treatment

COVID Roundup: Cardiac Complications, Nitazoxanide Treatment

Cardiac Complications1

Adverse cardiac outcomes such as myocarditis and pericarditis are associated with COVID-19 infection and vaccination, according to the results of a recent study.

Researchers utilized electronic health records data from 40 health care systems in the United States from January 1, 2021, to January 31, 2022. The included health care systems were all participants in the National Patient-Centered Clinical Research Network (PCORnet).

Included were individuals aged 5 years or older who were infected with COVID-19. The primary outcome was the incidence of myocarditis, and myocarditis or pericarditis after COVID-19 infection or mRNA vaccination.

The results indicated that men aged 12 to 17 years had the highest incidence of cardiac outcomes following a second dose of a COVID-19 vaccine. However, this risk was 1.8 to 5.6 times higher for cardiac outcomes among this patient population following COVID-19 infection.

“The risk for cardiac outcomes was likewise significantly higher after SARS-CoV-2 infection than after first, second, or unspecified dose of mRNA cOVID-19 vaccination for all other groups by sex and age,” researchers concluded. “These findings support continued use of mRNA COVID-19 vaccines among all eligible persons aged [5 years or older].”

Nitazoxanide Treatment2

Nitazoxanide may be a potential outpatient treatment for individuals with mild to moderate COVID-19, according to the results of a randomized clinical trial.

Included were 1082 participants from 36 health centers throughout the United States from August 2020 to February 2021. Of the total participants, 379 had laboratory confirmed COVID-19 infections and were enrolled in the study. Participants were randomized to receive a 600 mg dose of nitazoxanide orally twice per day for 5 days or placebo within 72 hours of symptom onset.

The time to sustained clinical recovery (TSR) was 13.3 days for the nitazoxanide group, and 12.4 days for the placebo group. In the nitazoxanide group, 1 of 184 individuals progressed to severe disease, compared with 7 of 195 in the placebo group. Individuals treated with nitazoxanide had reductions in median TSR and usual health days when compared with placebo.

“Further trials with larger numbers are warranted to evaluate efficacy of nitazoxanide therapy in preventing progression to severe illness in patients at high risk of severe illness and reducing TSR in patients with mild illness,” researchers concluded.

 

—Leigh Precopio

 

References:

  1. Block JP, Boehmer TK, Forrest CB, et al. Cardiac complications after SARS-CoV-2 infection and mRNA COVID-19 vaccination – PCORnet, United States, January 2021-January 2022. MMWR mob Moral Wkly Rep. 2022;71(14):517-523. doi:10.15585/mmwr.mm7114e1
  2. Rossignol JF, Bardin MC, Fulgenico J, Mogelnicki D, Bréchot C; Vanguard Study Group. A randomized double-blind placebo-controlled clinical trial of nitazoxanide for treatment of mild or moderate COVID-19. eClinicalMedicine. 2022;45:101310. doi:10.1016/j.eclinm.2022.101310