Central catecholaminergic blockade with clonidine prevent SARS-CoV-2 complication: A case series.
Central catecholaminergic blockade with clonidine prevent SARS-CoV-2 complication: A case series.
复制标题
作者：
Hyoju SK;Baral B;Jha PK
SARS-CoV-2感染导致交感神经过度活动。由于前交感神经过度活跃而患有共病的人，总有可能出现更糟糕的结果。FDA批准的药物可乐定可降低新冠肺炎感染期间的交感神经活性，防止并发症和死亡。可乐定应早期考虑增量治疗，以减少与SAR-CoV-2相关的并发症。这是第一个展示新冠肺炎早期使用可乐定有效性的病例系列。严重急性呼吸综合征冠状病毒2(SARS-CoV-2)是一种高度传染性和致命性的危及生命的病毒感染。虽然许多症状轻微的患者会康复，但急性感染的特征是快速演变的呼吸衰竭、急性炎症反应、器官衰竭和死亡。在此，我们描述了在三个病例中使用可乐定调节这种感染的急性炎症后果。这些患者是三名男性，年龄在40岁至50岁之间，生活在加德满都山谷，当时正值新冠肺炎高峰期(2020年9月至2021年1月)。3例患者均有典型的新冠肺炎症状(日常发热、嗅觉丧失、乏力、咳嗽)和肺炎，胸部CT表现典型。患者1虽然患有肺炎，但仍能保持充足的氧合，在家中通过定期自我监测生命体征和口服可乐定治疗，而患者2和3发展为严重肺炎，难以维持氧合，因此入院接受可乐定和补充氧气治疗。三名患者均完全康复。在这篇有限的报告中，我们提出了几种可乐定可能有助于控制快速演变的SARS-CoV-2感染的机制，其基础是早期给予可乐定可以干预以快速临床恶化为特征的儿茶酚胺反应，包括在易感人群中新冠肺炎感染中可能发生的细胞因子风暴。
SAR-CoV-2 infection lead to sympathetic overactivity. People with co morbid condition due to pre-sympathetic overactivity, there will be always possible of worse outcome. FDA-approved drug clonidine reduces sympathetic activity during COVID-19 infection and prevent complication and death. Clonidine should be considered early in incremental fashion to mitigate SAR-CoV-2 related complication. This is the first case series demonstrating the effectiveness of early use of clonidine in COVID-19. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a life-threating viral infection that is highly transmissible and be lethal. Although many patients with mild symptoms recover, an acute form of the infection is characterized by rapidly evolving respiratory failure, an acute inflammatory response, organ failure, and death. Herein, we describe the use of clonidine to modulate the acute inflammatory consequences of this infection in three cases. The patients were three men between 40–50 years from Kathmandu valley, during the peak of COVID-19 (September 2020- January 2021). All three patients presented with typical COVID-19 symptoms (daily fever, loss of smell and taste, excessive fatigue, cough) and had pneumonia with typical finding in CT Scan of chest. Patient 1was able to maintain adequate oxygenation despite having pneumonia, managed at home by regular self-monitoring of vitals and treatment with oral clonidine whereas patient 2 and 3 developed significant pneumonia and had difficult in maintaining oxygenation hence admitted in hospital and treated with clonidine and supplemental oxygen. All three patients recovered completely. In this limited report, we proposed several mechanisms by which clonidine may be useful in managing rapidly evolving SARS-CoV-2 infection based on the rationale that early clonidine administration can intervene in the catecholaminergic response that characterizes rapid clinical deterioration including presumptive cytokine storm that occurs in COVID-19 infection in vulnerable populations.
登录
查看更多内容
影响因子：
5.8
作者：
Kenney MJ;Ganta CK
通讯作者：
Ganta CK
影响因子：
5.4
作者：
Porzionato, Andrea;Emmi, Aron;De Caro, Raffaele
通讯作者：
De Caro, Raffaele
影响因子：
4.7
作者：
Hyoju SK;Zaborina O;van Goor H
通讯作者：
van Goor H
影响因子：
12.3
作者：
Perin, PC;Maule, S;Quadri, R
通讯作者：
Quadri, R
影响因子：
2.5
作者：
Cinelli, Elenia;Bongianni, Fulvia;Mutolo, Donatella
通讯作者：
Mutolo, Donatella