Cargando…
An open label randomized clinical trial of Indomethacin for mild and moderate hospitalised Covid-19 patients
Indomethacin, a non-steroidal anti-inflammatory drug (NSAID), has been presented as a broad-spectrum antiviral agent. This randomised clinical trial in a hospital setting evaluated the efficacy and safety of this drug in RT-PCR-positive coronavirus disease 2019 (COVID-19) patients. A total of 210 RT...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9016692/ https://www.ncbi.nlm.nih.gov/pubmed/35440611 http://dx.doi.org/10.1038/s41598-022-10370-1 |
_version_ | 1784688581377261568 |
---|---|
author | Ravichandran, Rajan Mohan, Surapaneni Krishna Sukumaran, Suresh Kumar Kamaraj, Devakumar Daivasuga, Sumetha Suga Ravi, Samson Oliver Abraham Samuel Vijayaraghavalu, Sivakumar Kumar, Ramarathnam Krishna |
author_facet | Ravichandran, Rajan Mohan, Surapaneni Krishna Sukumaran, Suresh Kumar Kamaraj, Devakumar Daivasuga, Sumetha Suga Ravi, Samson Oliver Abraham Samuel Vijayaraghavalu, Sivakumar Kumar, Ramarathnam Krishna |
author_sort | Ravichandran, Rajan |
collection | PubMed |
description | Indomethacin, a non-steroidal anti-inflammatory drug (NSAID), has been presented as a broad-spectrum antiviral agent. This randomised clinical trial in a hospital setting evaluated the efficacy and safety of this drug in RT-PCR-positive coronavirus disease 2019 (COVID-19) patients. A total of 210 RT-PCR-positive COVID-19 patients who provided consent were allotted to the control or case arm, based on block randomisation. The control arm received standard of care comprising paracetamol, ivermectin, and other adjuvant therapies. The patients in the case arm received indomethacin instead of paracetamol, with other medications retained. The primary endpoint was the development of hypoxia/desaturation with SpO(2) ≤ 93, while time to become afebrile and time for cough and myalgia resolution were the secondary endpoints. The results of 210 patients were available, with 103 and 107 patients in the indomethacin and paracetamol arms, respectively. We monitored patient profiles along with everyday clinical parameters. In addition, blood chemistry at the time of admission and discharge was assessed. As no one in either of the arms required high-flow oxygen, desaturation with a SpO(2) level of 93 and below was the vital goal. In the indomethacin group, none of the 103 patients developed desaturation. On the other hand, 20 of the 107 patients in the paracetamol arm developed desaturation. Patients who received indomethacin also experienced more rapid symptomatic relief than those in the paracetamol arm, with most symptoms disappearing in half the time. In addition, 56 out of 107 in the paracetamol arm had fever on the seventh day, while no patient in the indomethacin group had fever. Neither arm reported any adverse event. The fourteenth-day follow-up revealed that the paracetamol arm patients had faced several discomforts; indomethacin arm patients mostly complained only of tiredness. Indomethacin is a safe and effective drug for treating patients with mild and moderate covid-19. |
format | Online Article Text |
id | pubmed-9016692 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-90166922022-04-19 An open label randomized clinical trial of Indomethacin for mild and moderate hospitalised Covid-19 patients Ravichandran, Rajan Mohan, Surapaneni Krishna Sukumaran, Suresh Kumar Kamaraj, Devakumar Daivasuga, Sumetha Suga Ravi, Samson Oliver Abraham Samuel Vijayaraghavalu, Sivakumar Kumar, Ramarathnam Krishna Sci Rep Article Indomethacin, a non-steroidal anti-inflammatory drug (NSAID), has been presented as a broad-spectrum antiviral agent. This randomised clinical trial in a hospital setting evaluated the efficacy and safety of this drug in RT-PCR-positive coronavirus disease 2019 (COVID-19) patients. A total of 210 RT-PCR-positive COVID-19 patients who provided consent were allotted to the control or case arm, based on block randomisation. The control arm received standard of care comprising paracetamol, ivermectin, and other adjuvant therapies. The patients in the case arm received indomethacin instead of paracetamol, with other medications retained. The primary endpoint was the development of hypoxia/desaturation with SpO(2) ≤ 93, while time to become afebrile and time for cough and myalgia resolution were the secondary endpoints. The results of 210 patients were available, with 103 and 107 patients in the indomethacin and paracetamol arms, respectively. We monitored patient profiles along with everyday clinical parameters. In addition, blood chemistry at the time of admission and discharge was assessed. As no one in either of the arms required high-flow oxygen, desaturation with a SpO(2) level of 93 and below was the vital goal. In the indomethacin group, none of the 103 patients developed desaturation. On the other hand, 20 of the 107 patients in the paracetamol arm developed desaturation. Patients who received indomethacin also experienced more rapid symptomatic relief than those in the paracetamol arm, with most symptoms disappearing in half the time. In addition, 56 out of 107 in the paracetamol arm had fever on the seventh day, while no patient in the indomethacin group had fever. Neither arm reported any adverse event. The fourteenth-day follow-up revealed that the paracetamol arm patients had faced several discomforts; indomethacin arm patients mostly complained only of tiredness. Indomethacin is a safe and effective drug for treating patients with mild and moderate covid-19. Nature Publishing Group UK 2022-04-19 /pmc/articles/PMC9016692/ /pubmed/35440611 http://dx.doi.org/10.1038/s41598-022-10370-1 Text en © The Author(s) 2022, corrected publication 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Ravichandran, Rajan Mohan, Surapaneni Krishna Sukumaran, Suresh Kumar Kamaraj, Devakumar Daivasuga, Sumetha Suga Ravi, Samson Oliver Abraham Samuel Vijayaraghavalu, Sivakumar Kumar, Ramarathnam Krishna An open label randomized clinical trial of Indomethacin for mild and moderate hospitalised Covid-19 patients |
title | An open label randomized clinical trial of Indomethacin for mild and moderate hospitalised Covid-19 patients |
title_full | An open label randomized clinical trial of Indomethacin for mild and moderate hospitalised Covid-19 patients |
title_fullStr | An open label randomized clinical trial of Indomethacin for mild and moderate hospitalised Covid-19 patients |
title_full_unstemmed | An open label randomized clinical trial of Indomethacin for mild and moderate hospitalised Covid-19 patients |
title_short | An open label randomized clinical trial of Indomethacin for mild and moderate hospitalised Covid-19 patients |
title_sort | open label randomized clinical trial of indomethacin for mild and moderate hospitalised covid-19 patients |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9016692/ https://www.ncbi.nlm.nih.gov/pubmed/35440611 http://dx.doi.org/10.1038/s41598-022-10370-1 |
work_keys_str_mv | AT ravichandranrajan anopenlabelrandomizedclinicaltrialofindomethacinformildandmoderatehospitalisedcovid19patients AT mohansurapanenikrishna anopenlabelrandomizedclinicaltrialofindomethacinformildandmoderatehospitalisedcovid19patients AT sukumaransureshkumar anopenlabelrandomizedclinicaltrialofindomethacinformildandmoderatehospitalisedcovid19patients AT kamarajdevakumar anopenlabelrandomizedclinicaltrialofindomethacinformildandmoderatehospitalisedcovid19patients AT daivasugasumethasuga anopenlabelrandomizedclinicaltrialofindomethacinformildandmoderatehospitalisedcovid19patients AT ravisamsonoliverabrahamsamuel anopenlabelrandomizedclinicaltrialofindomethacinformildandmoderatehospitalisedcovid19patients AT vijayaraghavalusivakumar anopenlabelrandomizedclinicaltrialofindomethacinformildandmoderatehospitalisedcovid19patients AT kumarramarathnamkrishna anopenlabelrandomizedclinicaltrialofindomethacinformildandmoderatehospitalisedcovid19patients AT ravichandranrajan openlabelrandomizedclinicaltrialofindomethacinformildandmoderatehospitalisedcovid19patients AT mohansurapanenikrishna openlabelrandomizedclinicaltrialofindomethacinformildandmoderatehospitalisedcovid19patients AT sukumaransureshkumar openlabelrandomizedclinicaltrialofindomethacinformildandmoderatehospitalisedcovid19patients AT kamarajdevakumar openlabelrandomizedclinicaltrialofindomethacinformildandmoderatehospitalisedcovid19patients AT daivasugasumethasuga openlabelrandomizedclinicaltrialofindomethacinformildandmoderatehospitalisedcovid19patients AT ravisamsonoliverabrahamsamuel openlabelrandomizedclinicaltrialofindomethacinformildandmoderatehospitalisedcovid19patients AT vijayaraghavalusivakumar openlabelrandomizedclinicaltrialofindomethacinformildandmoderatehospitalisedcovid19patients AT kumarramarathnamkrishna openlabelrandomizedclinicaltrialofindomethacinformildandmoderatehospitalisedcovid19patients |