渗透性抗病毒抗炎聚合物鼻膜治疗新冠肺炎早期呼吸道症状的临床疗效

IF 1.4 Q4 MEDICINE, RESEARCH & EXPERIMENTAL
R. Shrivastava, Megha Vijay, Nathalie Maneby, R. Shrivastava
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引用次数: 3

摘要

背景:Covid-19感染是一种多因素疾病,病毒主要通过鼻腔进入,生长,引发炎症,破坏鼻黏膜细胞,使病毒进入全身并感染其他器官。当症状出现时,疾病的生理病理已经确立。免疫系统试图控制感染,但如果感染持续存在,它就会变得疲惫、疲劳、紧张,最后,会精疲力竭。因此,有效的治疗应该是多靶点的,而不应该只关注一个参数。尽量减少病毒浓度,减少鼻黏膜炎症,保持鼻表面清洁,可减少全身感染和发生严重呼吸窘迫的可能性。我们评估了渗透性鼻表面清洁、病毒和细胞因子捕获聚合膜在早期Covid-19阳性症状患者中的临床疗效和安全性。方法:采用随机、多中心、观察性研究,对213例患者进行渗透膜的疗效和安全性评估,随机分为2个相等组,在RT-PCR+检测后仅限14天。由于伦理原因,所有患者均接受对症治疗(ST)。另外,第1组患者接受试验产品(ST+TP, 2-3次喷雾,4-5次/天),疗程14天。每天评估莱斯特咳嗽问卷、视觉模拟量表以及与covid -19相关的症状,如发烧、疼痛、味觉、嗅觉和头痛。如果任何危及生命的临床症状加重,则立即住院治疗。结果:213例患者中,ST组98例,ST+TP组102例完成研究。13例患者未完成研究,ST组8例,ST+TP组5例在研究期间因低血氧水平或健康突然恶化住院,被排除在研究之外。在其余对照标准治疗组(n=98)中,临床症状在第1-2天急剧加重,第3-6天稳定,此后逐渐减轻。在测试产品组(n=102)中,首次使用后症状稳定并逐渐改善。试验产品组102例患者中只有42例由于产品的渗透性而出现鼻溢液或刺激。结论:持续多靶点从鼻表面分离和中和病毒颗粒和促炎细胞因子,以减少全身性病毒暴露,是一种非常合乎逻辑和有效的方法,可以避免covid -19诱导的全身病理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical Efficacy of an Osmotic, Antiviral and Anti-Inflammatory Polymeric Nasal Film to Treat Covid-19 Early-Phase Respiratory Symptoms
Background: Covid-19 infection is a multifactorial disease where the virus mainly enters through the nasal cavity, grows, triggers inflammation, and destroys nasal mucosa cells, allowing systemic virus entry and infection of other organs. When symptoms appear, the disease physiopathology is already established. The immune system tries to control the infection but if the infection persists, it gets tired, fatigued, stressed, and finally, there is burnout. Therefore, an effective treatment should be multi-targeted and should not focus only on one parameter. Minimizing virus concentration, reducing nasal mucosa inflammation, and keeping the nasal surface clean should lessen systemic infection and the probability of developing severe respiratory distress. We evaluated clinical efficacy and safety of an osmotic nasal surface cleaning, virus and cytokine trapping polymeric film, in early-stage Covid-19 positive symptomatic patients. Methods: A randomized, multicentric, observational study was performed to evaluate the efficacy and safety of the osmotic film in 213 patients, randomized in 2 equal arms, and confined for 14-days just after the RT-PCR+ test. Due to ethical reasons, all patients received symptomatic treatments (ST). In addition, the patients in Arm-1 received the test product (ST+TP, 2-3 sprays, 4-5 times/ day) for 14-days. Leicester Cough Questionnaire, Visual Analogue Scale, and Covid-19-associated symptoms such as fever, pain, taste, smell, and headache were evaluated daily. Home-confined patients were immediately hospitalized in case of aggravation of any life-threatening clinical sign. Results: Among 213 patients, 98 in the ST and 102 in the ST+TP group completed the study. Thirteen patients did not complete the study as 8 in the ST group and 5 in the ST+TP group were hospitalized during the study due to low blood oxygen levels or sudden health deterioration and were excluded from the study. In the remaining control standard treatment group (n=98), clinical signs sharply aggravated on day 1-2 followed by stabilisation between days 3-6 and progressive reduction thereafter. In the test product group (n=102), symptoms were stabilized just after the first application and improved progressively. Only 42/102 patients in the test product group presented nasal discharge or irritation due to the osmotic properties of the product. Conclusion: The continuous multi-target approach of detaching and neutralizing virus particles and pro-inflammatory cytokines from the nasal surface to minimize systemic virus exposure is a very logical and efficient approach to avoid Covid-19-induced systemic pathology.
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来源期刊
Open Access Journal of Clinical Trials
Open Access Journal of Clinical Trials MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
3.90
自引率
0.00%
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2
审稿时长
16 weeks
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