Mitigating the risks of post-acute sequelae of SARS-CoV-2 infection (PASC) with intranasal chlorpheniramine: perspectives from the ACCROS studies

Abstract Background The World Health Organization (WHO) declared the end of the COVID-19 (SARS-CoV-2) global public health emergency on May 5, 2023, but its long-term consequences have still been haunting the global population. Post-acute sequelae of COVID-19 (PASC) and long-term COVID-19 are seriou...

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Main Authors: Fernando Valerio-Pascua, Fernando Baires, Anupamjeet Kaur Sekhon, Mari L. Tesch, Estela Jackeline Pineda, Syed A. A. Rizvi, Jarmanjeet Singh, David Abraham Cortes-Bandy, Amy C. Madril, Jana Radwanski, Anita S. Lewis, Miguel Sierra-Hoffman, Mark L. Stevens, Franck F. Rahaghi
Format: Article
Language:English
Published: BMC 2024-11-01
Series:BMC Infectious Diseases
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Online Access:https://doi.org/10.1186/s12879-024-10211-8
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author Fernando Valerio-Pascua
Fernando Baires
Anupamjeet Kaur Sekhon
Mari L. Tesch
Estela Jackeline Pineda
Syed A. A. Rizvi
Jarmanjeet Singh
David Abraham Cortes-Bandy
Amy C. Madril
Jana Radwanski
Anita S. Lewis
Miguel Sierra-Hoffman
Mark L. Stevens
Franck F. Rahaghi
author_facet Fernando Valerio-Pascua
Fernando Baires
Anupamjeet Kaur Sekhon
Mari L. Tesch
Estela Jackeline Pineda
Syed A. A. Rizvi
Jarmanjeet Singh
David Abraham Cortes-Bandy
Amy C. Madril
Jana Radwanski
Anita S. Lewis
Miguel Sierra-Hoffman
Mark L. Stevens
Franck F. Rahaghi
author_sort Fernando Valerio-Pascua
collection DOAJ
description Abstract Background The World Health Organization (WHO) declared the end of the COVID-19 (SARS-CoV-2) global public health emergency on May 5, 2023, but its long-term consequences have still been haunting the global population. Post-acute sequelae of COVID-19 (PASC) and long-term COVID-19 are serious concerns and present with various symptoms. Intranasal chlorpheniramine (iCPM) has been shown to decrease the viral burden of SARS-COV-2. iCPM uses decreased COVID-19 disease progression and severity in Accelerating COVID-19 Clinical Recovery in an Outpatient Setting (ACROSS)-I & III randomized control trials (RCT). Methods This prospective survey study included 259 participants in ACROSS I and III RCTs. We compared the effect of iCPM versus placebo on the reduction of PASC symptoms. A PASC questionnaire containing 17 questions regarding the most common PASC symptoms was used in this study. T-test and Pearson chi-square statistics were performed according to continuous and categorical data using STATA 17.0 Basic Edition software. Findings The iCPM cohort had a lower proportion of patients with fatigue or tiredness vs. placebo (0 Vs 17, 21, p < 0.001). iCPM cohort had a lower proportion of patients with difficulty concentrating or mental confusion (0 vs. 22, 27, p < 0.001). iCPM cohort had also a lower number of patients with difficulty in the ability to perform daily activities or work vs. placebo (1 Vs 38, 48, p < 0.001). A smaller number of patients in the iCPM cohort sought medical attention for PACS symptoms compared to placebo (0 vs. 48, 68, p < 0.001). Interpretation The use of intranasal chlorpheniramine shows promise in preventing COVID-19 progression to the often-debilitating post-COVID-19 syndrome PASC. The association between iCPM use and a lower prevalence of PASC symptoms is strong. Further studies are needed to establish the role of ICPM in preventing PASC.
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spelling doaj-art-1b1738b9e2ce4af088219ed5969dcd172024-12-01T12:11:38ZengBMCBMC Infectious Diseases1471-23342024-11-012411910.1186/s12879-024-10211-8Mitigating the risks of post-acute sequelae of SARS-CoV-2 infection (PASC) with intranasal chlorpheniramine: perspectives from the ACCROS studiesFernando Valerio-Pascua0Fernando Baires1Anupamjeet Kaur Sekhon2Mari L. Tesch3Estela Jackeline Pineda4Syed A. A. Rizvi5Jarmanjeet Singh6David Abraham Cortes-Bandy7Amy C. Madril8Jana Radwanski9Anita S. Lewis10Miguel Sierra-Hoffman11Mark L. Stevens12Franck F. Rahaghi13Department of Critical Care, Hospital CEMESAUniversidad Nacional Autonoma de HondurasSleep Medicine, Kaiser PermanenteResearch and Development, Dr. Ferrer BiopharmaDepartment of Critical Care, Hospital CEMESACollege of Biomedical Sciences, Larkin UniversityDepartment of Cardiovascular Medicine, University of CaliforniaUniversidad Europea de MadridDepartment of Hospital Medicine, El Campo Memorial HospitalCitizens Medical CenterMemorial Hermann Surgical HospitalDepartment of Infectious Disease, Texas A&M Detar Family Medicine ProgramResearch Department, Texas A&M College of Medicine, Detar Family Medicine Residency ProgramDepartment of Pulmonary and Critical Care Medicine, Cleveland Clinic FloridaAbstract Background The World Health Organization (WHO) declared the end of the COVID-19 (SARS-CoV-2) global public health emergency on May 5, 2023, but its long-term consequences have still been haunting the global population. Post-acute sequelae of COVID-19 (PASC) and long-term COVID-19 are serious concerns and present with various symptoms. Intranasal chlorpheniramine (iCPM) has been shown to decrease the viral burden of SARS-COV-2. iCPM uses decreased COVID-19 disease progression and severity in Accelerating COVID-19 Clinical Recovery in an Outpatient Setting (ACROSS)-I & III randomized control trials (RCT). Methods This prospective survey study included 259 participants in ACROSS I and III RCTs. We compared the effect of iCPM versus placebo on the reduction of PASC symptoms. A PASC questionnaire containing 17 questions regarding the most common PASC symptoms was used in this study. T-test and Pearson chi-square statistics were performed according to continuous and categorical data using STATA 17.0 Basic Edition software. Findings The iCPM cohort had a lower proportion of patients with fatigue or tiredness vs. placebo (0 Vs 17, 21, p < 0.001). iCPM cohort had a lower proportion of patients with difficulty concentrating or mental confusion (0 vs. 22, 27, p < 0.001). iCPM cohort had also a lower number of patients with difficulty in the ability to perform daily activities or work vs. placebo (1 Vs 38, 48, p < 0.001). A smaller number of patients in the iCPM cohort sought medical attention for PACS symptoms compared to placebo (0 vs. 48, 68, p < 0.001). Interpretation The use of intranasal chlorpheniramine shows promise in preventing COVID-19 progression to the often-debilitating post-COVID-19 syndrome PASC. The association between iCPM use and a lower prevalence of PASC symptoms is strong. Further studies are needed to establish the role of ICPM in preventing PASC.https://doi.org/10.1186/s12879-024-10211-8COVID-19SARS-CoV-2Intranasal chlorpheniramineEfficacyRandomized clinical trialDouble-blind
spellingShingle Fernando Valerio-Pascua
Fernando Baires
Anupamjeet Kaur Sekhon
Mari L. Tesch
Estela Jackeline Pineda
Syed A. A. Rizvi
Jarmanjeet Singh
David Abraham Cortes-Bandy
Amy C. Madril
Jana Radwanski
Anita S. Lewis
Miguel Sierra-Hoffman
Mark L. Stevens
Franck F. Rahaghi
Mitigating the risks of post-acute sequelae of SARS-CoV-2 infection (PASC) with intranasal chlorpheniramine: perspectives from the ACCROS studies
BMC Infectious Diseases
COVID-19
SARS-CoV-2
Intranasal chlorpheniramine
Efficacy
Randomized clinical trial
Double-blind
title Mitigating the risks of post-acute sequelae of SARS-CoV-2 infection (PASC) with intranasal chlorpheniramine: perspectives from the ACCROS studies
title_full Mitigating the risks of post-acute sequelae of SARS-CoV-2 infection (PASC) with intranasal chlorpheniramine: perspectives from the ACCROS studies
title_fullStr Mitigating the risks of post-acute sequelae of SARS-CoV-2 infection (PASC) with intranasal chlorpheniramine: perspectives from the ACCROS studies
title_full_unstemmed Mitigating the risks of post-acute sequelae of SARS-CoV-2 infection (PASC) with intranasal chlorpheniramine: perspectives from the ACCROS studies
title_short Mitigating the risks of post-acute sequelae of SARS-CoV-2 infection (PASC) with intranasal chlorpheniramine: perspectives from the ACCROS studies
title_sort mitigating the risks of post acute sequelae of sars cov 2 infection pasc with intranasal chlorpheniramine perspectives from the accros studies
topic COVID-19
SARS-CoV-2
Intranasal chlorpheniramine
Efficacy
Randomized clinical trial
Double-blind
url https://doi.org/10.1186/s12879-024-10211-8
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