The first experience with Angiovit in the combination treatment of acute COVID-19 infection
Abstract
On March 11, 2020, the WHO announced the COVID-19 outbreak a pandemic. The disease was established to be caused by a new singlestranded RNA virus (ss-RNA, 29903 bp) that belongs to a group of coronaviruses (CoV).
Objective: to assess the results of a pilot analysis of the efficiency of using Angiovit in the combination treatment of acute COVID-19 with pneumonia or acute respiratory viral infection.
Patients and methods. The study enrolled 50 patients with acute COVID-19. In all the patients, the diagnosis of coronavirus infection was confirmed by polymerase chain reaction. Angiovit was used in 25 patients (13 (52%) women) (mean age, 39.4 years) with moderate infection who had been admitted on an average of disease day 3 (a study group). A comparison group consisted of 25 patients whose gender, age, and clinical features of COVID-19 did not differ at the time of admission; they were prescribed only mainstay therapy.
Results and discussion. Adding Angiovit to the mainstay therapy contributed to an average reduction in the fever period from 5.88 to 4.12 days (p<0.05) and to the earlier hospital discharge of patients with an improvement (on day 13 versus on day 16.8 days in the comparison group; p<0.05); Normalization of CRP, D-dimer, and homocysteine levels occurred considerably and faster.
Conclusion. The pilot study has shown that the use of Angiovit in the combination therapy of COVID-19 reduces the clinical and laboratory manifestations of inflammation and hypercoagulation, which may also be associated with the action of folic acid.
About the Authors
A. N. BoykoRussian Federation
Aleksey Nikolaevich Boyko.
Ostrovityanov St., Moscow 117997; 1, Ostrovityanov St., Build. 10, Moscow 117997.
Competing Interests: There are no conflicts of interest.
N. A. Shamalov
Russian Federation
11, Ostrovityanov St., Moscow 117997; 1, Ostrovityanov St., Build. 10, Moscow 117997.
Competing Interests: There are no conflicts of interest.
O. V. Boyko
Russian Federation
11, Ostrovityanov St., Moscow 117997; 1, Ostrovityanov St., Build. 10, Moscow 117997.
Competing Interests: There are no conflicts of interest.
E. E. Arinina
Russian Federation
1, Ostrovityanov St., Build. 10, Moscow 117997.
Competing Interests: There are no conflicts of interest.
O. V. Lyang
Russian Federation
1, Ostrovityanov St., Build. 10, Moscow 117997.
Competing Interests: There are no conflicts of interest.
E. A. Dubchenko
Russian Federation
1, Ostrovityanov St., Build. 10, Moscow 117997.
Competing Interests: There are no conflicts of interest.
A. V. Ivanov
Russian Federation
8; Baltiyskaya St., Moscow 125315.
Competing Interests: There are no conflicts of interest.
A. A. Kubatiev
Russian Federation
8; Baltiyskaya St., Moscow 125315.
Competing Interests: There are no conflicts of interest.
References
1. https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020
2. https://www.cdc.gov/coronavirus/types.html
3. Zou X, Chen K, Zou J, et al. Single-cell RNA-seq data analysis on the receptor ACE2 expression reveals the potential risk of different human organs vulnerable to 2019-nCoV infection. Front Med.2020 Apr;14(2):185-92. doi: 10.1007/s11684-020-0754-0. Epub 2020 Mar 12.
4. Liu F, Zhang Q, Huang C, et al. CT quantification of pneumonia lesions in early days predicts progression to severe illness in a cohort of COVID-19 patients. Theranostics. 2020 Apr 27; 10(12):5613-22. doi: 10.7150/thno.45985. eCollection 2020.
5. Yang Z, Shi J, He Z, et al. Predictors for imaging progression on chest CT from coronavirus disease 2019 (COVID-19) patients. Aging (Albany NY). 2020 Apr 10;12(7):6037-48. doi: 10.18632/aging.102999. Epub 2020 Apr 10.
6. Serseg T, Benarous K, Yousfi M. Hispidin and Lepidine E: two Natural Compounds and Folic acid as Potential Inhibitors of 2019-novel coronavirus Main Protease (2019-nCoVMpro), molecular docking and SAR study. Curr Comput Aided Drug Des. 2020 Apr 21. doi: 10.2174/1573409916666200422075440. Online ahead of print.
7. Dubchenko EA, Ivanov AV, Boiko AN, et al. Hyperhomocysteinemia and endothelial dysfunction in patients with cerebral vascular and autoimmune diseases. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova.2019;119(11): 127-32. (In Russ.).
8. https://static-1.rosminzdrav.ru/system/attachments/attaches/000/050/122/original/28042020_MR_COVID-19_v6.pdf
9. Bolander-Gouaille C. Focus on Homocysteine and the Vitamins involved in its metabolism. Springer Verlag France; 2002. 217 p.
10. Lentz SR, Haynes WG. Homocysteine: is it a clinically important cardiovascular risk factor? Cleve Clin J Med. 2004 Sep;71(9):729-34. doi: 10.3949/ccjm.71.9.729.
11. Rasic-Markovic A, Stanojlovic O, Hrncic D, et al. The activity of erythrocyte and brain Na+/K+ and Mg2+-ATPases in rats subjected to acute homocysteine and homocysteine thiolactone administration. Mol Cell Biochem.2009 Jul;327(1-2):39-45. doi: 10.1007/s11010-009-0040-6. Epub 2009 Feb 18.
12. Raposo B, Rodriguez C, Martinez-Gonzalez J, Badimon L. High levels of homocysteine inhibit lysyl oxidase (LOX) and down-regulate LOX expression in vascular endothelial cells. Atherosclerosis. 2004 Nov;177(1):1-8. doi: 10.1016/j.atherosclerosis.2004.06.015.
13. Sen U, Mishra PK, Tyagi N, Tyagi SC. Homocysteine to Hydrogen Sulfide or Hypertension. Cell Biochem Biophys. 20 1 0 Jul; 57(2-3):49-58. doi: 10.1007/s12013-010-9079-y.
14. Li JJ, Li Q, Du HP, et al. Homocysteine Triggers Inflammatory Responses in Macrophages through Inhibiting CSE-H2S Signaling via DNA Hypermethylation of CSE Promoter. Int J Mol Sci.2015 Jun 3;16(6):12560-77. doi: 10.3390/ijms160612560.
15. Price BR, Wilcock DM, Weekman EM. Hyperhomocysteinemia as a Risk Factor for Vascular Contributions to Cognitive Impairment and Dementia. Front Aging Neurosci. 2018 Oct 31;10:350. doi: 10.3389/fnagi.2018.00350. eCollection 2018.
16. Moretti R., Caruso P. The Controversial Role of Homocysteine in Neurology: From Labs to Clinical Practice. Int J Mol Sci. 2019 Jan 8;20(1):231. doi: 10.3390/ijms20010231.
17. Henry BM, Vikse J, Benoit S, et al. Hyperinflammation and derangement of renin-angiotensin-aldosterone system in COVID-19: A novel hypothesis for clinically suspected hypercoagulopathy and microvascular immunothrombosis. Clin Chim Acta.2020 Aug; 507:167-73. doi: 10.1016/j.cca.2020.04.027. Epub 2020 Apr 26.
18. Yao D, Sun NL. Hyperhomocysteinemia accelerates collagen accumulation in the adventitia of balloon-injured rat carotid arteries via angiotensin II type 1 receptor. Int J Mol Sci. 2014 Oct 27;15(11):19487-98. doi: 10.3390/ijms151119487.
19. Li T, Yu B, Liu Z, et al. Homocysteine directly interacts and activates the angiotensin II type I receptor to aggravate vascular injury. Nat Commun.2018 Jan 2;9(1):11. doi: 10.1038/s41467-017-02401-7.
20. Shi L, Liu XY, Huang ZG, et al. Endogenous hydrogen sulfide and ERK1/2-STAT3 signaling pathway may participate in the association between homocysteine and hypertension. J Geriatr Cardiol. 2019 Nov;16(11):822-834. doi: 10.11909/j.issn.1671-5411.2019.11.007.
Review
For citations:
Boyko A.N., Shamalov N.A., Boyko O.V., Arinina E.E., Lyang O.V., Dubchenko E.A., Ivanov A.V., Kubatiev A.A. The first experience with Angiovit in the combination treatment of acute COVID-19 infection. Neurology, Neuropsychiatry, Psychosomatics. 2020;12(3):82-86. (In Russ.) https://doi.org/10.14412/2074-2711-2020-3-82-86