LitCovid-sentences  

PMC:7696151 / 86811-92818 JSONTXT 3 Projects

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Id Subject Object Predicate Lexical cue
T550 0-6 Sentence denotes 2.4.4.
T551 7-27 Sentence denotes Bacterial Infections
T552 28-158 Sentence denotes HCQ is known to exert an antibacterial effect through the alkalinization of infected organelles, inhibiting bacterial replication.
T553 159-324 Sentence denotes In clinical practice, HCQ is not used in monotherapy but in combination with antibiotics, like doxycycline, to improve its bactericidal effects on two main bacteria:
T554 325-367 Sentence denotes Coxiella burnetii and Tropheryma whipplei.
T555 368-473 Sentence denotes C. burnetii is an obligate intraleukocytic Gram-negative bacterium responsible for query fever (Q fever).
T556 474-608 Sentence denotes The infection is mainly caused by direct contact with infected animals, although cases of human transmission have also been described.
T557 609-759 Sentence denotes Q fever diagnosis is primally founded on serological examination and based on a different evolution, acute and chronic infection can be distinguished.
T558 760-964 Sentence denotes In 50% of cases, the acute phase is asymptomatic, but when the acute phase is symptomatic, it is characterized by a febrile illness, myalgia, headache, chills, atypical hepatitis, and pneumonia [122,123].
T559 965-1093 Sentence denotes Approximately 2–5% of C. burnetii infections can develop into the chronic phase, leading to endocarditis and vascular infection.
T560 1094-1218 Sentence denotes The risk of developing chronic fever is higher in patients with pre-existing vascular disorders or valvulopathies [123,124].
T561 1219-1310 Sentence denotes C. burnetii is known to replicate in an intracellular phagolysosome with a pH range of 4–5.
T562 1311-1406 Sentence denotes However, at this pH, antibiotics, like doxycycline (DXC), exert only a bacteriostatic activity.
T563 1407-1495 Sentence denotes Therefore, a combination of DXC with a lysosomotropic agent, such as HCQ, was suggested.
T564 1496-1631 Sentence denotes In fact, HCQ was shown to increase the phagolysosomal compartment’s pH by improving the bactericidal activity of doxycycline [125,126].
T565 1632-1760 Sentence denotes The first successful results concerning the treatment of Q fever endocarditis combined with DXC and HCQ date back to 1993 [127].
T566 1761-1973 Sentence denotes These results were later confirmed by a case report of a young infected girl, where the treatment with 200 mg/day of DXC and 600 mg/day of HCQ led to a reduction in serum C. burnetii antibodies within 48 h [128].
T567 1974-2276 Sentence denotes Furthermore, in a 1999 clinical study, the administration of 100 mg DXC twice daily plus 200 mg HCQ three times daily for at least 18 months led to a short duration of therapy and a reduction in recurrences compared to alternative treatments including DXC plus 200 mg ofloxacin three times daily [129].
T568 2277-2505 Sentence denotes Since this moment, all infected subjects have been treated with DXC plus HCQ, as demonstrated by several case reports where this regimen results in an improvement of C. burnetii-related disease [130,131,132,133,134,135,139,140].
T569 2506-2796 Sentence denotes Furthermore, in patients with valvulopathy and diagnosticated acute Q fever (serologic criteria of a phase II IgG titer ≥ 200 and a phase II IgM titer ≥ 50) the administration as prophylaxis of DCX plus HCQ for at least 12 months resulted to be efficient in preventing Q fever endocarditis.
T570 2797-2888 Sentence denotes Contrarily, shorter regimes are associated with a failure of antibiotics prophylaxis [141].
T571 2889-3075 Sentence denotes When Q fever endocarditis occurs, the optimal treatment duration with DXC and HCQ seems to be 18 months for native valve patients and 24 months for subjects with prosthetic valves [142].
T572 3076-3162 Sentence denotes This duration should only be extended in the absence of favorable serological results.
T573 3163-3375 Sentence denotes However, long-term treatment with DXC and HCQ is not without important complications, since both can cause photosensitivity [144], abnormal weight gain [145], severe erythroderma, and impaired visual field [142].
T574 3376-3643 Sentence denotes Besides, it can be said that while the acute phase of the infection can be treated with only 200 mg/day DXC, the chronic phase is more difficult to treat and therapy with 100 mg DXC twice daily with 200 mg HCQ three times daily for 18–24 months was recommended [146].
T575 3644-3732 Sentence denotes Serological titers are used to follow the disease and determine the duration of therapy.
T576 3733-3827 Sentence denotes On the other hand, T. whipplei is a Gram-positive bacterium responsible for Whipple’s disease.
T577 3828-3982 Sentence denotes The natural niche of T. whipplei is the human intestine since, in the intestinal mucosa, the bacterium is taken by macrophages, where it replicates [147].
T578 3983-4145 Sentence denotes This bacterial infection is primally characterized by digestive tract disorders such as diarrhea (75% of cases), malabsorption, and weight loss (80–90% of cases).
T579 4146-4257 Sentence denotes Joint disease may appear more than six years before the diagnosis and occur in more than 80% of patients [148].
T580 4258-4363 Sentence denotes Furthermore, neurological and cardiac disorders can also be frequently associated with Whipple’s disease.
T581 4364-4524 Sentence denotes For years the standard treatment for T. whipplei has included a combination of trimethoprim and sulfamethoxazole; however, relapses were not uncommon [149,150].
T582 4525-4734 Sentence denotes Later, in vitro studies, demonstrated that trimethoprim was inactive on this bacterium [154], while sulfamethoxazole induced bacterial resistance, making the co-administration completely ineffective [154,156].
T583 4735-4898 Sentence denotes Based on the good results of treating C. burnetii infections, it was decided to test in vitro the association DCX/HCQ on T. whipplei, obtaining good results [154].
T584 4899-4988 Sentence denotes DCX/HCQ efficacy on T. whipplei diseases was demonstrated in a clinical trial dated 2014.
T585 4989-5206 Sentence denotes This study showed that the administration of 200 mg/day DCX and 600 mg/day HCQ to 13 patients results in better outcomes (0/13 failures) even after 1 year of treatment, compared to standard antibiotics regimens [155].
T586 5207-5456 Sentence denotes To date, several case reports available in the literature supported a therapy consisting of a combination of HCQ (600 mg/day) and DCX (200 mg/day) for a lifetime or at least one year, followed by a maintenance dosage of DXC used alone [156,157,158].
T587 5457-5628 Sentence denotes In some cases, prophylaxis of intravenous ceftriaxone (2g/day) for the first two weeks followed by HCQ/DXC for at least 12–18 months has been recommended [72,159,160,161].
T588 5629-5905 Sentence denotes Although HCQ was revealed to be effective against bacterial infections, in the last few years, in light of the current epidemiological situation, the research attention has shifted toward HCQ application as an antiviral agent, as it could be seen in the bubble map (Figure 8).
T589 5906-6007 Sentence denotes This visual map is obtained by VOSviewer software, analyzing recurring items from all keywords [171].