Background: Lopinavir/Ritonavir is an oral combination agent being used to treat Human Immunodeficiency Virus. It was demonstrated to have clinical and in vitro activity against coronaviruses. There are no specific anti viral preparation or biologic agents currently recommended to treat Severe Acute Respiratory Syndrome Corona Virus 2(SARS-CoV-2) infection. There are no in-vitro studies published as well, for Lopinavir/ritonavir against SARS- CoV-2. However, recent case series and cohort studies showed earlier clinical improvement and shorter duration of viral shedding were noted especially if the combination drug is administered early in the course of the disease. Objective: The objective of this review is to search, retrieve, appraise and summarize existing studies and clinical trials regarding the efficacy and safety of Lopinavir/Ritonavir combination in the treatment of SARS Cov-2 infection. The evidenced based recommendations may be used as a guide by clinicians and practitioners in their current practice. Methods: Electronic databases were searched for evidences (Medline, CENTRAL, ISRCTN registry, ClinicalTrial. gov and Chinese Clinical Trial Registry) and articles were selected based on a pre-defined criteria according to population, intervention, outcome and study designs. Results: Two randomized controlled trials were included in this review. Lopinavir/ritonavir treatment did not significantly accelerate clinical improvement, reduce mortality, or shoten the viral RNA detectability in patients with serious COVID-19. Conclusion There is little evidence to conclude on the effectiveness of lopinavir/ritonavir in patients with COVID-19. More high-quality randomized controlled trials are needed.
Lopinavir ; Ritonavir ; COVID-19

BACKGROUND AND OBJECTIVE

Nontuberculous mycobacteria (NTM) lung disease appears like tuberculosis infection but is resistant to primary anti-tuberculosis drugs. Hence, patients whose sputum sample tests positive for acid-fast bacilli (AFB) and bacterial culture for several times should be assessed for colonization or infection with NTM in a damaged lung secondary to TB. In such cases, though drug-resistant TB may be adequately treated, treatment may need to be directed towards the NTM as well. In NTM therapy, the duration and choice of treatment agent is based upon the specific organism and disease extent. This study used one-step multiplex PCR (mPCR) assay for rapid differentiation of solid cultures in Ogawa medium as Mycobacterium tuberculosis (MTB) and/or NTM.

METHODS

A total of 80 stocked isolates obtained from the Lung Center of the Philippines from January to December 2018 were screened for NTM in terms of growth in Ogawa medium, acid fastness, and MPT64 TB antigen test result. These were from sputum specimens of multidrug-resistant tuberculosis (MDR-TB) patients. DNA was extracted from cultures (n=55) grown in Ogawa medium and one-step mPCR was performed to identify NTM to the species level.

RESULTS

Out of 80 samples screened, a total of 55 isolates were identified as NTM. One-step mPCR identified 12.73% (7/55) as M. abscessus, 34.55% (19/55) as M. massiliense, 1.82% (1/55) as M. kansasii, and 50.91% (28/55) were identified only up to genus Mycobacteria spp. Neither M. avium complex nor M. intracellulare was identified among the samples tested.

CONCLUSION

One-step mPCR was able to identify isolates as MTB or NTM coinciding with the initial screening using MPT64 TB antigen test. Multiplex PCR has given a more specific identificati on to the species level. The use of mPCR in identifying MTB and clinically significant NTM’s is suitable for the adequate treatment of mycobacterial infection.

Human ; Bacteria ; Multiplex Pcr ; Multiplex Polymerase Chain Reaction ; Mycobacteria ; Mycobacterium ; Tuberculosis, Multidrug-resistant

Objectives: While many healthcare workers (HCWs) contracted COVID-19 during the pandemic, more information is needed to fully understand the potential for adverse health effects in this population segment. The aim of the present study is to examine the association between healthcare worker status and neurologic and clinical outcomes in COVID-19 infected inpatients. Methods: Using the nationwide database provided by the retrospective cohort Philippine CORONA study, we extracted relevant data and performed a secondary analysis primarily focusing on the presentation and outcomes of healthcare workers. Propensity score matching in a 3:1 ratio was performed to match HCWs and non-HCWs. We performed multiple logistic and Cox regression analyses to determine the relationship between HCWs and COVID-19 clinical outcomes. Results: We included 3,362 patients infected with COVID-19; of which, 854 were HCWs. Among the HCWs, a total of 31 (3.63%) and 45 (5.27%) had the primary outcomes of in-hospital mortality and respiratory failure, respectively. For both overall and 3:1 propensity-matched cohorts, being an HCW significantly decreased the odds of the following outcomes: severe/critical COVID-19 at nadir; in-hospital mortality; respiratory failure; intensive care unit admission; and hospital stay >14 days. Conclusion We found that being an HCW is not associated with worse neurologic and clinical outcomes among patients hospitalized for COVID-19.
Health Personnel ; COVID-19 ; SARS-CoV-2 ; Cohort Studies

OBJECTIVES

While many healthcare workers (HCWs) contracted COVID-19 during the pandemic, more information is needed to fully understand the potential for adverse health effects in this population segment. The aim of the present study is to examine the association between healthcare worker status and neurologic and clinical outcomes in COVID-19 infected inpatients.

METHODS

Using the nationwide database provided by the retrospective cohort Philippine CORONA study, we extracted relevant data and performed a secondary analysis primarily focusing on the presentation and outcomes of healthcare workers. Propensity score matching in a 3:1 ratio was performed to match HCWs and non-HCWs. We performed multiple logistic and Cox regression analyses to determine the relationship between HCWs and COVID-19 clinical outcomes.

RESULTS

We included 3,362 patients infected with COVID-19; of which, 854 were HCWs. Among the HCWs, a total of 31 (3.63%) and 45 (5.27%) had the primary outcomes of in-hospital mortality and respiratory failure, respectively. For both overall and 3:1 propensity-matched cohorts, being an HCW significantly decreased the odds of the following outcomes: severe/critical COVID-19 at nadir; in-hospital mortality; respiratory failure; intensive care unit admission; and hospital stay >14 days.

CONCLUSION

We found that being an HCW is not associated with worse neurologic and clinical outcomes among patients hospitalized for COVID-19.

Human ; Health Personnel ; Covid-19 ; Sars-cov-2 ; Cohort Studies