The Time to Offer Treatments for COVID-19

Introduction: COVID-19 has several overlapping phases. Treatment has focused on the late stage of the disease in hospital. Yet, the continuation of the pandemic is by propagation of the disease in outpatients. The current public health strategy relies solely on vaccines to prevent disease. Areas Covered: We searched the major national registries, pubmed.org, and the preprint servers for all ongoing, completed and published trial results with subject numbers of 100 or more on, and used a targeted search to find announcements of unpublished trial results. As of 2/15/2021, we found 111 publications reporting findings in human studies on 14 classes of agents, and on 9 vaccines. There were 62 randomized controlled studies, the rest retrospective observational analyses. Only 21 publications dealt with outpatient care, the rest all in hospitalized patients. Remdesivir and convalescent plasma have emergency use authorization for hospitalized patients in the U.S.A. There is also support for glucocorticoid treatment of the COVID-19 respiratory distress syndrome. Monoclonal antibodies are authorized for outpatients, but the supply is inadequate to treat all at time of diagnosis. Favipiravir, ivermectin, and interferons are approved in certain countries Expert Opinion: Worldwide vaccination is now underway. Vaccines and antibodies are highly antigen specific and new variants are appearing. There is a need for treatment of outpatients who contract the disease, in addition to mass immunization. We call on public health authorities to authorize treatments with known low risk and potential benefit for use in parallel with mass immunization

Impact of Fluorination on the Anodic Performance of Disodium Terephthalate: An Experimental and Computational Study

Advancing research into organic electrode materials is conducive for the development of affordable and sustainable Na-ion battery (NIB) technology owing to the low cost, abundance, and high structure tunability of organic materials. To obtain high-performance organic electrode materials, an in-depth understanding of the correlation between dynamic geometries of redox active functional groups in organic materials and electrochemical performance is critical but remains elusive. In this work, three fluorinated derivatives of disodium terephthalate (DTP) were synthesized to explore how fluorine substitutions altered the geometry and performance of the carboxylate groups in reversible sodiation/desodiation. Matching computational models, the monofluorinated disodium 2-fluoroterephthalate derivative outperformed disodium 2,3-difluoroterephthalate (196 mAh g–1 vs 88 mAh g–1), and disodium tetrafluoroterephthalate was found to not be redox active. The difference in performance is attributed to the dynamic geometry caused by the fluorine substituents that disrupt the planarity of the molecules, preventing favorable redox reactions of the carboxylate functional groups. This effect is more pronounced with higher degrees of fluorination

The Importance of Understanding the Stages of COVID-19 in Treatment and Trials

COVID-19, caused by SARS-CoV-2, continues to be a major health problem since its first description in Wuhan, China, in December 2019. Multiple drugs have been tried to date in the treatment of COVID-19. Critical to treatment of COVID-19 and advancing therapeutics is an appreciation of the multiple stages of this disease and the importance of timing for investigation and use of various agents. We considered articles related to COVID-19 indexed on PubMed published January 1, 2020-November 15, 2020, and considered papers on the medRxiv preprint server. We identified relevant stages of COVID-19 including three periods: pre-exposure, incubation, and detectable viral replication; and five phases: the viral symptom phase, the early inflammatory phase, the secondary infection phase, the multisystem inflammatory phase, and the tail phase. This common terminology should serve as a framework to guide when COVID-19 therapeutics being studied or currently in use is likely to provide benefit rather than harm