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      Real-world experience of arbidol for Omicron variant of SARS-CoV-2

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          Abstract

          Background

          At a crucial time with the rapid spread of Omicron severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus variant globally, we conducted a study to evaluate the efficacy and safety of arbidol tablets in the treatment of this variant.

          Methods

          From Mar 26 to April 26, 2022, we conducted a prospective, open-labeled, controlled, and investigator-initiated trial involving adult patients with confirmed Omicron variant infection. Patients with asymptomatic or mild clinical status were stratified 1:2 to receive either standard-of-care (SOC) or SOC plus arbidol tablets (oral administration of 200 mg per time, three times a day for 5 days). The primary endpoint was the negative conversion rate within the first week.

          Results

          A total of 367 patients were enrolled in the study; 246 received arbidol tablet treatment, and 121 were in the control group. The negative conversion rate of SARS-CoV-2 within the first week in patients receiving arbidol tablets was significantly higher than that of the SOC group [47.2% (116/246) vs. 35.5% (43/121); odds ratio (OR), 1.619; 95% confidence interval (CI): 1.034–2.535; P=0.035]. Compared to those in the SOC group, patients receiving arbidol tablets had a shorter negative conversion time [median 8.3 vs. 10.0 days; hazard ratio (HR), 0.645; 95% CI: 0.516–0.808; P<0.001], and a shorter duration of hospitalization (median 11.4 vs. 13.7 days; HR, 1.214; 95% CI: 0.966–1.526; P<0.001). Moreover, the addition of arbidol tablets led to better recovery of declined blood lymphocytes, CD3 +, CD4 +, and CD8 + cell counts. The most common adverse event (AE) was transaminase elevation in patients treated with arbidol tablets (3/246, 1.2%). No one withdrew from the study due to AEs or disease progression.

          Conclusions

          As a whole, arbidol may represent an effective and safe treatment in asymptomatic-mild patients suffering from Omicron variant during the pandemic of coronavirus disease 2019 (COVID-19).

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          Most cited references23

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          Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China

          In December 2019, novel coronavirus (2019-nCoV)-infected pneumonia (NCIP) occurred in Wuhan, China. The number of cases has increased rapidly but information on the clinical characteristics of affected patients is limited.
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            Clinical and immunological assessment of asymptomatic SARS-CoV-2 infections

            The clinical features and immune responses of asymptomatic individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have not been well described. We studied 37 asymptomatic individuals in the Wanzhou District who were diagnosed with RT-PCR-confirmed SARS-CoV-2 infections but without any relevant clinical symptoms in the preceding 14 d and during hospitalization. Asymptomatic individuals were admitted to the government-designated Wanzhou People's Hospital for centralized isolation in accordance with policy1. The median duration of viral shedding in the asymptomatic group was 19 d (interquartile range (IQR), 15-26 d). The asymptomatic group had a significantly longer duration of viral shedding than the symptomatic group (log-rank P = 0.028). The virus-specific IgG levels in the asymptomatic group (median S/CO, 3.4; IQR, 1.6-10.7) were significantly lower (P = 0.005) relative to the symptomatic group (median S/CO, 20.5; IQR, 5.8-38.2) in the acute phase. Of asymptomatic individuals, 93.3% (28/30) and 81.1% (30/37) had reduction in IgG and neutralizing antibody levels, respectively, during the early convalescent phase, as compared to 96.8% (30/31) and 62.2% (23/37) of symptomatic patients. Forty percent of asymptomatic individuals became seronegative and 12.9% of the symptomatic group became negative for IgG in the early convalescent phase. In addition, asymptomatic individuals exhibited lower levels of 18 pro- and anti-inflammatory cytokines. These data suggest that asymptomatic individuals had a weaker immune response to SARS-CoV-2 infection. The reduction in IgG and neutralizing antibody levels in the early convalescent phase might have implications for immunity strategy and serological surveys.
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              Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19): A Review

              The pandemic of coronavirus disease 2019 (COVID-19) caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) presents an unprecedented challenge to identify effective drugs for prevention and treatment. Given the rapid pace of scientific discovery and clinical data generated by the large number of people rapidly infected by SARS-CoV-2, clinicians need accurate evidence regarding effective medical treatments for this infection.
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                Author and article information

                Journal
                J Thorac Dis
                J Thorac Dis
                JTD
                Journal of Thoracic Disease
                AME Publishing Company
                2072-1439
                2077-6624
                05 February 2023
                28 February 2023
                : 15
                : 2
                : 452-461
                Affiliations
                [1 ]deptDepartment of Respiratory and Critical Care Medicine, Ruijin Hospital , Shanghai Jiaotong University School of Medicine , Shanghai, China;
                [2 ]deptInstitute of Respiratory Disease , Shanghai Jiaotong University School of Medicine , Shanghai, China;
                [3 ]Shanghai Key Laboratory of Emergency Prevention, Diagnosis and Treatment of Respiratory Infectious Disease , Shanghai, China;
                [4 ]deptDepartment of Thoracic Surgery, Ruijin Hospital , Shanghai Jiaotong University School of Medicine , Shanghai, China;
                [5 ]deptDepartment of Neurosurgery, Ruijin Hospital , Shanghai Jiaotong University School of Medicine , Shanghai, China;
                [6 ]deptDepartment of Traumatology of Traditional Chinese Medicine, Ruijin Hospital , Shanghai Jiaotong University School of Medicine , Shanghai, China;
                [7 ]deptDepartment of Gastroenterology, Ruijin Hospital , Shanghai Jiao Tong University School of Medicine , Shanghai, China;
                [8 ]deptClinical Research Center, Ruijin Hospital , Shanghai Jiaotong University School of Medicine , Shanghai, China;
                [9 ]deptShanghai National Research Centre for Endocrine and Metabolic Disease, State Key Laboratory of Medicine Genomics, Shanghai Institute for Endocrine and Metabolic Disease, Ruijin Hospital , Shanghai Jiaotong University School of Medicine , Shanghai, China
                Author notes

                Contributions: (I) Conception and design: J Zhao, Y Li, R Chen, Y Xu, Q Yang, G Ning, Q Cheng, M Zhou, J Qu; (II) Administrative support: G Ning, Q Cheng, M Zhou, J Qu; (III) Provision of study materials or patients: G Ning, Q Cheng, M Zhou, J Qu; (IV) Collection and assembly of data: H Zhang, Z Yin, W Gu, J Hu, L Chen; (V) Data analysis and interpretation: J Zhao, Y Li, R Chen, Y Xu, Q Yang, J Li; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.

                [#]

                These authors contributed equally to this work.

                Correspondence to: Prof. Jieming Qu. Department of Respiratory and Critical Care Medicine, Shanghai Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, No. 197, Rui Jin 2nd Road, Shanghai 200025, China. Email: jmqu0906@ 123456163.com ; Prof. Min Zhou. Department of Respiratory and Critical Care Medicine, Shanghai Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, No. 197, Rui Jin 2nd Road, Shanghai 200025, China. Email: doctor_zhou_99@ 123456163.com ; Prof. Qijian Cheng. Department of Respiratory and Critical Care Medicine, Shanghai Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, No. 197, Rui Jin 2nd Road, Shanghai 200025, China. Email: Chengqijian@ 123456aliyun.com .
                Article
                jtd-15-02-452
                10.21037/jtd-22-980
                9992600
                36910077
                16e22e70-2e8d-47bd-9ee6-3939c34ec7e0
                2023 Journal of Thoracic Disease. All rights reserved.

                Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0.

                History
                : 13 July 2022
                : 13 December 2022
                Categories
                Original Article

                arbidol,severe acute respiratory syndrome coronavirus 2 (sars-cov-2),omicron,efficacy,safety

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