RESUMO
INTRODUCTION: Nitazoxanide has shown efficacy in vitro against coronavirus infections (MERS, SARS, SARS-CoV-2). The aim of this report is to describe the results of treating COVID-19 positive patients with nitazoxanide in three clinical settings: pregnancy/puerperium, hospitalized patients in an Internal Medicine Service and in an ambulatory setting. METHODOLOGY: This was a prospective follow-up and report of COVID-19 cases in three different situations, pregnant women, hospitalized patients receiving medical attention in an Internal Medicine Service and ambulatory patients residing in Toluca City, and Mexico City. RESULTS: The experience with a first group of 20 women, pregnant (17) or in immediate puerperium (3) was successful in 18 cases with two unfortunate deaths. The five cases treated in an Internal Medicine service showed a positive outcome with two patients weaned from mechanical ventilation. Of the remaining 16 patients treated in an ambulatory setting, all got cured. Nitazoxanide seems to be useful against SARS-CoV-2, not only in an early intervention but also in critical condition as well as in pregnancy without undesired effects for the babies. As an adjunctive therapy budesonide was used that seems to contribute to the clinical improvement. CONCLUSIONS: Nitazoxanide could be useful against COVID-19 as a safe and available regimen to be tested in a massive way immediately.
Assuntos
Antivirais/uso terapêutico , Betacoronavirus , Infecções por Coronavirus/tratamento farmacológico , Pneumonia Viral/tratamento farmacológico , Tiazóis/uso terapêutico , Adulto , Assistência Ambulatorial , COVID-19 , Infecções por Coronavirus/mortalidade , Feminino , Seguimentos , Hospitalização , Humanos , Masculino , México/epidemiologia , Nitrocompostos , Pandemias , Pneumonia Viral/mortalidade , Gravidez , Complicações Infecciosas na Gravidez/tratamento farmacológico , Complicações Infecciosas na Gravidez/mortalidade , Estudos Prospectivos , SARS-CoV-2 , Resultado do TratamentoRESUMO
Pregnancy presents a large number of metabolic adaptations and requirements of micro and macronutrients could be increased, which are not always covered by the diet making necessary to supplement some of them. The micronutrients are an important part of metabolic reactions and both; their deficiency as their excess could participate in damage to organs and tissues of the mother and the fetus. Actually the hypertension pregnant states (HPS) participate in the leading causes of death during pregnancy, making necessary the search for interventions to prevent or reduce the consequences.The oxidative stress levels are linked with the risk to develop HPS, which has created assumptions about the use of micronutrients with antioxidant power and its possible role as protectors in these pathologies, however, the information is still uncertain and the metabolic action of the use of micronutrients supplementation is not precisely known because some micronutrients have shown a protective effect on the development of HPS. It is necessary to evaluate the nutritional status before and during pregnancy, as well to realize more studies about it and strengthen public policies about the use of micronutrients during the pregnancy.
Assuntos
Suplementos Nutricionais , Hipertensão Induzida pela Gravidez/dietoterapia , Micronutrientes/uso terapêutico , Feminino , Humanos , GravidezRESUMO
We reviewed the literature regarding pregnancy-induced hypertension and its relation with thrombotic microangiopathy and intravascular hemolysis (TMIH). In the present work we described the background, frequency, mortality, clinical picture, classification, diagnosis, complications and treatment. In addition, we analyzed Weinstein's report of 1982, and we concluded that the reported data of the HELLP syndrome is not conclusive because the presence of TMIH is not demonstrable in his group of patients. Also, we retrospectively reviewed the medical charts from three Intensive Care Units from two specialized gyneco-obstetrics hospitals and from one General Hospital. From all the patients with pregnancy-induced hypertension and who developed TMIH confirmed clinically and by laboratory findings, we described the incidence of acute renal failure and the mortality in this group of patients.