Convalescent plasma (CP) from patients recovered from COVID-19 is one of the most studied anti-viral therapies against SARS-COV-2 infection. The aim of this study is to summarize the evidence from the available systematic reviews on the efficacy and safety of CP in COVID-19 through an overview of the published systematic reviews (SRs). A systematic literature search was conducted up to August 2021 in Embase, PubMed, Web of Science, Cochrane and Medrxiv databases to identify systematic reviews focusing on CP use in COVID-19. Two review authors independently evaluated reviews for inclusion, extracted data and assessed quality of evidence using AMSTAR (A Measurement Tool to Assess Reviews) and GRADE tools. The following outcomes were analyzed: mortality, viral clearance, clinical improvement, length of hospital stay, adverse reactions. In addition, where possible, subgroup analyses were performed according to study design (e.g., RCTs vs. non-RCTs), CP neutralizing antibody titer and timing of administration, and disease severity. The methodological quality of included studies was assessed using the checklist for systematic reviews AMSTAR-2 and the GRADE assessment. Overall, 29 SRs met the inclusion criteria based on 53 unique primary studies (17 RCT and 36 non-RCT). Limitations to the methodological quality of reviews most commonly related to absence of a protocol (11/29) and funding sources of primary studies (27/29). Of the 89 analyses on which GRADE judgements were made, effect estimates were judged to be of high/moderate certainty in four analyses, moderate in 38, low in 38, very low in nine. Despite the variability in the certainty of the evidence, mostly related to the risk of bias and inconsistency, the results of this umbrella review highlight a mortality reduction in CP over standard therapy when administered early and at high titer, without increased adverse reactions.

Safety and Efficacy of Convalescent Plasma in COVID-19: An Overview of Systematic Reviews.

The widespread respiratory disease of virus known as severe acute respiratory syndrome–coronavirus 2019 (SAR-CoV-2) had infected more than 200 countries and caused pandemic and havoc in the world. The genome of the virus was sequenced rapidly to study its mechanism, epidemiology, drugs, and vaccines. Many drugs and vaccines are being studied by researchers to treat and prevent the SARS-CoV-2. Favipiravir and dexamethasone are repurposed drugs which showed therapeutic potential and pharmaceutical efficacy against SARS-CoV-2. The review describes the path of favipiravir and dexamethasone from chemistry to mechanisms of action to combat SARS-CoV-2. In addition, the potential side effects are also summarized to study their potential to control corona virus 2019.

/pdf/efficacy-and-safety-of-new-and-emerging-drugs-for-covid-19-3uvfqnujyc.pdf

Efficacy and Safety of New and Emerging Drugs for COVID-19: Favipiravir and Dexamethasone.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a virus with single positive-strand RNA, having glycoproteins projection on envelopes so reveals a halo-like appearance or corona. Coronavirus is of four types: (1) α-coronavirus (α-COV); (2) β-coronavirus (β-COV); (3) δ-coronavirus (δ-COV); and (4) γ-coronavirus (γ-COV) and belongs to family Coronaviridae and subfamily Coronavirinae. Coronaviruses are the normal pathogens that cause broad band of gastrointestinal and respiratory diseases in domestic as well as wild animals such as pigs, birds, and rodents. Coronavirus is highly infectious in case of elders for mortality rate. The elder peoples are at 2-fold higher risk as compared to the younger population and the greater part of the population dying from coronavirus disease (COVID-19) is male. The virus enters into the body by the mouth, eyes, or nose, then particles march inside of the body by different pathways and affect vital organs in severe ways such as liver, heart muscle, blood vessels, kidneys, central nervous system, etc. Right now, the only solution to avoid COVID-19 infection is “precautions.” Different companies of different countries at different steps are in race to develop effective medicines for treatment and management of the same. Here, in this review, we tried to give an overview of all about SARS-CoV-2, COVID-19 infection, pathophysiology, mechanisms, and various treatment trials.

A review on Coronavirus Disease and potentially active drugs targeting Coronavirus

Introduction The tobacco industry has for decades been associated with environmental damage, health-related diseases, human rights violations and corruption issues. The World Health Organisation formulated the Framework Convention on Tobacco Control with the aim of controlling tobacco production and consumption. Most of the countries on the continent of Africa were also the target of the framework given the high importation and use of tobacco products. The main aim of this study was to find out the current status of tobacco control policies and their effectiveness in Africa. Material and methods This study was a systematic literature review that was conducted between the months of August and November 2020 by extracting data from the databases of PubMed, Elsevier Scopus and Web of Science. Only English articles were culled from the retrieved papers. Out of the 910 papers retrieved, only 17 papers from African countries were selected on the quality synthesis after meeting the inclusion criteria. Results The results of the study showed that three governance resources were identified of regulatory (64.70%, N=11) which had smoke-free environment, advertisement bans, and cessation programs, economics (29.41%, N=5) which were taxation measures and informative (5.886%, N=1) which were mass media campaigns. Furthermore, Western African countries especially South Africa reported many pronouncements on smoke-free environment and taxation measures. Mass media campaigns proved to be more effective policies as compared to others. Conclusion This study recommends that the future research should be done on the effectiveness of mixed policy instruments as compared to single application. Furthermore, the researcher recommends the use of more informative policies in dealing with inelastic behaviours like those related to tobacco due to the addictive nature.

/pdf/assessment-of-tobacco-control-policy-instruments-status-and-3znl9v5qpv.pdf

Assessment of Tobacco Control Policy Instruments, Status and Effectiveness in Africa: A Systematic Literature Review.

COVID-19 convalescent plasma therapy and immunodeficiency.

Corona Virus Disease 2019 (COVID-9) is an acute respiratory infection caused by extreme acute coronavirus-2 (SARS-CoV-2) respiratory syndrome. WHO has designated COVID-19 as a pandemic with a very high mortality rate and increasing very rapidly, in only 3 months COVID- 19 has infected 1.133046 people and in many cases only 14 days COVID-19 has caused death? With very high mortality and mordibility rates, no effective and safe of antivirus treatment has yet been found to cure COVID-19, so research is needed to find the most effective and safe of antivirus drugs to cure COVID-19. To know the best and safe of antivirus medication to cure COVID-19. This research uses a structured analysis focused on preferred reporting items for systematic reviews and meta-analyzes (PRISMA) in order to classify all existing literature with appropriate keywords. The database using PRISMA (Preferred Reporting Items for Systematic Reviews & Meta Analyses) for instruments and used flowcharts based on the 2009 PRISMA checklist and based on inclusion and exclusion criteria, we found 6 anti-virus drugs used to treat SARS-CoV-1 or MERS-CoV and very potential to treat COVID-19, that is Favipiravir (Avigan, Favilavir), Lopinavir and Ritonavir (LPV / RTV; Kaletra) , Neuraminidase inhibitors (eg, oseltamivir), Umifenovir (Arbidol) Remdesivir, and Baloxavir. The most efficacy and safe of anti-virus is Favipiravir because this drug can improve significantly time-to-relief for fever and cough and is associated with manageable adverse effects.

/pdf/the-efficacy-and-safety-of-antivirus-drugs-for-covid-19-a-4tne93t3gi.pdf

The efficacy and safety of antivirus drugs for COVID-19: A systematic review

Convalescent plasma therapy (CP) has long been used to prevent and treat various infectious diseases before COVID-19 such as SARS, MERS, and H1N1 Because the viral and clinical characteristics of COVID-19 share the similarities between SARS and MERS, CP treatment could be a promising treatment option to save COVID-19 With only low quality medical evidence, but massive media support and a very significant public demand for the use of convalescent plasma for COVID-19, we are now faced with an ethical dilemma Therefore, this paper uses a structured analysis that focuses on the preferred reporting items for a systematic review of ethical issues regarding the use of Convalescent Plasma Therapy for COVID-19 The use of convalescent plasma must meet the ethical principles of autonomy; such as voluntary, informed consent, and confidentiality Consideration of the risk-benefit ratio for potential donor recipients also needs to be considered in order to meet the beneficence and non-maleficence principles The principle of justice also needs to be applied both to donors, donor recipients and health workers, such as determining the priority of donor recipients, due to the increasing demand for convalescent plasma amid the limited circumstances of patients who have recovered from Covid-19 who voluntarily donate

Bioethical perspective of convalescent plasma therapy for COVID-19: A systematic review.

Orthopaedic surgeons may wonder what preparation and recuperation would be like during pandemics. We are concerned about the patient's safety during the operation. All surgical centres have received instructions to discontinue all elective surgery operations, although urgent surgical cases are still being carried out. This procedure should not be delayed in orthopaedic issues such as fracture repositioning surgery, as the unionization process is ongoing.We gather review articles from a variety of sources. The keywords "Ethics," "COVID-19," "Elective Surgery," and "Orthopedic Surgery" were used to filter the documents. We found 863 documents and then set the criteria for including documents that we thought eligible for review articles, such as research journals and newspaper pieces from reliable sources, resulting in the discovery of 40 papers that met our requirements.We will discuss four basic principles of medical ethics: beneficence, nonmaleficence, autonomy, and justice. Orthopaedic surgeons will face many decisions that will challenge these ethical principles, especially in performing elective surgery during a pandemic.Physicians must protect the most vulnerable, but they are under no obligation to administer treatment they believe to be ineffective. In individuals who are positive for COVID-19, orthopaedic surgical procedures have a significant mortality rate. Surgical leaders must remain attentive, and surgical services must be reintroduced gradually and carefully. A good option is to carry out treatment at a different place and time and ensure that the patient has tested negative for COVID-19 before the procedure, thereby creating safety for patients and health workers. 

https://doi.org/10.1016/j.amsu.2022.103845

A medical ethics review of elective orthopaedic surgery management during the pandemic COVID-19 Era

BACKGROUND: WHO declared the coronavirus disease (COVID)-19 outbreaks as a worldwide pandemic in March 2020. More than 1,500,000 confirmed cases have been diagnosed in more than 130 countries and regions, estimated to cause 93,000 deaths so far recorded on April 10, 2020. There is no vaccine or antiviral treatment for coronavirus.
METHODS: The literature sources from the research were obtained by searching for national and international journals. The journal is indexed in Google Scholar, PubMed, Science Direct, e-books, and others. Five journals were obtained, including a literature review, systematic review, and randomized controlled trials (RCT) discussing the use of dexamethasone in COVID-19 therapy, Middle East respiratory syndrome, and severe acute respiratory syndrome.
RESULTS: A study from Oxford University compared 2100 COVID-19 patients who received low and moderate potential dexamethasone at a dose of 6 mg/day for 10 days with 4300 COVID-19 patients who only received standard treatment for coronavirus infection. The results obtained in patients using ventilator mortality decreased from 40% to 28%, and patients using oxygen, the mortality rate decreased from 40% to 20%. The dexamethasone RCT study can reduce the death rate of 1 in 3 COVID-19 patients who received mechanical ventilation therapy and 1 in 5 patients who received oxygen therapy without mechanical ventilation but did not reduce patients’ mortality rate who did not receive therapy oxygen.
CONCLUSION: The use of dexamethasone with oxygen therapy and mechanical ventilation can reduce mortality patients with COVID-19.

/pdf/effectiveness-of-the-use-of-dexamethasone-in-treatment-of-7i7jhdbv9y.pdf

Effectiveness of the use of dexamethasone in treatment of coronavirus infections: A systematic review

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The efficacy and safety of antivirus drugs for COVID-19: A systematic review

Bioethical perspective of convalescent plasma therapy for COVID-19: A systematic review.

A medical ethics review of elective orthopaedic surgery management during the pandemic COVID-19 Era

Effectiveness of the use of dexamethasone in treatment of coronavirus infections: A systematic review