Lopinavir-Ritonavir - Ribavirin - Interferon beta-1b - Covid Treatment Clinical Studies

12 May 2020/8 May 2020
Methods  Patients were randomly assigned (2:1) to a 14-day combination of lopinavir 400 mg and ritonavir 100 mg every 12 h, ribavirin 400 mg every 12 h, and three doses of 8 million international units of interferon beta-1b on alternate days (combination group) or to 14 days of lopinavir 400 mg and ritonavir 100 mg every 12 h (control group). The study is registered with ClinicalTrials.gov, NCT04276688.
https://clinicaltrials.gov/ct2/show/NCT04276688


India prices

Lopinavir-Ritonavir  - Elmetra  Rs. 1700 per bottle of 60 tablets.
https://www.indiamart.com/proddetail/emletra-lopinavir-ritonavir-12670234530.html

Ribavirin -  120 per strip of 10 tablets of 200 mg
https://dir.indiamart.com/impcat/ribavirin.html

Interferon beta-1b -  0.25 mg vial Rs. 116.
https://www.medindia.net/drug-price/interferon-beta-1-b/betaferon.htm
https://dir.indiamart.com/impcat/interferon-beta-1-alpha.html


Covid 19 Therapeutics Tracker
https://www.raps.org/news-and-articles/news-articles/2020/3/covid-19-therapeutics-tracker

15 May 2020
India - The Indian Council of Medical Research (ICMR) announced that potential anti-viral agents, Remdesivir, Chloroquine/Hydroxychloroquine, Lopinavir-Ritonavir and Lopinavir-Ritonavir with Interferon (ß1a) will be evaluated in India as part of the solidarity trial.
https://economictimes.indiatimes.com/industry/healthcare/biotech/healthcare/india-to-test-four-drugs-for-covid-19-as-part-of-the-who-solidarity-trial/articleshow/75721525.cms

17 April 2020
COVID-19 Ring-based Prevention Trial With Lopinavir/Ritonavir (CORIPREV-LR)
Actual Study Start Date  : April 17, 2020
Estimated Primary Completion Date  : March 31, 2021
Estimated Study Completion Date  : March 31, 2022

https://clinicaltrials.gov/ct2/show/NCT04321174

14 April 2020
Lopinavir/ritonavir: A rapid review of effectiveness in COVID-19
https://www.cebm.net/covid-19/lopinavir-ritonavir-a-rapid-review-of-the-evidence-for-effectiveness-in-treating-covid/

7 April 2020

The lopinavir-ritonavir clinical trial: Researchers at the Jin Yin-Tan Hospital treated 199 COVID-19 patients with either the HIV antiviral combination of lopinavir-ritonavir or the standard of care. According to the team, the symptoms of patients treated with lopinavir-ritonavir improved faster than those given the standard of care alone. Acceptable safety levels were observed throughout.

https://www.europeanpharmaceuticalreview.com/news/116491/positive-results-from-initial-lopinavir-ritonavir-covid-19-clinical-trial/

March 18, 2020

N Engl J Med 2020; 382:1787-1799

article was published on March 18, 2020, at NEJM.org.

A Trial of Lopinavir–Ritonavir in Adults Hospitalized with Severe Covid-19

List of authors.

Bin Cao, M.D., Yeming Wang, M.D., Danning Wen, M.D., Wen Liu, M.S., Jingli Wang, M.D., Guohui Fan, M.S., Lianguo Ruan, M.D., Bin Song, M.D., Yanping Cai, M.D., Ming Wei, M.D., Xingwang Li, M.D., Jiaan Xia, M.D., et al.

Article CONCLUSIONS

In hospitalized adult patients with severe Covid-19, no benefit was observed with lopinavir–ritonavir treatment beyond standard care.

https://www.nejm.org/doi/full/10.1056/NEJMoa2001282

Editorial on the above study - Interesting remarks on the above study.
https://www.nejm.org/doi/full/10.1056/NEJMe2005477

Pomegranate - Health Benefits

The study, by researchers from Queen Margaret University in Edinburgh, involved 58 volunteers aged between 21 and 64.
Men and women who drank a daily glass of the fruit’s juice had a surge in testosterone
As a side effect the acclaimed superfood can help raise mood and memory
https://www.dailymail.co.uk/sciencetech/article-2139292/Viagra-effect-daily-glass-pomegranate-juice.html

1968 Pandemic (H3N2 virus) - One Million Deaths

1968 Pandemic (H3N2 virus)

The 1968 pandemic was caused by an influenza A (H3N2) virus comprised of two genes from an avian influenza A virus, including a new H3 hemagglutinin, but also contained the N2 neuraminidase from the 1957 H2N2 virus. It was first noted in the United States in September 1968. The estimated number of deaths was 1 million worldwide and about 100,000 in the United States. Most excess deaths were in people 65 years and older. The H3N2 virus continues to circulate worldwide as a seasonal influenza A virus. Seasonal H3N2 viruses, which are associated with severe illness in older people, undergo regular antigenic drift.
https://www.cdc.gov/flu/pandemic-resources/1968-pandemic.html

The Hong Kong flu (also known as 1968 flu pandemic) was a category 2 flu pandemic whose outbreak in 1968 and 1969 killed an estimated one million people all over the world.  It was caused by an H3N2 strain of the influenza A virus, descended from H2N2 through antigenic shift, a genetic process in which genes from multiple subtypes reassorted to form a new virus.

The first record of the outbreak in Hong Kong appeared on 13 July 1968. By the end of July 1968, extensive outbreaks were reported in Vietnam and Singapore.

By September 1968, the flu reached India, the Philippines, northern Australia, and Europe. That same month, the virus entered California from returning Vietnam War troops but did not become widespread in the United States until December 1968. It would reach Japan, Africa, and South America by 1969. The outbreak in Hong Kong, where population density is greater than 6,000 people per square kilometre, reached maximum intensity in two weeks, lasting six months in total from July to December 1968. However, worldwide deaths from this virus peaked much later, in December 1968 and January 1969.

In comparison to other pandemics, the Hong Kong flu yielded a low death rate, with a case-fatality ratio below 0.5% making it a category 2 disease on the Pandemic Severity Index. The pandemic infected an estimated 500,000 Hong Kong residents, 15% of the population.

The same virus returned the following years: a year later, in late 1969 and early 1970, and in 1972. The CDC currently estimates that, in total, the virus killed 1 million people worldwide and around 100,000 people in the U.S.

https://en.wikipedia.org/wiki/1968_flu_pandemic
https://www.britannica.com/event/Hong-Kong-flu-of-1968

1957-1958 Pandemic (H2N2 virus) - 1.1 Million Deaths Worldwide

In February 1957, a new influenza A (H2N2) virus emerged in East Asia, triggering a pandemic (“Asian Flu”). This H2N2 virus was comprised of three different genes from an H2N2 virus that originated from an avian influenza A virus, including the H2 hemagglutinin and the N2 neuraminidase genes. It was first reported in Singapore in February 1957, Hong Kong in April 1957, and in coastal cities in the United States in summer 1957.

The estimated number of deaths was 1.1 million worldwide and 116,000 in the United States.

https://www.cdc.gov/flu/pandemic-resources/1957-1958-pandemic.html

Coronavirus Test and Load Related Research

Coronavirus patients with mild symptoms are most contagious and have the highest virus shedding in early infection days and become less infectious as the disease begins to weaken, according to a new study
https://www.newsgram.com/coronavirus-patients-symptoms-dangerous

https://www.medscape.com/viewarticle/926275

Fiber Content in Foods - Recommended Daily Requirement

Your Ultimate High-Fiber Grocery List
By Gina Shaw
FROM THE WEBMD ARCHIVES
https://www.webmd.com/cholesterol-management/features/fiber-groceries

Chart of high-fiber foods
By Mayo Clinic Staff
https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/high-fiber-foods/art-20050948

Stent versus Coronary Artery Bypass Surgery

Stent versus Coronary Artery Bypass Surgery in Multi-Vessel and Left Main Coronary Artery Disease: A Meta-Analysis of Randomized Trials with Subgroups Evaluation

Pedro José Negreiros de Andrade1  2

João Luiz de Alencar Araripe Falcão1  2

Breno de Alencar Araripe Falcão1  2

Hermano Alexandre Lima Rocha1  2

Arq. Bras. Cardiol. vol.112 no.5 São Paulo May 2019  Epub Feb 21, 2019
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2019000500511





Harvard Heart Letter
Bypass or angioplasty with stenting: How do you choose?
July, 2013
https://www.health.harvard.edu/heart-health/bypass-or-angioplasty-with-stenting-how-do-you-choose


Percutaneous Transluminal Coronary Angioplasty (PTCA)
Talia F. Malik; Vijai S. Tivakaran.
Last Update: December 15, 2018.
Andreas Gruentzig first developed PCTA in 1977, and the procedure was performed in Zurich, Switzerland that same year.
https://www.ncbi.nlm.nih.gov/books/NBK535417/