Possibility of the blood clot, thrombotic thrombocytopenia following injection of COVID-19-vaccine AstraZeneca; a systematic review

Introduction: Recently, it has been reported that the injection of vaccines such as the ChAdOx1 nCoV-19 (AstraZeneca) involves some rare cases of thrombocytopenia and blood clots, although the vaccines created immunity in people. Estimates of this phenomenon are not the same in different countries, probably due to age distribution and number. Objectives: This study attempted to study AstraZeneca’s rare side effects in people injected with this vaccine. Methods: This systematic study was conducted using articles published in 2021 under the title of blood clot and thrombocytopenia by AstraZeneca injection. The references and data were gathered through national and international sites such as Magiran, Google Scholar, PubMed, Web of Science, and Scopus. They were also gathered and examined using report cases and the available data on COVID-19 vaccine immunization in various countries. The keywords used mainly are COVID-19 vaccine, ChAdOx1 nCoV-19 vaccine, blood clots, thrombus, thrombotic, and thrombocytopenia. Eventually, 25 articles were searched and examined, of which 15 related ones were selected after reviewing and re-studying. While investigating the summary and method in those 15, they were filtered more accurately; finally, ten articles were chosen. Inclusion criteria consisted of all related articles and exclusion criteria contained articles that were less related to our research subject after purification or were redundant and not of high quality. Results: This study found that rare blood clot cases and thrombocytopenia were seen despite mild side effects after AstraZeneca injection. After assessing its benefits, adverse effects, and age distribution, the countries using AstraZeneca decided to continue using it. The main difference in reported statistics in these countries is due to the variety in the age and number of people receiving the vaccine. Conclusion: Blood clots and thrombocytopenia are among the rare side effects of the AstraZeneca vaccine. In different countries, the vaccine side effects vary depending on the age and number of participants. Anyway, according to the investigations conducted in this area, the highest records of these side effects are observed in Norway, which is still low. Overall, through studying this study and other similar ones, politicians, managers, and even ordinary people can be informed about the pros and cons of this vaccine

Zidovudine and Interferon Alfa based regimens for the treatment of adult T-cell leukemia/lymphoma (ATLL): a systematic review and meta-analysis

Abstract Background ATLL (Adult T-Cell Leukemia/Lymphoma) is an aggressive hematological malignancy. This T-cell non-Hodgkin lymphoma, caused by the human T-cell leukemia virus type 1 (HTLV-1), is challenging to treat. There is no known treatment for ATLL as of yet. However, it is recommended to use Zidovudine and Interferon Alfa-based regimens (AZT/IFN), chemotherapy, and stem cell transplant. This study aims to review the outcome of patients with different subtypes of ATLL treated with Zidovudine and Interferon Alfa-based regimens. Methods A systematic search was carried out for articles evaluating outcomes of ATLL treatment by AZT/IFN agents on human subjects from January 1, 2004, until July 1, 2022. Researchers assessed all studies regarding the topic, followed by extracting the data. A random-effects model was used in the meta-analyses. Results We obtained fifteen articles on the AZT/IFN treatment of 1101 ATLL patients. The response rate of the AZT/IFN regimen yielded an OR of 67% [95% CI: 0.50; 0.80], a CR of 33% [95% CI: 0.24; 0.44], and a PR of 31% [95% CI: 0.24; 0.39] among individuals who received this regimen at any point during their treatment. Our subgroup analyses’ findings demonstrated that patients who received front-line and combined AZT/IFN therapy responded better than those who received AZT/IFN alone. It is significant to note that patients with indolent subtypes of disease had considerably higher response rates than individuals with aggressive disease. Conclusion IFN/AZT combined with chemotherapy regimens is an effective treatment for ATLL patients, and its use in the early stages of the disease may result in a greater response rate

Effect of Ammonium Chloride in addition to standard of care in outpatients and hospitalized COVID-19 patients: A randomized clinical trial

Objective: The COVID-19 pandemic has called an urgent need for drug repurposing to improve the outcome of the disease. Quaternary ammonium compounds have been demonstrated to have antiviral effects and may be of use against SARS-CoV-2 infections. Design: In this double-blind, single-center study, we enrolled patients with positive PCR test and/or CT findings for COVID-19. The participants of each group were randomly assigned to Diphenhydramine Compound (Diphenhydramine + Ammonium Chloride) plus standard of care or to Diphenhydramine alone and standard of care groups. The primary outcome was all-cause mortality within 30 days of randomization. Secondary outcomes include viral burden, clinical status, assessed by a 5-point ordinal scale, and length of stay in hospitalized patients. Results: A total of 120 patients were included in the trial, 60 of which were assigned to the Ammonium Chloride group. The primary endpoint was not statistically different between the two groups (HR: 3.02 (95% CI, 0.57–16.06; p = 0.195)). Recovery time and viral burden were significantly lower in the Ammonium Chloride group, corresponding to an odds ratios of 1.8 (95% CI, 1.15–2.83; p = 0.01) and 7.90 (95% CI, 1.62–14.17; p = 0.014), respectively. Conclusion: The findings of this study advocate the careful addition of Ammonium Chloride to standard of care for COVID-19 patients