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  1. Article: Hydroxychloroquine and Coronavirus Disease 2019: A Systematic Review of a Scientific Failure.

    Rakedzon, Stav / Khoury, Yara / Rozenberg, Gilad / Neuberger, Ami

    Rambam Maimonides medical journal

    2020  Volume 11, Issue 3

    Abstract: Introduction: Hydroxychloroquine (HCQ) emerged early in the course of the coronavirus disease 2019 (COVID-19) pandemic as a possible drug with potential therapeutic and prophylactic benefits. It was quickly adopted in China, Europe, and the USA. We ... ...

    Abstract Introduction: Hydroxychloroquine (HCQ) emerged early in the course of the coronavirus disease 2019 (COVID-19) pandemic as a possible drug with potential therapeutic and prophylactic benefits. It was quickly adopted in China, Europe, and the USA. We systematically reviewed the existing clinical evidence of HCQ use for the prevention and treatment of COVID-19.
    Methods: We screened for clinical studies describing HCQ administration to treat or prevent COVID-19 in PubMed. We included randomized controlled trials (RCTs), non-randomized comparative cohorts, and case series studies that had all undergone peer review.
    Results: A total of 623 studies were screened; 17 studies evaluating HCQ treatment were included. A total of 13 were observational studies, and 4 were RCTs. In terms of effect on mortality rates, observational studies provided conflicting results. As a whole, RCTs, including one large British RCT that has not yet been published, showed no significant effect of HCQ on mortality rates, clinical cure, and virologic response. The use of HCQ as a post-exposure prophylactic agent was found to be ineffective in one RCT.
    Conclusion: There is no evidence supporting HCQ for prophylaxis or treatment of COVID-19. Many observational trials were methodologically flawed. Scientific efforts have been disappointingly fragmented, and well-conducted trials have only recently been completed, more than 7 months and 600,000 deaths into the pandemic.
    Keywords covid19
    Language English
    Publishing date 2020-07-31
    Publishing country Israel
    Document type Journal Article ; Review
    ZDB-ID 2573657-7
    ISSN 2076-9172
    ISSN 2076-9172
    DOI 10.5041/RMMJ.10416
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Hydroxychloroquine and Coronavirus Disease 2019: A Systematic Review of a Scientific Failure

    Rakedzon, Stav / Khoury, Yara / Rozenberg, Gilad / Neuberger, Ami

    Rambam Maimonides medical journal

    Abstract: INTRODUCTION: Hydroxychloroquine (HCQ) emerged early in the course of the coronavirus disease 2019 (COVID-19) pandemic as a possible drug with potential therapeutic and prophylactic benefits It was quickly adopted in China, Europe, and the USA We ... ...

    Abstract INTRODUCTION: Hydroxychloroquine (HCQ) emerged early in the course of the coronavirus disease 2019 (COVID-19) pandemic as a possible drug with potential therapeutic and prophylactic benefits It was quickly adopted in China, Europe, and the USA We systematically reviewed the existing clinical evidence of HCQ use for the prevention and treatment of COVID-19 METHODS: We screened for clinical studies describing HCQ administration to treat or prevent COVID-19 in PubMed We included randomized controlled trials (RCTs), non-randomized comparative cohorts, and case series studies that had all undergone peer review RESULTS: A total of 623 studies were screened;17 studies evaluating HCQ treatment were included A total of 13 were observational studies, and 4 were RCTs In terms of effect on mortality rates, observational studies provided conflicting results As a whole, RCTs, including one large British RCT that has not yet been published, showed no significant effect of HCQ on mortality rates, clinical cure, and virologic response The use of HCQ as a post-exposure prophylactic agent was found to be ineffective in one RCT CONCLUSION: There is no evidence supporting HCQ for prophylaxis or treatment of COVID-19 Many observational trials were methodologically flawed Scientific efforts have been disappointingly fragmented, and well-conducted trials have only recently been completed, more than 7 months and 600,000 deaths into the pandemic
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #721596
    Database COVID19

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  3. Article ; Online: Evaluation of the relationship between quantitative PCR results and cell culturing of SARS2-CoV with respect to symptoms onset and Viral load – a systematic review

    rozenberg, gilad / Erster, Oran / Ghersin, Itai / Mandelboim, Michal / neuberger, Ami / Schwartz, Eli

    medRxiv

    Abstract: Background: Viral culture is currently the most accurate method to demonstrate viability and infectivity of Severe acute respiratory syndrome Coronavirus (SARS–2 CoV). Routine clinical diagnosis, however, is mostly performed by PCR – based assays that do ...

    Abstract Background: Viral culture is currently the most accurate method to demonstrate viability and infectivity of Severe acute respiratory syndrome Coronavirus (SARS–2 CoV). Routine clinical diagnosis, however, is mostly performed by PCR – based assays that do not discriminate between infectious and non–virus. Herein, we aimed to determine the correlation between positive viral cultures and either PCR positivity, the Cycle Threshold (Ct) or the number of viral copies. Methods: A systematic electronic literature search was performed and studies that reported both viral SARS–CoV–2 culture and PCR–based assays were included. A separate search for samples from blood, urine, stool, breast milk and tears were performed. To convert Ct values reported in the reviewed studies were to viral genomic copies, calibration experiments with four different reaction performed, using quantified RNA molecules. Results: A total 540 articles were reviewed, and 38 studies were included in this review. Out of 276 positive–culture of non-severe patients, 272 (98.55%) were negative ten days after symptoms onset, while PCR assays remained positive for up to 67 days. In severely ill or immunocompromised patients positive-culture was obtained up to 32 days and out of 168 cultures, 31 (18.45%) stayed positive after day 10. In non-severe patients, in Ct value greater than 30 only 10.8% were still culture–positive while in Ct >35 it was nearly universally negative. The minimal calculated number of viral genome copies in culture- positive sample was 2.5 X 103 copies / mL. These findings were similar in immunocompromised patients. Recovering positive culture from non–respiratory samples was sporadically obtained in stool or urine samples. Conversion of Ct values to viral genome copies showed variability between different PCR assays and highlighted the need to standardize reports to correctly compare results obtained in different laboratories. Conclusion: During the pandemic phase, non-severe COVID-19 patients who are recovering and are not immuno-suppressed, can be regarded as non–infectious, within 10 days from symptom onset, or with Ct value greater than 35 (or a calculated viral load lower than 1.2X103 copies / mL). These findings have important implications for recovering patients and asymptomatic patients, with respect to isolation criteria. The conversion of Cq values to viral genome copies described herein may be useful in future work, enabling a more standardized comparison between results reported in different studies from different laboratories.
    Keywords covid19
    Language English
    Publishing date 2021-08-25
    Publisher Cold Spring Harbor Laboratory Press
    Document type Article ; Online
    DOI 10.1101/2021.08.23.21262162
    Database COVID19

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  4. Article ; Online: Standard pre-travel consultation versus shorter consultation combined with smartphone support: a randomized controlled trial.

    Rozenberg, Gilad / Petersiel, Neta / Korytny, Alexander / Bishop, Boaz / Mousa, Amjad / Fried, Carmit / Maister, Alina / Neuberger, Ami

    Journal of travel medicine

    2019  Volume 26, Issue 3

    Abstract: Immediate and long-term recalls of a pre-travel consultation are suboptimal. We aimed to assess the role of online consultation for travellers.: We randomized travellers into two study groups. In the intervention arm, each traveller was given a short ... ...

    Abstract Immediate and long-term recalls of a pre-travel consultation are suboptimal. We aimed to assess the role of online consultation for travellers.
    We randomized travellers into two study groups. In the intervention arm, each traveller was given a short pre-travel consultation of 8-12 minutes, combined with the option of smartphone support before and during the trip. In the control arm, each traveller was given a standard length pre-travel consultation of 18-22 minutes. Endpoints included knowledge about potential risks, travellers' satisfaction, time allocated to each traveller and clinical events.
    We enrolled 75 patients in the intervention group and 74 patients in the control group. Online consultation was used 33 times, by 24 travellers, both before and during the trip. Important health hazards that were addressed included animal and insect bites (8), treatment of diarrhea (4), malaria prophylaxis (2) and altitude sickness prophylaxis (5). Other consultations consisted mainly of reassurances of worried travellers and provision of data. Knowledge about travel-related risks was higher in the control group before travelling (8.86 ± 1.12 vs 8.34 ± 1.32, P = 0.014), and there was a trend towards higher levels of knowledge also during the trip (8.29 ± 1.35 vs 7.89 ± 1.39, P = 0.06). Travellers' satisfaction before and during the trip was similar in both groups: median 10 (10, 10) in both groups before traveling (P = 0.51) and median 9 (8, 10) in both groups during the trip (P = 0.71). In the intervention group, time allocated to each traveller was <12 minutes. There were no differences in the number of clinical events (P > 0.2 for all comparisons).
    Online WhatsApp support addressed several important travel-related hazards but, when combined with a shortened pre-travel consultation, was associated with a lower level of knowledge about health risks. Therefore, such smartphone support should augment, rather than replace, pre-travel consultation.
    MeSH term(s) Adult ; Altitude Sickness/prevention & control ; Counseling/methods ; Developing Countries ; Diarrhea/therapy ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Insect Bites and Stings/prevention & control ; Internet ; Malaria/prevention & control ; Male ; Smartphone ; Travel ; Young Adult
    Language English
    Publishing date 2019-04-01
    Publishing country England
    Document type Journal Article ; Randomized Controlled Trial
    ZDB-ID 1212504-0
    ISSN 1708-8305 ; 1195-1982
    ISSN (online) 1708-8305
    ISSN 1195-1982
    DOI 10.1093/jtm/taz025
    Database MEDical Literature Analysis and Retrieval System OnLINE

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