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Rev Esp Quimioter 2022; 35(3): 249-259

Efficacy of early use of remdesivir: a systematic review of subgroup analysis

MANUEL DAVID GIL-SIERRA, MARIA DEL PILAR BRICEÑO-CASADO, EMILIO JESÚS ALEGRE-DEL REY, MARINA SÁNCHEZ-HIDALGO

Published: 17 March 2022

http://www.doi.org/10.37201/req/154.2021

Introduction. A possible benefit has been suggested for early treatment of severe coronavirus disease 2019 (COVID-19) with remdesivir. The efficacy of this drug is controversial and could significantly influence the efficiency in healthcare systems. The objective is the methodological interpretation of subgroup analyzes according to starting of remdesivir treatment with respect to symptom onset of COVID-19.
Methods. A search in Pubmed® database was performed. Randomized clinical trials (RCTs) with subgroup analysis regarding early and late use of remdesivir were selected. All endpoints were assessed using two methodologies. First methodology considered statistical interaction, pre-specification, biological plausibility, and consistency of results. Second methodology was a validated tool with preliminary questions to discard subset analysis without relevant minimum conditions, and a checklist with recommendations for applicability.
Results. A total of 54 results were found and five RCTs were selected. According first methodology, consistent heterogeneity was only found in time to clinical improvement and better clinical status score at day 15 for patients with severe COVID-19 and <7 days of symptoms. About second methodology, these results about early use of remdesivir may be applied to clinical practice with caution.
Conclusions. We developed a systematic search and application of an established methodology for interpretation of subgroup analysis about early use of remdesivir. Results in severe COVID-19 suggested that early use of remdesivir provides a greater benefit in <7 days of symptoms for time to clinical improvement and better clinical status score at day 15. Future studies could use 7-day cut-off of symptoms to evaluate remdesivir.

Rev Esp Quimioter 2022; 35(3): 249-259 [Full-text PDF]


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Rev Esp Quimioter 2022; 35(4):333-343

COVID in Pediatric Age: an opinion paper

TERESA HERNÁNDEZ-SAMPELAYO, JAVIER GÓMEZ-PAVÓN, JUAN GONZÁLEZ DEL CASTILLO, MARI CRUZ MARTÍN-DELGADO, FRANCISCO JAVIER MARTÍN SÁNCHEZ, MANUEL MARTÍNEZ-SELLÉS, JOSÉ MARÍA MOLERO GARCÍA, SANTIAGO MORENO GUILLÉN, FERNANDO RODRÍGUEZ-ARTALEJO, JULIÁN RUIZ-GALIANA, RAFAEL CANTÓN, PILAR DE LUCAS RAMOS, ALEJANDRA GARCÍA-BOTELLA, ALBERTO GARCÍA-LLEDÓ, CRISTINA CALVO REY, EMILIO BOUZA

Published: 15 March 2022

http://www.doi.org/10.37201/req/012.2022

The incidence of COVID in pediatrics was underestimated during the first months of the pandemic due to the oligosymptomatic nature of the infection in many children and the scarcity of diagnostic tests applied to this population. It is now accepted that children are infected and transmit the disease in the same way as adults. On the contrary, children have less severe and less lethal COVID, probably due to a lower maturity of the child’s immune system, a lower number of ACE2 receptors and the lower presence of comorbidities in this population group.
The development of a multisystemic inflammatory syndrome after SARS-CoV-2 infection in children, despite its rarity, is a very serious condition that frequently requires intensive care. Other less severe post-COVID manifestations have been described in children but are not yet well defined.
COVID has had and continues to have a significant psychological impact on the children themselves, on their caregivers and on the exacerbation of pre-existing psychiatric conditions. We apply adult therapeutic principles to children but with very low levels of evidence. Information on the tolerability of the available medications in this population group is still scarce. The mortality of COVID in children is very low and generally affects children with significant comorbidities.
There are, at present, three vaccines licensed for pediatric use which are compatible with all other vaccines applicable to children.
In these circumstances, there has been much speculation about the indication for vaccination in the pediatric age group, but given its good tolerance, there are clinical and ethical reasons that, in our opinion, justify it.

Rev Esp Quimioter 2022; 35(4):333-343 [Full-text PDF]


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Rev Esp Quimioter 2022; 35(4):307-332

Air pollution and health prevention: A document of reflection

EMILIO BOUZA, FRANCISCO VARGAS, BERNARDINO ALCÁZAR, TERESA ÁLVAREZ, ÁNGEL ASENSIO, GLORIA CRUCETA, DIEGO GRACIA, JESÚS GUINEA, MIGUEL ANGEL GIL, CRISTINA LINARES, PATRICIA MUÑOZ, EDUARDO OLIER, PAULINO PASTOR, MARÍA LUISA PEDRO-BOTET, XAVIER QUEROL, JAVIER TOVAR, ISABEL URRUTIA, FELIPE VILLAR, ESTEBAN PALOMO

Published: 11 March 2022

http://www.doi.org/10.37201/req/171.2021

Ambient air quality, pollution and its implication on health is a topic of enormous importance that is normally dealt with by major specialists in their particular areas of interest. In general, it is not discussed from multidisciplinary approaches or with a language that can reach everyone. For this reason, the Health Sciences Foundation, from its prevention area, has formulated a series of questions to people with very varied competences in the area of ambient air quality in order to obtain a global panorama of the problem and its elements of measurement and control. The answers have been produced by specialists in each subject and have been subjected to a general discussion that has allowed conclusions to be reached on each point. The subject was divided into three main blocks: external ambient air, internal ambient air, mainly in the workplace, and hospital ambient air and the consequences of its poor control. Along with the definitions of each area and the indicators of good and bad quality, some necessary solutions have been pointed out. We have tried to know the current legislation on this problem and the competences of the different administrations on it. Despite its enormous importance, ambient air  uality and health is not usually a topic of frequent presence in the general media and we have asked about the causes of this. Finally, the paper addresses a series of reflections from the perspective of ethics and very particularly in the light of the events that the present pandemic raises. This work aims to provide objective data and opinions that will enable non-specialists in the field to gain a better understanding of this worrying reality.

Rev Esp Quimioter 2022; 35(4):307-332 [Full-text PDF]


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Rev Esp Quimioter 2022; 35(3): 260-264

Retrospective observational study of the persistence of SARS-CoV-2 infection in patients previously treated with rituximab

MARÍA TERESA GÓMEZ LLUCH, BEATRIZ PROY VEGA, MARTÍN CABERO BECERRA, ÁLVARO RODRÍGUEZ, ALBERTO ESCALERA ZALVIDE, SIMÓN ÁNGEL SÁNCHEZ

Published: 10 March 2022

http://www.doi.org/10.37201/req/122.2022

Introduction. Rituximab-induced immunosuppression could be a risk factor for mortality from COVID-19. The aim of the study was to describe the prevalence of SARS-CoV-2 infection in patients who have received rituximab and its association with a persistent viral infection
Material and methods. Retrospective observational study of patients who received rituximab in the 6 months before to the onset of the pandemic. We analyzed the presence of infection and associated them with demographic variables, pathological history related to an increased risk of developing severe COVID-19, the doses of rituximab received, the type of ventilatory support, thromboembolic events, and the treatment received. A descriptive analysis of all the variables was carried out and infected and uninfected patients were compared.
Results. We screened a total of 68 patients who had received rituximab (median cumulative dose: 4,161mg (2,611–8,187.5)). 54.4% men, mean age 60.8 years (15.7; 25-87)). C + was confirmed for 22 patients. Of these, 45.5% had high blood pressure, 36.4% Diabetes Mellitus, 31.8% smokers/ex-smoker, 22.7% lung disease, 13.6% heart disease and 4.5% obesity. There were no statistically significant differences between C+ and C-. Only 2 patients developed immunity. For 10 patients (45.5%) did not have a negative CRP until the end of the follow-up. There was no association with cumulative dose of rituximab. The mortality rate was 22.7% in the C+.
Conclusions. We observe that the persistence of the infection leads to a worse evolution of COVID-19. The use of alternatives should be considered during the pandemic, because of patients with decreased B-cell function may have high risk of fatal progression from COVID-19.

Rev Esp Quimioter 2022; 35(3): 260-264 [Texto completo PDF]


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Rev Esp Quimioter 2022; 35(3): 299-300

Neumonía secundaria por Bordetella hinzii en paciente con infección por SARS-CoV-2  

MARÍA NIEVES CARMONA TELLO, TOMÁS TOSCO NÚÑEZ, IRENE JOSEFINA SAINZ DE AJA CURBELO, FERNANDO CAÑAS HERNÁNDEZ

Published: 7 March 2022

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/160.2021

Rev Esp Quimioter 2022; 35(3): 299-300 [Texto completo PDF]


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Rev Esp Quimioter 2022; 35(3): 293-294

Neisseria meningitidis bacteraemia and SARS-CoV-2 infection: a coinfection that reminds previous epidemic outbreaks  

MIGUEL MARTÍN-ROMERO, DAVID CLAVERO-MARTÍNEZ, ANTONIA MARÍA CASTILLO-NAVARRO, ELISA GARCÍA-VÁZQUEZ

Published: 4 March 2022

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/151.2021

Rev Esp Quimioter 2022; 35(3): 293-294 [Full-text PDF]


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Rev Esp Quimioter 2022; 35(3): 295-298

A case report. Rediscovering tuberculostatics drugs: skin rash and pyrazinamide  

SILVIA CALPENA MARTÍNEZ, IRENE CARRILLO ACOSTA, BEATRIZ ÁLVAREZ ÁLVAREZ, MIGUEL GÓRGOLAS, HERNÁNDEZ-MORA

Published: 1 March 2022

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/157.2021

Rev Esp Quimioter 2022; 35(3): 295-298 [Full-text PDF]


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Rev Esp Quimioter 2022; 35(2):222-224

Optic neuritis as sign presentation of acute disseminated encephalomyelitis following Mycoplasma pneumoniae infection  

BEATRIZ GONZÁLEZ-RODRÍGUEZ, MARÍA GONZÁLEZ-RODRÍGUEZ, NATALIA BEJARANO RAMÍREZ, FRANCISCO JAVIER REDONDO CALVO

Published: 25 February 2022

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/112.2021

Rev Esp Quimioter 2022; 35(2):222-224 [Full-text PDF]


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Rev Esp Quimioter 2022; 35(3): 236-240

Nirmatrelvir plus ritonavir (Paxlovid) a potent SARS-CoV-2 3CLpro protease inhibitor combination

JORDI REINA, CARLA IGLESIAS

Published: 21 February 2022

http://www.doi.org/10.37201/req/002.2022

All coronavirus, including SARS-CoV-2, encode two proteases needed for the processing of PP1A and PP1AB polyproteins. The main protease 3CL (chemotripsine-like) gives rise to the formation of NSP11/16 proteins. The 3CL protease has been constituted as one of the possible therapeutic targets for the development of antiviral drugs against SARS-COV-2 due to its highly conserved sequence and structure among all coronaviruses. During the SARS-COV-1 pandemic, a hydroxymethyl ketone derivative (PF-00835231) was identified with an intense inhibitory activity against the 3CL protease. Subsequent chemical modifications gave rise to derivative PF-07321332 (nirmatrelvir) which has shown a high antiviral efficacy against SARS-COV-2. The company’s data indicate that it is capable of reducing 89% the risk of hospitalization and death of patients infected with hardly adverse effects. Its effectiveness improves if it is administered orally in the first 24-48 hours and the duration of treatment has been established between 3-5 days. The commercial form has been associated with the antiviral ritonavir that has shown the metabolism of nirmatrelvir, lengthening its average life. This antiviral would be effective against current and future viral variants, since 3CL is not modified in them. The FDA approved this antiviral in November 2021 and EMA is in the final evaluation phase.

Rev Esp Quimioter 2022; 35(3): 236-240 [Texto completo PDF]


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Rev Esp Quimioter 2022; 35(3): 231-235

The Victoria and Yamagata Lineages of Influenza B Viruses, unknown and undervalued

JORDI REINA

Published: 18 February 2022

http://www.doi.org/10.37201/req/159.2021

The influenza virus B belongs to the family Orthomyxoviriridae and to the genus Influenzavirus B. It has a negative RNA-type genome made up of about 14,648 nucleotides divided into eight different segments that encode about 11 proteins. Before 1980 all influenza B viruses belonged to a single genetic lineage; but in this year two antigenically and genetically distinct lineages emerged which were named B/Victoria/2/1987 and B/Yamagata/16/1988. Intralineage and interlineage genetic exchange processes have been demonstrated; The most frequent of them are those in which the Victoria lineage acquires genes from the Yamagata lineage. It has been proposed that the differences in the evolutionary dynamics of the two lineages are due to the different binding preferences of influenza hemagglutinin to the cellular receptor. The Victoria lineage has shown the ability to bind to cell receptors with sialic acid residues at the α-2,3 and α-2,6 positions; whereas the Yamagata lineage does so exclusively in the human α-2,6 positions of the respiratory tract. Low circulation in recent months may have contributed to the temporary elimination (“extinction”) of the Yamagata lineage. Since 2017, almost all of the strains of this lineage belong to clade 3A, when previously multiple circulating clades were detected. Although this clade 3A is diverse at the genetic level and has acquired surrogate mutations in the hemagglutinin gene, these have not determined significant antigenic changes that have made it necessary to replace its antigenic component (B/Pukhet/3073/2013) in the influenza vaccine since 2015.

Rev Esp Quimioter 2022; 35(3): 231-235 [Texto completo PDF]


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