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Characteristics of patients with non-severe infections of different SARS-CoV-2 omicron subvariants in China

Yuan et al., Frontiers in Medicine, doi:10.3389/fmed.2024.1511227
Dec 2024  
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Time to viral- 9% Improvement Relative Risk Azvudine for COVID-19  Yuan et al.  LATE TREATMENT Is late treatment with azvudine beneficial for COVID-19? Retrospective 244 patients in China (August - October 2022) Faster viral clearance with azvudine (p=0.032) c19early.org Yuan et al., Frontiers in Medicine, Dec 2024 Favorsazvudine Favorscontrol 0 0.5 1 1.5 2+
Azvudine for COVID-19
44th treatment shown to reduce risk in July 2023, now with p = 0.000000082 from 31 studies.
Lower risk for mortality, progression, and viral clearance.
No treatment is 100% effective. Protocols combine treatments.
5,300+ studies for 116 treatments. c19early.org
Retrospective 244 non-severe COVID-19 patients in China infected with Omicron BA.2.76 or BA.5.1 subvariants, showing improved viral clearance with azvudine.
Viral load measured by PCR may not accurately reflect infectious virus measured by viral culture. Porter et al. show that viral load early in infection was correlated with infectious virus, but viral load late in infection could be high even with low or undetectable infectious virus. Assessing viral load later in infection may underestimate reductions in infectious virus with treatment.
Standard of Care (SOC): SOC for COVID-19 in the study country, China, is average with moderate average efficacy for approved treatments2.
This study is excluded in the after exclusion results of meta analysis: substantial unadjusted confounding by indication likely.
time to viral-, 9.1% lower, relative time 0.91, p = 0.03, treatment 121, control 123.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Yuan et al., 18 Dec 2024, retrospective, China, peer-reviewed, 10 authors, study period 10 August, 2022 - 9 October, 2022. Contact: daieh2008@126.com, yongzhelipumch@126.com.
This PaperAzvudineAll
Characteristics of patients with non-severe infections of different SARS-CoV-2 omicron subvariants in China
Wenfang Yuan, Yongmei Liu, Haoting Zhan, Feng Wei, Qian Zhang, Huixia Gao, Huimin Yan, Tao Huang, Yongzhe Li, Erhei Dai
Frontiers in Medicine, doi:10.3389/fmed.2024.1511227
Objective: The aim of this study was to explore the clinical characteristics of patients infected with different Omicron subvariants presenting non-severe disease, evaluate the safety and efficacy of Azvudine for treatment of COVID-19, in order to broaden understanding of Omicron subvariant infections. Method: A total of 244 individuals with Omicron subvariant (BA.2.76, n = 158; BA.5.1, n = 86) were included in the study. Demographic, clinical, and laboratory data of the study participants were collected and analyzed. Result: Patients infected with BA.5.1 exhibited a higher incidence of clinical symptoms like fatigue (25.58% vs. 2.53%, p < 0.001), headache/dizziness (12.79% vs. 4.43%, p = 0.017), nausea/vomiting (10.47% vs. 1.27%, p = 0.002), viral loads and inflammatory factors, and shorter virus shedding time than those with BA.2.76. There are 28.1% patients reporting mild adverse events following Azvudine administration. After treatment, the levels of anti-SARS-CoV-2 IgG/ IgM, white blood cell, and lymphocyte obviously increased, while C-reactive protein, procalcitonin, and D-dimer reduced. Azvudine speeded up the time for virus clearance compared to control treatment (10 vs. 11 days, p = 0.032). Low lymphocyte counts (odd ratio (OR) = 0.607, p = 0.001) and anti-SARS-CoV-2 IgG titer (OR = 0.990, p = 0.028) were the independent risk factors for long nucleic acid negativization duration after infection. Patients with pneumonia were often accompanied by dyspnea, fatigue and high level of D-dimer. Dyspnea (OR = 10.176, p = 0.019) could be used to identify the occurrence of pneumonia in patients infected with Omicron. Conclusion: The study demonstrated the difference in clinical and laboratory parameters between patients infected with Omicron BA.2.76 and BA.5.1, as well as the safety and efficacy of Azvudine therapy. Our study linked patient manifestations to Omicron subvariant, treatment, and clinical outcomes, which is conducive to healthcare providers/policymakers to revise and implement appropriate countermeasures, facilitating appropriately advise for individuals with Omicron subvariant infections.
Ethics statement The study was approved by the Ethics Committee of the Fifth Hospital of Shijiazhuang (2022001). Informed consent was obtained from all participants. The studies were conducted in accordance with the local legislation and institutional requirements. The participants provided their written informed consent to participate in this study. Author contributions Funding The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This work was supported by Key Research and Development Plan of Hebei Province, Special Health Innovation Project (22377744D), the Beijing Natural 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. Generative AI statement The author(s) declare that no Gen AI was used in the creation of this manuscript. 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. Supplementary material The Supplementary material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fmed.2024.1511227/..
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DOI record: { "DOI": "10.3389/fmed.2024.1511227", "ISSN": [ "2296-858X" ], "URL": "http://dx.doi.org/10.3389/fmed.2024.1511227", "abstract": "<jats:sec><jats:title>Objective</jats:title><jats:p>The aim of this study was to explore the clinical characteristics of patients infected with different Omicron subvariants presenting non-severe disease, evaluate the safety and efficacy of Azvudine for treatment of COVID-19, in order to broaden understanding of Omicron subvariant infections.</jats:p></jats:sec><jats:sec><jats:title>Method</jats:title><jats:p>A total of 244 individuals with Omicron subvariant (BA.2.76, <jats:italic>n</jats:italic> = 158; BA.5.1, <jats:italic>n</jats:italic> = 86) were included in the study. Demographic, clinical, and laboratory data of the study participants were collected and analyzed.</jats:p></jats:sec><jats:sec><jats:title>Result</jats:title><jats:p>Patients infected with BA.5.1 exhibited a higher incidence of clinical symptoms like fatigue (25.58% vs. 2.53%, <jats:italic>p</jats:italic> &amp;lt; 0.001), headache/dizziness (12.79% vs. 4.43%, <jats:italic>p</jats:italic> = 0.017), nausea/vomiting (10.47% vs. 1.27%, <jats:italic>p</jats:italic> = 0.002), viral loads and inflammatory factors, and shorter virus shedding time than those with BA.2.76. There are 28.1% patients reporting mild adverse events following Azvudine administration. After treatment, the levels of anti-SARS-CoV-2 IgG/IgM, white blood cell, and lymphocyte obviously increased, while C-reactive protein, procalcitonin, and D-dimer reduced. Azvudine speeded up the time for virus clearance compared to control treatment (10 vs. 11 days, <jats:italic>p</jats:italic> = 0.032). Low lymphocyte counts (odd ratio (OR) = 0.607, <jats:italic>p</jats:italic> = 0.001) and anti-SARS-CoV-2 IgG titer (OR = 0.990, <jats:italic>p</jats:italic> = 0.028) were the independent risk factors for long nucleic acid negativization duration after infection. Patients with pneumonia were often accompanied by dyspnea, fatigue and high level of D-dimer. Dyspnea (OR = 10.176, <jats:italic>p</jats:italic> = 0.019) could be used to identify the occurrence of pneumonia in patients infected with Omicron.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The study demonstrated the difference in clinical and laboratory parameters between patients infected with Omicron BA.2.76 and BA.5.1, as well as the safety and efficacy of Azvudine therapy. Our study linked patient manifestations to Omicron subvariant, treatment, and clinical outcomes, which is conducive to healthcare providers/policymakers to revise and implement appropriate countermeasures, facilitating appropriately advise for individuals with Omicron subvariant infections.</jats:p></jats:sec>", "alternative-id": [ "10.3389/fmed.2024.1511227" ], "author": [ { "affiliation": [], "family": "Yuan", "given": "Wenfang", "sequence": "first" }, { "affiliation": [], "family": "Liu", "given": "Yongmei", "sequence": "additional" }, { "affiliation": [], "family": "Zhan", "given": "Haoting", "sequence": "additional" }, { "affiliation": [], "family": "Wei", "given": "Feng", "sequence": "additional" }, { "affiliation": [], "family": "Zhang", "given": "Qian", "sequence": "additional" }, { "affiliation": [], "family": "Gao", "given": "Huixia", "sequence": "additional" }, { "affiliation": [], "family": "Yan", "given": "Huimin", "sequence": "additional" }, { "affiliation": [], "family": "Huang", "given": "Tao", "sequence": "additional" }, { "affiliation": [], "family": "Li", "given": "Yongzhe", "sequence": "additional" }, { "affiliation": [], "family": "Dai", "given": "Erhei", "sequence": "additional" } ], "container-title": "Frontiers in Medicine", "container-title-short": "Front. Med.", "content-domain": { "crossmark-restriction": true, "domain": [ "frontiersin.org" ] }, "created": { "date-parts": [ [ 2024, 12, 18 ] ], "date-time": "2024-12-18T06:47:20Z", "timestamp": 1734504440000 }, "deposited": { "date-parts": [ [ 2024, 12, 18 ] ], "date-time": "2024-12-18T06:47:23Z", "timestamp": 1734504443000 }, "indexed": { "date-parts": [ [ 2024, 12, 19 ] ], "date-time": "2024-12-19T05:14:20Z", "timestamp": 1734585260989, "version": "3.30.2" }, "is-referenced-by-count": 0, "issued": { "date-parts": [ [ 2024, 12, 18 ] ] }, "license": [ { "URL": "https://creativecommons.org/licenses/by/4.0/", "content-version": "vor", "delay-in-days": 0, "start": { "date-parts": [ [ 2024, 12, 18 ] ], "date-time": "2024-12-18T00:00:00Z", "timestamp": 1734480000000 } } ], "link": [ { "URL": "https://www.frontiersin.org/articles/10.3389/fmed.2024.1511227/full", "content-type": "unspecified", "content-version": "vor", "intended-application": "similarity-checking" } ], "member": "1965", "original-title": [], "prefix": "10.3389", "published": { "date-parts": [ [ 2024, 12, 18 ] ] }, "published-online": { "date-parts": [ [ 2024, 12, 18 ] ] }, "publisher": "Frontiers Media SA", "reference": [ { "DOI": "10.3389/fimmu.2021.809244", "article-title": "SARS-CoV-2 variants, vaccines, and host immunity", "author": "Mistry", "doi-asserted-by": "publisher", "first-page": "809244", "journal-title": "Front Immunol", "key": "ref1", "volume": "12", "year": "2021" }, { "DOI": "10.1038/s41586-022-04462-1", "article-title": "Attenuated fusogenicity and pathogenicity of SARS-CoV-2 omicron variant", "author": "Suzuki", "doi-asserted-by": "publisher", "first-page": "700", "journal-title": "Nature", "key": "ref2", "volume": "603", "year": "2022" }, { "DOI": "10.15585/mmwr.mm7137a4", "article-title": "Mortality risk among patients hospitalized primarily for COVID-19 during the omicron and Delta variant pandemic periods - 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Late treatment
is less effective
Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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