease were as confounding variables.Results:The study found that the most common TCM symptoms of COVID-19 patients with Omicron were cough,dry throat,expectoration,fever,sore throat,pharyngeal itching,running nose,and nasal congestion.Regression analysis showed that the fit regressive equation showed a significant difference(F=4.286,P<0.001),R=0.400,the adjusted R^(2)=0.123,and three variables in the regression equation showed significant difference(P<0.05).The results showed that nucleic acid turningnegative-time was mostly related to constipation,fever,and expectoration.If the patients had the symptoms of constipation,fever,and expectoration;that is,if patients showed these symptoms,the turning-negative-time of nucleic acid in patients with Omicron will be prolonged.Conclusions:Treatment based on symptoms for patients with constipation,fever,and expectoration may have important clinical significance for the COVID-19 patients with Omicron.展开更多
As a newly emerged disease,COVID-19's in-depth understanding is still being explored.And also as the epidemic changes,various new situations will be encountered.Atypical patients have brought difficulties to our p...As a newly emerged disease,COVID-19's in-depth understanding is still being explored.And also as the epidemic changes,various new situations will be encountered.Atypical patients have brought difficulties to our prevention and control of this disease.Among them,asymptomatic patients are a special category,and puerperae are a special population.What happens when a puerpera is infected with asymptomatic COVID-19?This study describes 1 case of COVID-19 asymptomatic infection with positive nucleic acid and negative antibodies in puerpera.The aim is to remind clinicians to take special cases seriously,such as puerperae and pregnant women,AIDS,and other immunocompromised patients.It may not be enough to rely solely on antibody detection,but more than two repeated nucleic acid tests are necessary,so that no suspicious patient can be easily let off.展开更多
To explore the impact of ursodeoxycholic acid(UDCA)on severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection and clinical outcomes in patients with autoimmune liver disease(AILD).Patients diagnosed with ...To explore the impact of ursodeoxycholic acid(UDCA)on severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection and clinical outcomes in patients with autoimmune liver disease(AILD).Patients diagnosed with AILD were enrolled and divided into a UDCA group and a non-UDCA group based on whether they received UDCA treatment.Relevant data were collected regarding AILD diagnosis,treatment,biochemical indicators,and imaging examination.The incidence of SARS-CoV-2 infection and the prognosis of AILD patients were observed.A total of 1,138 patients completed follow-up.The usage rate of hormone(P=0.003)and immunosuppressant(P=0.001)used for treating AILD in the non-UDCA group was markedly lower than in the UDCA group.The UDCA usage rate was markedly lower in SARS-CoV-2 infected patients than in uninfected patients(P=0.003).The rate of SARS-CoV-2 infection in the non-UDCA group was significantly higher than in the UDCA group(P=0.018).Logistic regression analysis showed that UDCA use(P=0.003)was correlated to a lower incidence of SARS-CoV-2,while immunosuppressant use(P=0.017)increased the incidence.Recovery time from SARS-CoV-2 infection was markedly longer for those receiving UDCA treatment than those in the non-UDCA group(P=0.018).UDCA is associated with low SARS-CoV-2 incidence in AILD patients,while immunosuppressant increases its incidence instead.Patients receiving UDCA treatment have a longer recovery time after being infected.展开更多
Background:In a few discharged patients with coronavirus disease 2019(COVID-19),the nucleic acid test shows positive results again.Whether this is due to relapse of the disease,reinfection by the virus,or a false-posi...Background:In a few discharged patients with coronavirus disease 2019(COVID-19),the nucleic acid test shows positive results again.Whether this is due to relapse of the disease,reinfection by the virus,or a false-positive result at hospital discharge is worth exploring.Case presentation:A woman with COVID-19 was discharged from the hospital after integrative treatment with traditional Chinese and Western medicine because she met the discharge standards.However,she obtained positive results on a nucleic acid test 22 days later.Conclusion:Based on this positive test result in a discharged patient with COVID-19,anal tests and coronavirus antibody tests should be combined with throat swab tests to further develop the diagnosis and discharge standards for patients with COVID-19.展开更多
BACKGROUND The global outbreak of human severe acute respiratory syndrome coronavirus(SARS-CoV)-2 infection represents an urgent need for readily available,accurate and rapid diagnostic tests.Nucleic acid testing of r...BACKGROUND The global outbreak of human severe acute respiratory syndrome coronavirus(SARS-CoV)-2 infection represents an urgent need for readily available,accurate and rapid diagnostic tests.Nucleic acid testing of respiratory tract specimens for SARS-CoV-2 is the current gold standard for diagnosis of coronavirus disease 2019(COVID-19).However,the diagnostic accuracy of reverse transcription polymerase chain reaction(RT-PCR)tests for detecting SARS-CoV-2 nucleic acid may be lower than optimal.The detection of SARS-CoV-2-specific antibodies should be used as a serological non-invasive tool for the diagnosis and management of SARS-CoV-2 infection.AIM To investigate the diagnostic value of SARS-CoV-2 IgM/IgG and nucleic acid detection in COVID-19.METHODS We retrospectively analyzed 652 suspected COVID-19 patients,and 206 non-COVID-19 patients in Wuhan Integrated TCM and Western Medicine Hospital.Data on SARS-CoV-2 nucleic acid tests and serum antibody tests were collected to investigate the diagnostic value of nucleic acid RT-PCR test kits and immunoglobulin(Ig)M/IgG antibody test kits.The j2 test was used to compare differences between categorical variables.A 95%confidence interval(CI)was provided by the Wilson score method.All analyses were performed with IBM SPSS Statistics version 22.0(IBM Corp.,Armonk,NY,United States).RESULTS Of the 652 suspected COVID-19 patients,237(36.3%)had positive nucleic acid tests,311(47.7%)were positive for IgM,and 592(90.8%)were positive for IgG.There was a significant difference in the positive detection rate between the IgM and IgG test groups(P<0.001).Using the RT-PCR results as a reference,the specificity,sensitivity,and accuracy of IgM/IgG combined tests for SARS-CoV-2 infection were 98.5%,95.8%,and 97.1%,respectively.Of the 415 suspected COVID-19 patients with negative nucleic acid test results,366 had positive IgM/IgG tests with a positive detection rate of 88.2%.CONCLUSION Our data indicate that serological IgM/IgG antibody combined test had high sensitivity and specificity for the diagnosis of SARS-CoV-2 infection,and can be used in combination with RT-PCR for the diagnosis of SARS-CoV-2 infection.展开更多
Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has emerged as one of the most dreadful viruses the mankind has witnessed.It has caused worldwide havoc and wrecked human life.In our quest to find therapeuti...Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has emerged as one of the most dreadful viruses the mankind has witnessed.It has caused worldwide havoc and wrecked human life.In our quest to find therapeutic options to counter this threat,several drugs have been tried,with varying success.Certain agents like corticosteroids,some anti-virals and immunosuppressive drugs have been found useful in improving clinical outcomes.Vitamin C,a water-soluble vitamin with good safety profile,has been tried to reduce progression and improve outcomes of patients with coronavirus disease 2019(COVID-19).Because of its anti-oxidant and immunomodulatory properties,the role of vitamin C has expanded well beyond the management of scurvy and it is increasingly been employed in the treatment of critically ill patients with sepsis,septic shock,acute pancreatitis and even cancer.However,in spite of many case series,observational studies and even randomised control trials,the role of vitamin C remains ambiguous.In this review,we will be discussing the scientific rationale and the current clinical evidence for using high dose vitamin C in the management of COVID-19 patients.展开更多
Background:The emergence of Coronavirus SARS-CoV-2 evoked an unprecedented threat globally.Ever since the spread of this pandemic research and clinical trials have concentrated on the repurposing of already exciting F...Background:The emergence of Coronavirus SARS-CoV-2 evoked an unprecedented threat globally.Ever since the spread of this pandemic research and clinical trials have concentrated on the repurposing of already exciting FDA drugs to find a successful candidate to combat Covid-19.Objective:The objective of this study is to propose a therapeutic protocol that may have a potential solution to treat the severe infections associated with coronavirus.The clinical application of this protocol(Al-Akidi Therapeutic Protocol,A-TP)is highly recommended,as there are several scientific evidences that support this trusted protocol to be of great potential.Methods and Materials:This A-TP includes the use of one of the respiratory Fluoroquinolones(Levofloxacin or Moxifloxacin)in doses of 500 mg twice daily for 7-10 days,together with high doses of Vitamin D3(10000 IU/day)and Zinc(50 mg daily)for few weeks.This protocol is based on the previous antiviral activity of those Fluoroquinolones towards few viruses,the potent antibacterial activity on respiratory infections and high available concentrations in the lungs.It is also based on molecular docking of Levofloxacin and Moxifloxacin on various viral enzymes.Results:Molecular docking showed encouraging and very interesting docking scores and binding affinity of Levofloxacin and Moxifloxacin to certain viral enzymes,such as,RNA dependent RNA polymerase(RdRp),3-Cysteine-Like protease,Neuraminidase,Replicase polyproteins and Trans-Membrane Protease Serine 2 inhibitor(TMPRSS2).The highly expected clinical results of using this protocol are:reduce infection,control of temperature,improve breathing with less dependent on supplemented oxygen,and remarkable reduction of the pro-inflammatory cytokine storm,and hence,reduce hospitalization and mortality.Conclusion:Levofloxacin is highly recommended in managing the severe infections associated with Corona virus and has a remarkable reduction of pro-inflammatory cytokine storm as an immuomodulating agent.Levofloxacin is superior in this protocol over Moxifloxacin,due to its high excretion(≤83%)as unchanged through the kidneys,while Moxifloxacin is only 20%is excreted unchanged.It is an extra advantage of Levofloxacin to manage coronavirus in the kidneys.High doses of Vitamin D3 and Zinc are very useful to provide additional effective measures to combat Corona virus.Therefore,the use of this A-TP is highly and strongly recommended,as it serves the full requirements for excellent and potential therapy for the severe infections associated with Covid-19.展开更多
文摘The coronavirus disease 2019(COVID-19)mortality rate in 55 African countries is almost 4.5 times lower than in the coronavirus disease 2019(COVID-19)despite Africa having over 4.2 times more people.This mortality paradox is also evident when comparing Nigeria,a heavily populated,poorly vaccinated and weakly mandated country to Israel,a small,highly vaccinated and strictly mandated country.Nigeria has almost 4 times lower COVID mortality than Israel.In this Field of Vision perspective,I explain how this paradox has evolved drawing upon my academic,clinical and social experience.Since April 2020,I’ve developed and been using the Egyptian immune-modulatory Kelleni’s protocol to manage COVID-19 patients including pediatric,geriatric,pregnant,immune-compromised and other individuals suffering from multiple comorbidities.It’s unfortunate that severe acute respiratory syndrome coronavirus 2 is still evolving accompanied by more deaths.However in Africa,we’ve been able to live without anxiety or mandates throughout the pandemic because we trust science and adopted early treatment using safe,and effective repurposed drugs that have saved the majority of COVID-19 patients.This article represents an African and Egyptian tale of honor.
基金This study was approved by the First Hospital Affiliated to Tianjin University of Traditional Chinese Medicine(Tianjin,China)(Approved No.TYLL2020[K]006).
文摘Objective:To explore on the association between nucleic acid turning-negative-time and traditional Chinese medicine(TCM)symptoms in coronavirus disease 2019(COVID-19)patients with the Omicron variant.Method:For this retrospective cross-sectional study,we enrolled 189 patients with COVID-19(age 20-90 years)were included.multiple linear regression models were used to investigate the TCM symptoms affecting the nucleic acid turning-negative-time of COVID-19 patients,during the process of data analysis,taking with nucleic acid turning-negative-time as the dependent variable,and TCM symptoms as independent variables,and at the same time,sex,age,hypertension,diabetes,and coronary heart disease were as confounding variables.Results:The study found that the most common TCM symptoms of COVID-19 patients with Omicron were cough,dry throat,expectoration,fever,sore throat,pharyngeal itching,running nose,and nasal congestion.Regression analysis showed that the fit regressive equation showed a significant difference(F=4.286,P<0.001),R=0.400,the adjusted R^(2)=0.123,and three variables in the regression equation showed significant difference(P<0.05).The results showed that nucleic acid turningnegative-time was mostly related to constipation,fever,and expectoration.If the patients had the symptoms of constipation,fever,and expectoration;that is,if patients showed these symptoms,the turning-negative-time of nucleic acid in patients with Omicron will be prolonged.Conclusions:Treatment based on symptoms for patients with constipation,fever,and expectoration may have important clinical significance for the COVID-19 patients with Omicron.
文摘As a newly emerged disease,COVID-19's in-depth understanding is still being explored.And also as the epidemic changes,various new situations will be encountered.Atypical patients have brought difficulties to our prevention and control of this disease.Among them,asymptomatic patients are a special category,and puerperae are a special population.What happens when a puerpera is infected with asymptomatic COVID-19?This study describes 1 case of COVID-19 asymptomatic infection with positive nucleic acid and negative antibodies in puerpera.The aim is to remind clinicians to take special cases seriously,such as puerperae and pregnant women,AIDS,and other immunocompromised patients.It may not be enough to rely solely on antibody detection,but more than two repeated nucleic acid tests are necessary,so that no suspicious patient can be easily let off.
基金the National Key Research and Development Program(2022YFC2603500,2022YFC2603505)Beijing Municipal Health Commission high-level public health technical personnel construction project,discipline leader-03-26,Beijing Hospitals Authority Clinical medicine Development of special funding support(XMLX 202127)+1 种基金the capital health research and development of special public health project(2022-1-2172)The Digestive Medical Coordinated Development Center of Beijing Hospitals Authority(XXZ0302).
文摘To explore the impact of ursodeoxycholic acid(UDCA)on severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection and clinical outcomes in patients with autoimmune liver disease(AILD).Patients diagnosed with AILD were enrolled and divided into a UDCA group and a non-UDCA group based on whether they received UDCA treatment.Relevant data were collected regarding AILD diagnosis,treatment,biochemical indicators,and imaging examination.The incidence of SARS-CoV-2 infection and the prognosis of AILD patients were observed.A total of 1,138 patients completed follow-up.The usage rate of hormone(P=0.003)and immunosuppressant(P=0.001)used for treating AILD in the non-UDCA group was markedly lower than in the UDCA group.The UDCA usage rate was markedly lower in SARS-CoV-2 infected patients than in uninfected patients(P=0.003).The rate of SARS-CoV-2 infection in the non-UDCA group was significantly higher than in the UDCA group(P=0.018).Logistic regression analysis showed that UDCA use(P=0.003)was correlated to a lower incidence of SARS-CoV-2,while immunosuppressant use(P=0.017)increased the incidence.Recovery time from SARS-CoV-2 infection was markedly longer for those receiving UDCA treatment than those in the non-UDCA group(P=0.018).UDCA is associated with low SARS-CoV-2 incidence in AILD patients,while immunosuppressant increases its incidence instead.Patients receiving UDCA treatment have a longer recovery time after being infected.
文摘Background:In a few discharged patients with coronavirus disease 2019(COVID-19),the nucleic acid test shows positive results again.Whether this is due to relapse of the disease,reinfection by the virus,or a false-positive result at hospital discharge is worth exploring.Case presentation:A woman with COVID-19 was discharged from the hospital after integrative treatment with traditional Chinese and Western medicine because she met the discharge standards.However,she obtained positive results on a nucleic acid test 22 days later.Conclusion:Based on this positive test result in a discharged patient with COVID-19,anal tests and coronavirus antibody tests should be combined with throat swab tests to further develop the diagnosis and discharge standards for patients with COVID-19.
基金Natural Science Foundation of Hubei Province,China,No.2016CFB596and Wuhan City Medical Research Project,China,No.WX17Q39 and No.WX15B14.
文摘BACKGROUND The global outbreak of human severe acute respiratory syndrome coronavirus(SARS-CoV)-2 infection represents an urgent need for readily available,accurate and rapid diagnostic tests.Nucleic acid testing of respiratory tract specimens for SARS-CoV-2 is the current gold standard for diagnosis of coronavirus disease 2019(COVID-19).However,the diagnostic accuracy of reverse transcription polymerase chain reaction(RT-PCR)tests for detecting SARS-CoV-2 nucleic acid may be lower than optimal.The detection of SARS-CoV-2-specific antibodies should be used as a serological non-invasive tool for the diagnosis and management of SARS-CoV-2 infection.AIM To investigate the diagnostic value of SARS-CoV-2 IgM/IgG and nucleic acid detection in COVID-19.METHODS We retrospectively analyzed 652 suspected COVID-19 patients,and 206 non-COVID-19 patients in Wuhan Integrated TCM and Western Medicine Hospital.Data on SARS-CoV-2 nucleic acid tests and serum antibody tests were collected to investigate the diagnostic value of nucleic acid RT-PCR test kits and immunoglobulin(Ig)M/IgG antibody test kits.The j2 test was used to compare differences between categorical variables.A 95%confidence interval(CI)was provided by the Wilson score method.All analyses were performed with IBM SPSS Statistics version 22.0(IBM Corp.,Armonk,NY,United States).RESULTS Of the 652 suspected COVID-19 patients,237(36.3%)had positive nucleic acid tests,311(47.7%)were positive for IgM,and 592(90.8%)were positive for IgG.There was a significant difference in the positive detection rate between the IgM and IgG test groups(P<0.001).Using the RT-PCR results as a reference,the specificity,sensitivity,and accuracy of IgM/IgG combined tests for SARS-CoV-2 infection were 98.5%,95.8%,and 97.1%,respectively.Of the 415 suspected COVID-19 patients with negative nucleic acid test results,366 had positive IgM/IgG tests with a positive detection rate of 88.2%.CONCLUSION Our data indicate that serological IgM/IgG antibody combined test had high sensitivity and specificity for the diagnosis of SARS-CoV-2 infection,and can be used in combination with RT-PCR for the diagnosis of SARS-CoV-2 infection.
文摘Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has emerged as one of the most dreadful viruses the mankind has witnessed.It has caused worldwide havoc and wrecked human life.In our quest to find therapeutic options to counter this threat,several drugs have been tried,with varying success.Certain agents like corticosteroids,some anti-virals and immunosuppressive drugs have been found useful in improving clinical outcomes.Vitamin C,a water-soluble vitamin with good safety profile,has been tried to reduce progression and improve outcomes of patients with coronavirus disease 2019(COVID-19).Because of its anti-oxidant and immunomodulatory properties,the role of vitamin C has expanded well beyond the management of scurvy and it is increasingly been employed in the treatment of critically ill patients with sepsis,septic shock,acute pancreatitis and even cancer.However,in spite of many case series,observational studies and even randomised control trials,the role of vitamin C remains ambiguous.In this review,we will be discussing the scientific rationale and the current clinical evidence for using high dose vitamin C in the management of COVID-19 patients.
基金The author acknowledges the help and support of Dr.Sabah J.Saleh(The National Center for Quality Control and Research,Ministry of Health(Iraq))and Ameer H.Khadem(Department of Pharmaceutical Chemistry,College of Pharmacy,Al-Bayan University).
文摘Background:The emergence of Coronavirus SARS-CoV-2 evoked an unprecedented threat globally.Ever since the spread of this pandemic research and clinical trials have concentrated on the repurposing of already exciting FDA drugs to find a successful candidate to combat Covid-19.Objective:The objective of this study is to propose a therapeutic protocol that may have a potential solution to treat the severe infections associated with coronavirus.The clinical application of this protocol(Al-Akidi Therapeutic Protocol,A-TP)is highly recommended,as there are several scientific evidences that support this trusted protocol to be of great potential.Methods and Materials:This A-TP includes the use of one of the respiratory Fluoroquinolones(Levofloxacin or Moxifloxacin)in doses of 500 mg twice daily for 7-10 days,together with high doses of Vitamin D3(10000 IU/day)and Zinc(50 mg daily)for few weeks.This protocol is based on the previous antiviral activity of those Fluoroquinolones towards few viruses,the potent antibacterial activity on respiratory infections and high available concentrations in the lungs.It is also based on molecular docking of Levofloxacin and Moxifloxacin on various viral enzymes.Results:Molecular docking showed encouraging and very interesting docking scores and binding affinity of Levofloxacin and Moxifloxacin to certain viral enzymes,such as,RNA dependent RNA polymerase(RdRp),3-Cysteine-Like protease,Neuraminidase,Replicase polyproteins and Trans-Membrane Protease Serine 2 inhibitor(TMPRSS2).The highly expected clinical results of using this protocol are:reduce infection,control of temperature,improve breathing with less dependent on supplemented oxygen,and remarkable reduction of the pro-inflammatory cytokine storm,and hence,reduce hospitalization and mortality.Conclusion:Levofloxacin is highly recommended in managing the severe infections associated with Corona virus and has a remarkable reduction of pro-inflammatory cytokine storm as an immuomodulating agent.Levofloxacin is superior in this protocol over Moxifloxacin,due to its high excretion(≤83%)as unchanged through the kidneys,while Moxifloxacin is only 20%is excreted unchanged.It is an extra advantage of Levofloxacin to manage coronavirus in the kidneys.High doses of Vitamin D3 and Zinc are very useful to provide additional effective measures to combat Corona virus.Therefore,the use of this A-TP is highly and strongly recommended,as it serves the full requirements for excellent and potential therapy for the severe infections associated with Covid-19.
