Aerobuster hunts for coronaviruses

Aerosols play an important role in the spreading of COVID 19. When breathing, speaking, or coughing, these small droplets loaded with coronaviruses disperse in indoor air. Schools, kindergartens, lecture halls of universities, medical practices, or restaurants are particularly affected. Scientists of Karlsruhe Institute of Technology (KIT) have now developed an effective, safe, and quickly available solution. Aerobuster is a simple, compact device that effectively inactivates viruses and other pathogens in room air.

Aerosols and the viruses they carry disperse in rooms very quickly and float in the air for hours. If they are inhaled by humans, these may be infected easily by the coronavirus. "First results reveal that nearly 100 percent of airborne model viruses can be inactivated by our Aerobuster. Thanks to its high air flow rate, Aerobuster is highly powerful, but available at far lower costs than conventional air cleaning systems," says Professor Horst Hahn, Head of KIT's Institute of Nanotechnology and one of the inventors of Aerobuster. Simulations of aerosol movements in an average classroom with 20 pupils confirm that Aerobuster drastically reduces the concentration of active viruses in room air and, hence, largely decreases the risk of infection.

Flexible Use and Simple Design

"Of course, this also applies to all other highly crowded public areas, such as hospitals, residential and nursing homes, restaurants, offices, factory halls, or public transport means and their waiting areas," Hahn says. Aerobuster can be used at all these locations, as the device has about the size of a floor lamp, is light, and may be fixed to a post, the ceiling, or the wall. "The system consists of a simple metal tube, a fan of the type used for cooling PCs, a heating module, and a radiator that emits ultraviolet light of a certain wavelength," the expert says. "With the help of the fan, air is sucked in via the tube. Then, the aerosols are dried and the viruses are inactivated using UV-C radiation—a long-established disinfection method," explains Dr. Jochen Kriegseis from the Institute of Fluid Mechanics. "The waste heat can be used for heating the rooms," adds Dr. Thomas Blank from the Institute for Data Processing and Electronics. The three inventors of the system agree that Aerobuster is an investment in the future, as it may also be used to fight future pandemics or the annual wave of influenza.

Quickly Available in Large Numbers

In the next step, Hahn and his colleagues from other institutes of KIT plan to build 100 prototypes and to further test and optimize them on site. "With a suitable industry partner, 10,000 devices can be produced within a few weeks," Hahn thinks and hopes for political interest and tailwind. The procurement costs for the materials from which the Aerobuster is composed are estimated by the experts at about 50 Euro.

https://medicalxpress.com/news/2020-11-aerobuster-coronaviruses.html

N-Acetylcysteine to Combat COVID-19: Evidence Review

Zhongcheng Shi,^1,2 Carlos A Puyo³

¹Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX, USA; ²Department of Pathology, Texas Children’s Hospital, Houston, TX, USA; ³Department of Anesthesia and Critical Care, Holy Family Hospital, Steward Health Care, Methuen, MA, USA

Abstract: The novel coronavirus disease (COVID-19) is caused by a virus (SARS-Cov-2) and is known for inducing multisystem organ dysfunction associated with significant morbidity and mortality. Current therapeutic strategies for COVID-19 have failed to effectively reduce mortality rate, especially for elderly patients. A newly developed vaccine against SARS-Cov-2 has been reported to induce the production of neutralizing antibodies in young volunteers. However, the vaccine has shown limited benefit in the elderly, suggesting an age-dependent immune response. As a result, exploring new applications of existing medications could potentially provide valuable treatments for COVID-19. N-acetylcysteine (NAC) has been used in clinical practice to treat critically ill septic patients, and more recently for COVID-19 patients. NAC has antioxidant, anti-inflammatory and immune-modulating characteristics that may prove beneficial in the treatment and prevention of SARS-Cov-2. This review offers a thorough analysis of NAC and discusses its potential use for treatment of COVID-19.

Conclusions

N-acetylcysteine (NAC) is inexpensive, has very low toxicity, has been FDA approved for many years, and has the potential to improve therapeutic strategies for COVID-19. NAC administered intravenously, orally, or inhaled, may suppress SARS-CoV-2 replication and may improve outcomes if used timely. Potential therapeutic benefits of NAC include, extracellularly scavenging ROS radicals, replenishing intracellular GSH, suppression of cytokine storm, and T cell protection, thus mitigating inflammation and tissue injury. NAC administration in combination with other antiviral agents may dramatically reduce hospital admission rate, mechanical ventilation and mortality.

Disclosure

The authors report no conflicts of interest for this work.

https://www.dovepress.com/n-acetylcysteine-to-combat-covid-19-an-evidence-review-peer-reviewed-fulltext-article-TCRM

Small molecule therapeutics for COVID-19: repurposing of inhaled furosemide

Zhiyu Wang,^1,2 Yanfei Wang,¹ Prachi Vilekar,¹ Seung-Pil Yang,¹ Mayuri Gupta,¹ Myong In Oh,¹ Autumn Meek,¹ Lisa Doyle,¹ Laura Villar,¹ Anja Brennecke,¹ Imindu Liyanage,^1,3 Mark Reed,^1,4 Christopher Barden,¹ and Donald F. Weaver^1,2,3

doi: 10.7717/peerj.9533

PDF: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7350920/pdf/peerj-08-9533.pdf

Abstract

The novel coronavirus SARS-CoV-2 has become a global health concern. The morbidity and mortality of the potentially lethal infection caused by this virus arise from the initial viral infection and the subsequent host inflammatory response. The latter may lead to excessive release of pro-inflammatory cytokines, IL-6 and IL-8, as well as TNF-α ultimately culminating in hypercytokinemia (“cytokine storm”). To address this immuno-inflammatory pathogenesis, multiple clinical trials have been proposed to evaluate anti-inflammatory biologic therapies targeting specific cytokines. However, despite the obvious clinical utility of such biologics, their specific applicability to COVID-19 has multiple drawbacks, including they target only one of the multiple cytokines involved in COVID-19’s immunopathy. Therefore, we set out to identify a small molecule with broad-spectrum anti-inflammatory mechanism of action targeting multiple cytokines of innate immunity. In this study, a library of small molecules endogenous to the human body was assembled, subjected to in silico molecular docking simulations and a focused in vitro screen to identify anti-pro-inflammatory activity via interleukin inhibition. This has enabled us to identify the loop diuretic furosemide as a candidate molecule. To pre-clinically evaluate furosemide as a putative COVID-19 therapeutic, we studied its anti-inflammatory activity on RAW264.7, THP-1 and SIM-A9 cell lines stimulated by lipopolysaccharide (LPS). Upon treatment with furosemide, LPS-induced production of pro-inflammatory cytokines was reduced, indicating that furosemide suppresses the M1 polarization, including IL-6 and TNF-α release. In addition, we found that furosemide promotes the production of anti-inflammatory cytokine products (IL-1RA, arginase), indicating M2 polarization. Accordingly, we conclude that furosemide is a reasonably potent inhibitor of IL-6 and TNF-α that is also safe, inexpensive and well-studied. Our pre-clinical data suggest that it may be a candidate for repurposing as an inhaled therapy against COVID-19.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7350920/

Evidence Supporting Use of Ivermectin in Prophylaxis, Treatment of COVID

• Pierre Kory
• G. Meduri
• Jose Iglesias, DO
• Joseph Varon, MD
• Keith Berkowitz, MD
• Howard Kornfeld, MD
• Eivind Vinjevoll
• Mitchell Scott
• Fred Wagshul, MD
• Paul E. Marik, MD

PDF: https://osf.io/wx3zn/download

Abstract

In March 2020, an expert panel called the Front Line COVID-19 Critical Care Alliance (FLCCC) was created and led by Professor Paul E. Marik, with the goal of continuously reviewing the rapidly emerging basic science, translational, and clinical data in order to gain insight into and to develop a treatment protocol for COVID-19. At the same time, many centers and groups employed a multitude of novel therapeutic agents empirically, and within clinical trials, often during inappropriate time points during this now well-described multi-phase disease. Either as a result of these frequent trial design failures, or due to the lack of their insufficient anti-viral or anti-inflammatory properties, nearly all trialed agents have proven ineffective in treating COVID-19 as of November 11, 2020. Based on a recent series of negative published therapeutic study results, in particular the SOLIDARITY trial, they now virtually eliminate any treatment role for remdesivir, hydroxychloroquine, lopinavir/ritonavir, interferon, convalescent plasma, tocilizumab, and monoclonal antibody therapy. Despite this growing list of failed therapeutics in COVID-19, the FLCCC recently discovered that ivermectin, an anti-parasitic medicine, has highly potent real-world, anti-viral, and anti-inflammatory properties against SARS-CoV-2 and COVID-19. This conclusion is based on the increasing numbers of study results reporting effectiveness, not only within vitro and animal models, but also in numerous randomized and observational controlled clinical trials. Repeated, large magnitude improvements in clinical outcomes have now been recorded when ivermectin is used not only as a prophylactic agent but also in mild, moderate, and even severe disease states. The review that follows of the existing evidence for ivermectin relies on “emerging” data in that, although compelling, only a minority of studies have been published in peer-reviewed publications with the majority of results compiled from manuscripts uploaded to medicine pre-print servers or posted on clinicaltrials.gov.

https://osf.io/wx3zn/

Texas Doc Cleared of Malpractice Claims After Using Hydroxychloroquine to Treat Coronavirus

A Houston medical doctor has been exonerated by the Texas Medical Board (TMB) of an accusation of malpractice stemming from his use of hydroxychloroquine to treat coronavirus patients.

In a letter to Dr. Richard Urso, the TMB stated “the standard of care was met” and that the complaint against him had been dismissed.

Though the letter does not specifically mention hydroxychloroquine, Urso indicated in a town hall forum in August that he had been reported to the TMB for his use of hydroxychloroquine to treat COVID-19.

“Thank you for everyone’s support. Science prevailed over science fiction. Appreciate the TMB decision,” Urso said in a social media post.

The TMB letter stated that there was no basis for the complaint against Urso.

“The investigation referenced above has been dismissed because the Board determines there was insufficient evidence to prove that a violation of the Medical Practice Act occurred,” the letter reads. “Specifically, the investigation determined that Dr. Urso was appropriate in his care and treatment of BM, JM and KM.”

Urso is an ardent proponent of the use of hydroxychloroquine for treating COVID-19. He is among a number of doctors in the Lone Star State who have criticized the TMB for its alleged invidious treatment of physicians who employ the drug to fight the coronavirus.

The president of the TMB, Dr. Sherif Saafran, has denied claims that the TMB has been targeting doctors who use hydroxychloroquine.

Zaafran explicitly said in August that physicians are free to prescribe hydroxychloroquine if they believe it is appropriate. The statement came after the agency had added roadblocks to the use of the drug earlier in the year.

The TMB did not offer any comment regarding Urso’s exoneration.

“Unfortunately the Board cannot confirm or deny information regarding complaints as it is statutorily confidential,” a TMB spokesperson told The Texan.

Urso could not be reached for comment at the time of publication.

https://thetexan.news/texas-doctor-cleared-of-malpractice-claims-after-using-hydroxychloroquine-to-treat-coronavirus/