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Combined Therapy of Ciclosporin Plus Favipiravir in the Management of Patients with Severe COVID-19, not Responding to Dexamethasone: A non-Controlled Prospective Trial

BACKGROUND: Regarding the COVID-19 pandemic, potential therapeutic agents are being evaluated almost every day. Ciclosporin, a calcineurin inhibitor, is characterized by beneficial antiviral and immunomodulatory effects. The present study aimed to evaluate the efficacy of ciclosporin in managing COV...

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Autores principales: Barati, Saghar, MohammadReza Hashemian, Seyed, Tabarsi, Payam, Abedini, Atefeh, Ashrafzadeh, Mahshid, Haseli, Sara, Abtahian, Zahra, Yousefian, Sahar, Dastan, Alireza, Sobhanian, Ali, Dastan, Farzaneh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier B.V. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8332739/
https://www.ncbi.nlm.nih.gov/pubmed/34426105
http://dx.doi.org/10.1016/j.intimp.2021.108043
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author Barati, Saghar
MohammadReza Hashemian, Seyed
Tabarsi, Payam
Abedini, Atefeh
Ashrafzadeh, Mahshid
Haseli, Sara
Abtahian, Zahra
Yousefian, Sahar
Dastan, Alireza
Sobhanian, Ali
Dastan, Farzaneh
author_facet Barati, Saghar
MohammadReza Hashemian, Seyed
Tabarsi, Payam
Abedini, Atefeh
Ashrafzadeh, Mahshid
Haseli, Sara
Abtahian, Zahra
Yousefian, Sahar
Dastan, Alireza
Sobhanian, Ali
Dastan, Farzaneh
author_sort Barati, Saghar
collection PubMed
description BACKGROUND: Regarding the COVID-19 pandemic, potential therapeutic agents are being evaluated almost every day. Ciclosporin, a calcineurin inhibitor, is characterized by beneficial antiviral and immunomodulatory effects. The present study aimed to evaluate the efficacy of ciclosporin in managing COVID-19. METHODS: This study was a prospective non-controlled clinical trial carried out on 20 patients. Confirmed COVID-19 patients received two doses of ciclosporin (10 mg/kg and 5 mg/kg injections) 24 h apart. Mortality rate and the lengths of intensive care unit (ICU) and hospital stays were assessed for all 20 patients. RESULTS: The mortality rate and the need for mechanical ventilation were calculated as 50%. The percentage of ICU admission was 70%. The lengths of ICU and hospital stays were 8.13 ± 6.81 and 14.25 ± 8.55 days, respectively. The levels of ferritin and white blood cells were significantly higher after injecting the second dose of ciclosporin. Seven patients (35%) had radiologically improved lungs after ciclosporin therapy. CONCLUSION: It seems that the protocol of two doses of ciclosporin in combination with favipiravir does not have favorable effects among COVID-19 patients that do not respond to dexamethasone. Controlled trials are needed to confirm the results.
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spelling pubmed-83327392021-08-04 Combined Therapy of Ciclosporin Plus Favipiravir in the Management of Patients with Severe COVID-19, not Responding to Dexamethasone: A non-Controlled Prospective Trial Barati, Saghar MohammadReza Hashemian, Seyed Tabarsi, Payam Abedini, Atefeh Ashrafzadeh, Mahshid Haseli, Sara Abtahian, Zahra Yousefian, Sahar Dastan, Alireza Sobhanian, Ali Dastan, Farzaneh Int Immunopharmacol Article BACKGROUND: Regarding the COVID-19 pandemic, potential therapeutic agents are being evaluated almost every day. Ciclosporin, a calcineurin inhibitor, is characterized by beneficial antiviral and immunomodulatory effects. The present study aimed to evaluate the efficacy of ciclosporin in managing COVID-19. METHODS: This study was a prospective non-controlled clinical trial carried out on 20 patients. Confirmed COVID-19 patients received two doses of ciclosporin (10 mg/kg and 5 mg/kg injections) 24 h apart. Mortality rate and the lengths of intensive care unit (ICU) and hospital stays were assessed for all 20 patients. RESULTS: The mortality rate and the need for mechanical ventilation were calculated as 50%. The percentage of ICU admission was 70%. The lengths of ICU and hospital stays were 8.13 ± 6.81 and 14.25 ± 8.55 days, respectively. The levels of ferritin and white blood cells were significantly higher after injecting the second dose of ciclosporin. Seven patients (35%) had radiologically improved lungs after ciclosporin therapy. CONCLUSION: It seems that the protocol of two doses of ciclosporin in combination with favipiravir does not have favorable effects among COVID-19 patients that do not respond to dexamethasone. Controlled trials are needed to confirm the results. Elsevier B.V. 2021-10 2021-08-04 /pmc/articles/PMC8332739/ /pubmed/34426105 http://dx.doi.org/10.1016/j.intimp.2021.108043 Text en © 2021 Elsevier B.V. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Article
Barati, Saghar
MohammadReza Hashemian, Seyed
Tabarsi, Payam
Abedini, Atefeh
Ashrafzadeh, Mahshid
Haseli, Sara
Abtahian, Zahra
Yousefian, Sahar
Dastan, Alireza
Sobhanian, Ali
Dastan, Farzaneh
Combined Therapy of Ciclosporin Plus Favipiravir in the Management of Patients with Severe COVID-19, not Responding to Dexamethasone: A non-Controlled Prospective Trial
title Combined Therapy of Ciclosporin Plus Favipiravir in the Management of Patients with Severe COVID-19, not Responding to Dexamethasone: A non-Controlled Prospective Trial
title_full Combined Therapy of Ciclosporin Plus Favipiravir in the Management of Patients with Severe COVID-19, not Responding to Dexamethasone: A non-Controlled Prospective Trial
title_fullStr Combined Therapy of Ciclosporin Plus Favipiravir in the Management of Patients with Severe COVID-19, not Responding to Dexamethasone: A non-Controlled Prospective Trial
title_full_unstemmed Combined Therapy of Ciclosporin Plus Favipiravir in the Management of Patients with Severe COVID-19, not Responding to Dexamethasone: A non-Controlled Prospective Trial
title_short Combined Therapy of Ciclosporin Plus Favipiravir in the Management of Patients with Severe COVID-19, not Responding to Dexamethasone: A non-Controlled Prospective Trial
title_sort combined therapy of ciclosporin plus favipiravir in the management of patients with severe covid-19, not responding to dexamethasone: a non-controlled prospective trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8332739/
https://www.ncbi.nlm.nih.gov/pubmed/34426105
http://dx.doi.org/10.1016/j.intimp.2021.108043
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