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All Studies   Meta Analysis    Recent:   

Antihistamines improve cardiovascular manifestations and other symptoms of long-COVID attributed to mast cell activation

Salvucci et al., Frontiers in Cardiovascular Medicine, doi:10.3389/fcvm.2023.1202696
Jul 2023  
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PASC 29% Improvement Relative Risk Antihistamine H1RAs  Salvucci et al.  LATE TREATMENT  LONG COVID Do antihistamine H1RAs reduce the risk of long COVID (PASC)? Retrospective 27 patients in Italy Lower PASC with antihistamine H1RAs (not stat. sig., p=0.098) c19early.org Salvucci et al., Frontiers in Cardiova.., Jul 2023 Favorsantihistamine H1RA Favorscontrol 0 0.5 1 1.5 2+
10th treatment shown to reduce risk in December 2020
 
*, now with p = 0.00006 from 15 studies.
Lower risk for mortality, recovery, and cases.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,400+ studies for 81 treatments. c19early.org
Retrospective 14 patients with long-COVID symptoms attributed to mast cell activation treated with H1 and H2 antihistamines compared to 13 control patients, showing significant improvements in several symptoms in the treatment group compared to controls after 20 days. 29% of treated patients had complete resolution of long-COVID symptoms, compared with none in the control group.
risk of PASC, 28.6% lower, RR 0.71, p = 0.10, treatment 10 of 14 (71.4%), control 13 of 13 (100.0%), NNT 3.5.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Salvucci et al., 17 Jul 2023, retrospective, Italy, peer-reviewed, 9 authors. Contact: carmine.gazzaruso@unimi.it.
This PaperH1RAsAll
Antihistamines improve cardiovascular manifestations and other symptoms of long-COVID attributed to mast cell activation
Fabrizio Salvucci, Roberto Codella, Adriana Coppola, Irene Zacchei, Gabriella Grassi, Maria Luisa Anti, Nicolita Nitisoara, Livio Luzi, Carmine Gazzaruso
Frontiers in Cardiovascular Medicine, doi:10.3389/fcvm.2023.1202696
Introduction: Long-COVID is a broadly defined condition and there are no effective therapies. Cardiovascular manifestations of long-COVID include high heart rate, postural tachycardia, and palpitations. Previous studies have suggested that mast cell activation (MCA) may play a role in the pathophysiology of long-COVID, including in the mechanisms of its cardiovascular manifestations. The present study aimed to evaluate the effectiveness of a treatment with blockers of histamine receptors in patients with long-COVID who did not respond to other therapies. Methods: In all, 14 patients (F/M = 9/5; 49.5 ± 11.5 years) and 13 controls (F/M = 8/5; 47.3 ± 8.0 years) with long-COVID symptoms attributed to MCA were evaluated. Patients were treated with fexofenadine (180 mg/day) and famotidine (40 mg/day). Fatigue, brain fog, abdominal disorders, and increased heart rate were evaluated in treated and untreated patients at baseline and 20 days later. Results: Long-COVID symptoms disappeared completely in 29% of treated patients. There was a significant improvement in each of the considered symptoms (improved or disappeared) in all treated patients, and the improvement grade was significantly greater in treated patients compared to controls. No significant differences in the outcomes were observed in the controls. Conclusions: Our data confirm that histamine receptors blockade may be an effective target to successfully treat long-COVID. Our finding supports the underlying role of MCA in the pathophysiology of long-COVID.
Ethics statement Ethical review and approval was not required for the study on human participants in accordance with the local legislation and institutional requirements. The patients/participants provided their written informed consent to participate in this study. Author contributions FS, LL, and CG designed the study. AC, RC, and CG analysed the data and drafted the manuscript. GG, IZ, MA, and NN contributed with data acquisition. FS, MA, NN, and LL assisted with the literature search and revised the manuscript. IZ, GG, and AC provided critical input and extensively revised the manuscript. All authors contributed to the article and approved the submitted version. Conflict of interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Publisher's note All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
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Late treatment
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