Promising Treatments for Acute Respiratory Distress Syndrome Associated with Covid-19
DOI:
https://doi.org/10.12970/2308-8044.2022.10.01Keywords:
Respiratory Distress Syndrome, COVID-19, SARS-CoV-2, Therapeutic Measures, Corticosteroids, Drugs, Drug Induced Liver Injury, Roussel Uclaf Causality Assessment MethodAbstract
Acute Respiratory Distress Syndrome (ARDS) can occur in critically ill people due to COVID-19. These combinations of ARDS and COVID-19 are usually fatal, and the risk increases with age and severity of the disease. The main clinical aspect is the intense shortness of breath and often cannot breathe on their own, requiring mechanical ventilatory support. Treatment includes the administration of oxygen and medications. As a result, the aim of the study was to address the promising treatments for COVID-19-associated ARDS, reporting the main forms of recommendation of therapies such as corticosteroid use, ozone therapy and hyperbaric oxygenation (HBO). This study is a systematic review conducted through international articles with English language located in PubMed and VHL in addition to Clinicaltrials.gov. In the study, we found 117 studies that were submitted to eligibility analysis and, subsequently, 59 studies were included and discussed in this study. Recent studies show that corticosteroids used in ARDS with COVID-19 have achieved clinical improvement, especially during mechanical ventilation. In ozone therapy, improvement was found in the pulmonary parenchyma and in the release of plasma cytokines such as interleukin-6 (IL-6), lymphocyte typing for CD3, CD4, CD8, HLA-DR, CD45. In HBO, it is a useful alternative in the treatment of the disease since it provided inflammatory relief and facilitated the reversal of hypoxemia. As there is little evidence of damage, the data suggest the use of these promising treatments; however, more studies are needed to prove the efficacy of these therapies.
References
Meyer NJ, Calfee CS. Novel translational approaches to the search for precision therapies for acute respiratory distress syndrome. Lancet Respir Med 2017; 5(6): 512-523. https://doi.org/10.1016/S2213-2600(17)30187-X
Matthay MA, Zemans RL, Zimmerman GA, et al. Acute respiratory distress syndrome. Nature Reviews Disease Primers 2019; 5(18): 1-22. https://doi.org/10.1038/s41572-019-0069-0
Cardinal-Fernández P, Lorente JA, Ballén-Barragán A, Matute-Bello G. Acute respiratory distress syndrome and diffuse alveolar damage. New insights on a complex relationship. Ann Am Thorac Soc 2017; 14(6): 844-850. https://doi.org/10.1513/AnnalsATS.201609-728PS
Kao KC, Chiu LC, Hung CY, et al. Coinfection and mortality in pneumonia-related acute respiratory distress syndrome patients with bronchoalveolar lavage: a prospective observational study. Shock 2017; 47(5): 615-620. https://doi.org/10.1097/SHK.0000000000000802
Xi Y, Kim T, Brumwell AN, et al. Local lung hypoxia determines epithelial fate decisions during alveolar regeneration. Nat Cell Biol 2017; 19(8): 904-914. https://doi.org/10.1038/ncb3580
Matthay MA, McAuley DF, Ware LB. Clinical trials in acute respiratory distress syndrome: challenges and opportunities. Lancet Respir Med 2017; 5(6): 524-534. https://doi.org/10.1016/S2213-2600(17)30188-1
Abrams D, Schmidt M, Pham T, et al. Mechanical ventilation for acute respiratory distress syndrome during extracorporeal life support. Research and practice. Am J Respir Crit Care Med 2020; 201(5): 514-525. https://doi.org/10.1164/rccm.201907-1283CI
Pelosi P, Ball L, Barbas CSV, et al. Personalized mechanical ventilation in acute respiratory distress syndrome. Critical Care 2021; 25(250): 1-10. https://doi.org/10.1186/s13054-021-03686-3
Li X, Ma X. Acute respiratory failure in COVID-19: is it "typical" ARDS? Crit Care 2020; 24: 198. https://doi.org/10.1186/s13054-020-02911-9
Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395(10223): 497-506. https://doi.org/10.1016/S0140-6736(20)30183-5
Tong ZD, Tang A, Li KF, et al. Potential presymptomatic transmission of SARS-CoV-2, Zhejiang Province, China, 2020. Emerg Infect Dis 2020; 26 (5). https://doi.org/10.3201/eid2605.200198
Costa APA, Rocha VL, Ramos RR, et al. History and global status of the new coronavirus COVID-2019 and aspects of previous infections of SARS-CoV and MERS-CoV: a systematic review. Coronaviruses 2021; 2(6): e130621190409. https://doi.org/10.2174/2666796702666210118153843
Mason RJ. Pathogenesis of COVID-19 from a cell biology perspective. ERJ 2020; 55: 2000607. https://doi.org/10.1183/13993003.00607-2020
Silva LA, Simonato LE, Ramos RR. Phylogeny and pathogenesis of SARS-CoV-2: a systematic study. J Mod Med Chem 2020; 8: 49-55. https://doi.org/10.12970/2308-8044.2020.08.06
Fan E, Beitler JR, Brochard L, et al. COVID-19-associated acute respiratory distress syndrome: is a different approach to management warranted? Lancet Respir Med 2020; 8(8): 816-821. https://doi.org/10.1016/S2213-2600(20)30304-0
Bordallo B, Bellas M, Cortez AF, Vieira M, Pinheiro M. Severe COVID-19: what have we learned with the immunopathogenesis? Adv Rheumatol 2020; 60: 50. https://doi.org/10.1186/s42358-020-00151-7
Misra DP, Agarwal V, Gasparyan AY, Zimba O. Rheumatologists' perspective on coronavirus disease 19 (COVID-19) and potential therapeutic targets. Clin Rheumatol 2020; 39(7): 2055-2062. https://doi.org/10.1007/s10067-020-05073-9
Wang F, Nie J, Wang H, et al. Characteristics of peripheral lymphocyte subset alteration in COVID-19 pneumonia. J Infect Dis 2020; 221(11): 1762-1769. https://doi.org/10.1093/infdis/jiaa150
FitzGerald GA. Misguided drug advice for COVID-19. Science 2020; 367: 1434. https://doi.org/10.1126/science.abb8034
Barbateskovic M, Schjørring OL, Russo Krauss S, et al. Higher versus lower fraction of inspired oxygen or targets of arterial oxygenation for adults admitted to the intensive care unit. Cochrane Database Syst Rev 2019; 2019(11): CD012631. https://doi.org/10.1002/14651858.CD012631.pub2
Les Bujanda I, Loureiro-Amigo J, Bastons FC, et al. Treatment of COVID-19 pneumonia with glucocorticoids (CORTIVID): a structured summary of a study protocol for a randomised controlled trial. Trials 2021; 22: 43. https://doi.org/10.1186/s13063-020-04999-4
Giamarellos-Bourboulis EJ, Netea MG, Rovina N, et al. Complex immune dysregulation in COVID-19 patients with severe respiratory failure. Cell Host Microbe 2020; 27(6): 992-1000.e3. https://doi.org/10.1016/j.chom.2020.04.009
Muhović D, Bojović J, Bulatović A, et al. First case of drug-induced liver injury associated with the use of tocilizumab in a patient with COVID-19. Liver Int 2020; 40(8): 1901-1905. https://doi.org/10.1111/liv.14516
Tang X, Feng YM, Ni JX, et al. Early use of corticosteroid may prolong SARS-CoV-2 shedding in non-intensive care unit patients with COVID-19 pneumonia: a multicenter, single-blind, randomized control trial. Respiration 2021; 100(2): 116-126. https://doi.org/10.1159/000512063
Salinas M, Andino P, Palma L, Valencia J, Figueroa E, Ortega J. Early use of corticosteroids in non-critical patients with COVID-19 pneumonia (PREDCOVID): a structured summary of a study protocol for a randomized controlled trial. Trials 2021; 22: 92. https://doi.org/10.1186/s13063-021-05046-6
So C, Ro S, Murakami M, et al. High-dose, short-term corticosteroids for ARDS caused by COVID-19: a case series. Respirol Case Rep 2020; 8: e00596. https://doi.org/10.1002/rcr2.596
Annane D, Pastores SM, Rochwerg B, et al. Guidelines for the diagnosis and management of critical illness-related corticosteroid insufficiency (CIRCI) in critically Ill patients (Part I): Society of Critical Care Medicine (SCCM) and European Society of Intensive Care Medicine (ESICM) 2017. Crit Care Med 2017; 45(12): 2078-2088. https://doi.org/10.1097/CCM.0000000000002737
Alhazzani W, Møller MH, Arabi YM, et al. Surviving sepsis campaign: Guidelines on the management of critically ill adults with coronavirus disease 2019 (COVID-19). Intensive Care Med 2020; 46(5): 854-887. https://doi.org/10.1007/s00134-020-06022-5
Marmor M, Jonas A. Corticosteroids for COVID-19-associated ARDS. Clinical Pulmonary Medicine 2020; 27(6): 165-167. https://doi.org/10.1097/CPM.0000000000000381
van Paassen J, Vos JS, Hoekstra EM, Neumann KMI, Boot PC, Arbous SM. Corticosteroid use in COVID-19 patients: a systematic review and meta-analysis on clinical outcomes. Crit Care 2020; 24: 696. https://doi.org/10.1186/s13054-020-03400-9
Mongardon N, Piagnerelli M, Grimaldi D, Perrot B, Lascarrou JB; COVADIS study group investigators. Impact of late administration of corticosteroids in COVID-19 ARDS. Intensive Care Med 2021; 47: 110-112. https://doi.org/10.1007/s00134-020-06311-z
Alhazzani W, Møller MH, Arabi YM, et al. Surviving sepsis campaign: Guidelines on the management of critically Ill adults with coronavirus disease 2019 (COVID-19). Crit Care Med 2020; 48(6): e440-e469. https://doi.org/10.1097/CCM.0000000000004363
Prescott HC, Rice TW. Corticosteroids in COVID-19 ARDS evidence and hope during the pandemic. JAMA 2020; 324(13): 1292-1295. https://doi.org/10.1001/jama.2020.16747
Bhimraj A, Morgan RL, Shumaker AH, et al. Infectious Diseases Society of America Guidelines on the treatment and management of patients with COVID-19. Clin Infect Dis 2020; ciaa478. https://doi.org/10.1093/cid/ciaa478
Tascini C, Sozio E, De Monte A. et al. Blood ozonization in patients with SARS-CoV-2 respiratory failure (CORMOR). ClinicalTrials.gov 2020. Available from: https://clinicaltrials.gov/ct2/show/NCT04388514
Cattel F, Giordano S, Bertiond C, et al. Ozone therapy in COVID-19: a narrative review. Virus Res 2021; 291: 198207. https://doi.org/10.1016/j.virusres.2020.198207
Smith NL, Wilson AL, Gandhi J, Vatsia S, Khan SA. Ozone therapy: an overview of pharmacodynamics, current research, and clinical utility. Med Gas Res 2017; 7(3): 212–219. https://doi.org/10.4103/2045-9912.215752
Di Mauro R, Cantarella G, Bernardini R, et al. The biochemical and pharmacological properties of ozone: the smell of protection in acute and chronic diseases. Int J Mol Sci 2019; 20(3): 634. https://doi.org/10.3390/ijms20030634
Rowen RJ. Ozone and oxidation therapies as a solution to the emerging crisis in infectious disease management: a review of current knowledge and experience. Med Gas Res 2019; 9(4): 232-237. https://doi.org/10.4103/2045-9912.273962
Rowen RJ, Robins H. A plausible “penny” costing effective treatment for corona virus- ozone therapy. J Infect Dis Epidemiol 2020; 6: 113. https://doi.org/10.23937/2474-3658-1510113
Yousefi B, Banihashemian SZ, Feyzabadi ZK, et al. Potential therapeutic effect of oxygen-ozone in controlling of COVID-19 disease. Med Gas Res 2022; 12(2): 33-40. Available from: https://pubmed.ncbi.nlm.nih.gov/34677149/
Wang Z, Zhang A, Meng W, et al. Ozone protects the rat lung from ischemia-reperfusion injury by attenuating NLRP3-mediated inflammation, enhancing Nrf2 antioxidant activity and inhibiting apoptosis. Eur J Pharmacol 2018; 15(835): 82-93. https://doi.org/10.1016/j.ejphar.2018.07.059
Kirby JP. Hyperbaric oxygen therapy emergencies. Mo Med 2019; 116(3): 180-183. Available from: https://pubmed.ncbi.nlm.nih.gov/31527936/
Kirby JP, Snyder J, Schuerer DJE, Peters JS, Bochicchio GV. Essentials of hyperbaric oxygen therapy: 2019 review. Mo Med 2019; 116(3): 176-179. Available from: https://pubmed.ncbi.nlm.nih.gov/31527935/
Ozgok-Kangal K, Zaman T, Koc B. The outcomes of COVID-19 measures in a hyperbaric oxygen therapy center during the pandemic. Int Marit Health 2021; 72(3): 228-236. https://doi.org/10.5603/IMH.2021.0042
Xiao X. Treatment and prevention of traditional Chinese medicines (TCMs) on COVID-19 infection. ClinicalTrials.gov 2020. Available from: https://clinicaltrials.gov/ct2/show/NCT04251871
Gonzalez‑Ramirez JA, Ramírez‑Nava JC, Gonzalez‑Lopez S, et al. Hyperbaric oxygen therapy in overweight and obese patients with COVID‑19. World Academy of Sciences Journal 2021; 3(6): 61. https://doi.org/10.3892/wasj.2021.132
Ortiz GX, Lenhart G, Becker MW, Schwambach KH, Tovo CV, Blatt CR. Drug-induced liver injury and COVID-19: a review for clinical practice, World J Hepatol 2021; 13(9): 1143-1153. https://doi.org/10.4254/wjh.v13.i9.1143
Sodeifian F, Seyedalhosseini ZS, Kian N, et al. Drug-induced liver injury in COVID-19 patients: a systematic review. Front Medicine 2021; 8: 731436. https://doi.org/10.3389/fmed.2021.731436
Ke L, Lu C, Shen R, Lu T, Ma B, Hua Y. Knowledge mapping of drug-induced liver injury: a scientometric investigation (2010-2019). Front Pharmacol 2020; 11: 842. https://doi.org/10.3389/fphar.2020.00842
Teschke R, Danan G. Worldwide use of RUCAM for causality assessment in 81,856 idiosyncratic DILI and 14,029 HILI cases published 1993-mid 2020: a comprehensive analysis. Medicines (Basel) 2020; 7(10): 62. https://doi.org/10.3390/medicines7100062
Real M, Barnhill MS, Higley C, Rosenberg J, Lewis JH. Drug-induced liver injury: highlights of the recent literature. Drug Saf 2019; 42(3): 365-387. https://doi.org/10.1007/s40264-018-0743-2
Teschke R, Danan G. Idiosyncratic drug-induced liver injury (DILI) and herb-induced liver injury (HILI): diagnostic algorithm based on the quantitative Roussel Uclaf Causality Assessment Method (RUCAM). Diagnostics 2021; 11: 458. https://doi.org/10.3390/diagnostics11030458
Teschke R. Idiosyncratic DILI: analysis of 46,266 cases assessed for causality by RUCAM and published from 2014 to early 2019. Front Pharmacol 2019; 10: 730. https://doi.org/10.3389/fphar.2019.00730
Danan G, Teschke R. RUCAM in drug and herb induced liver injury: the update. Int J Mol Sci 2015; 17: 14. https://doi.org/10.3390/ijms17010014
Cai Q, Huang D, Yu H, et al. COVID-19: Abnormal liver function tests. J Hepatol 2020; 73(3): 566-574. https://doi.org/10.1016/j.jhep.2020.04.006
Ferron PJ, Gicquel T, Mégarbane B, Clément B, Fromenty B. Treatments in COVID-19 patients with pre-existing metabolic dysfunction-associated fatty liver disease: a potential threat for drug-induced liver injury? Biochimie 2020; 179: 266-274. https://doi.org/10.1016/j.biochi.2020.08.018
Wu H, Liu S, Luo H, Chen M. Progress in the clinical features and pathogenesis of abnormal liver enzymes in coronavirus disease 2019. J Clin Transl Hepatol 2021; 9: 239-246. https://doi.org/10.14218/JCTH.2020.00126
Clinton JW, Kiparizoska S, Aggarwal S, Woo S, Davis W, Lewis JH. Drug-induced liver injury: highlights and controversies in the recent literature. Drug Saf 2021; 44: 1125-1149. https://doi.org/10.1007/s40264-021-01109-4
