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Open Access Original Article Issue
Concomitant and sequential administration of nirmatrelvir‐ritonavir and azvudine in patients with COVID‐19 caused by the Omicron variant: Safety and efficacy
iLABMED 2024, 2(2): 88-97
Published: 22 April 2024
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Background

This study assessed the safety and efficacy of nirmatrelvir‐ritonavir (Paxlovid®) and azvudine when administered sequentially or concomitantly in patients with coronavirus 2019 (COVID‐19) caused by the Omicron variant.

Methods

Ninety‐three patients confirmed to be infected with the Omicron variant by nucleic acid detection were retrospectively investigated. Information was collected on general health status, medication, and adverse drug reactions (ADRs) according to whether nirmatrelvir‐ritonavir and azvudine were administered sequentially or concomitantly. Data on times of onset, clinical manifestations, and outcomes of ADRs and on conversion to a negative nucleic acid test were also recorded.

Results

Possible ADRs were recorded in 41 patients (44.1%). There were 22 gastrointestinal reactions in 18 patients and 18 hematological abnormalities in 16 after sequential or concomitant treatment with nirmatrelvir‐ritonavir and azvudine. Liver enzyme levels increased in nine cases and creatinine clearance decreased in two. Cases of atrial fibrillation (n = 1), sleep disorder (n = 2), rash (n = 2), dizziness (n = 1), and weakness (n = 5) were also documented. Only vomiting, poor appetite, diarrhea, xerostomia, bitter taste, and rash were considered probable ADRs; others were thought to be possible ADRs. In all cases, the nucleic acid test did not turn negative after the first antiviral was applied. The nucleic acid test of 28 patients did not turn negative before discharge. The remaining 65 patients (69.9%) returned a negative nucleic acid test after receiving the second antiviral agent.

Conclusions

Treatment with nirmatrelvir‐ritonavir and azvudine is safe and effective whether administered sequentially or concomitantly in patients with COVID‐19 caused by the Omicron variant.

Open Access Review Issue
Diagnostic approaches for monkeypox virus
iLABMED 2024, 2(1): 6-13
Published: 07 March 2024
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Mpox (formerly Monkeypox) is a zoonotic infection caused by Monkeypox virus (MPXV). Since 2022, Mpox epidemics have occurred in many non‐endemic countries and regions, leading the World Health Organization to declare a public health emergency of international concern. With the persistent transmission and evolution of MPXV, symptoms of Mpox have become milder, with some infections being asymptomatic. In addition, MPXV has become more contagious. Therefore, rapid and accurate diagnosis and screening of MPXV is vital to prevent and control MPXV epidemics. Here, we review and summarize the technical details, application scenarios, and the advantages and disadvantages of MPXV‐specific diagnostic methods.

Research Article Issue
Ratiometric fluorescence immunoassay of SARS-CoV-2 nucleocapsid protein via Si-FITC nanoprobe-based inner filter effect
Nano Research 2023, 16(4): 5383-5390
Published: 17 August 2022
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The global pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus has necessitated rapid, easy-to-use, and accurate diagnostic methods to monitor the virus infection. Herein, a ratiometric fluorescence enzyme-linked immunosorbent assay (ELISA) was developed using Si-fluorescein isothiocyanate nanoparticles (FITC NPs) for detecting SARS-CoV-2 nucleocapsid (N) protein. Si-FITC NPs were prepared by a one-pot hydrothermal method using 3-aminopropyl triethoxysilane (APTES)-FITC as the Si source. This method did not need post-modification and avoided the reduction in quantum yield and stability. The p-nitrophenyl (pNP) produced by the alkaline phosphatase (ALP)-mediated hydrolysis of p-nitrophenyl phosphate (pNPP) could quench Si fluorescence in Si-FITC NPs via the inner filter effect. In ELISA, an immunocomplex was formed by the recognition of capture antibody/N protein/reporter antibody. ALP-linked secondary antibody bound to the reporter antibody and induced pNPP hydrolysis to specifically quench Si fluorescence in Si-FITC NPs. The change in fluorescence intensity ratio could be used for detecting N protein, with a wide linearity range (0.01–10.0 and 50–300 ng/mL) and low detection limit (0.002 ng/mL). The concentration of spiked SARS-CoV-2 N protein could be determined accurately in human serum. Moreover, this proposed method can accurately distinguish coronavirus disease 2019 (COVID-19) and non-COVID-19 patient samples. Therefore, this simple, sensitive, and accurate method can be applied for the early diagnosis of SARS-CoV-2 virus infection.

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