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A small examine from India, however buttressed with a potential bigger examine, quickly to be printed has superior the case for the use of indomethacin, a robust anti-inflammatory drug, in low doses, for efficient treatment of milder COVID-19 cases.
The case was made in a letter printed in International Journal of Medical Reviews and Case Reports (2020) by Ravichandran Rajan, of the Madras Institute of Nephrology; Srinivasan Subramanian of Voluntary Health Services Hospital; and Chritine Clark of the Royal Pharmaceutical Society, UK.
Lead creator and senior nephrologist Rajan Ravichandran says at the moment, paracetamol is extensively used for symptomatic treatment in COVID-19, however with poor outcomes. “In the paper, we describe our experience in using indomethacin, a low-priced drug, in a small number of patients with COVID-19, including those classified as ‘high-risk’. The results were very encouraging, and that became the basis for a project supported by IIT-Madras, studying the impact of indomethacin in a larger subset of patients, 100, in two hospitals.”
A 2006 Pubmed article by Carla Amici and colleagues from the University of Rome Tor Vergata, Italy, recognized indomethacin as a potent inhibitor of coronavirus (SARS-CoV) replication and prompt that having each anti-inflammatory and antiviral exercise, it may very well be helpful in SARS remedy.
Dr. Ravichandran provides that indomethacin is a robust anti-inflammatory drug, one that offers reduction even with low doses. The drug helps management the dry, persistent cough that could be a frequent function amongst COVID-19 sufferers.
He says the drug has been used for over 35 years, and with a lot success. In addition to being an anti-inflammatory, it has anti-viral properties, he argues. “We have also observed its efficiency when we deal with the impact of the cytomegalovirus among post-transplant patients who have poor immunity. It has an effect on suppressing the cytokine release syndrome, and ameliorating the side effects thereof.”
The paper describes 17 sufferers who examined optimistic for COVID-19 and had been handled at dwelling with two doses of indomethacin. All of them got indomethacin 25mg twice every day. In 14 sufferers, fever, cough and musculoskeletal ache resolved after two doses. One affected person required escalation of dose to 75mg and have become asymptomatic after 5 days. Two sufferers developed low ranges of oxygen saturation and had been began on steroids. “Of the 15 patients who became asymptomatic, four were renal transplant recipients, one on maintenance dialysis, two were over 80 years of age, three had type 2 diabetes mellitus, and one was obese.”
“Our approach is to start treatment with a low dose of indomethacin as early as possible in the course of the disease to reduce the severity of symptoms — fever, coughing and musculoskeletal pain. We believe this can reduce the need for hospitalisation and the risk of spreading the disease,” Dr. Ravichandran says.
The preliminary outcomes of the bigger examine, being carried out in Chennai and Nellore, are additionally displaying optimistic responses from sufferers, he says. Only individuals with enough oxygen saturation are being taken up for such intervention, he provides.
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