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The COVID-19 pandemic has disrupted life throughout the world. Newly developed vaccines promise relief to people who live in high-income countries, although vaccines and expensive new treatments are unlikely to arrive in time to help people who live in low-and middle-income countries. The pathogenesis of COVID-19 is characterized by endothelial dysfunction. Several widely available drugs like statins, ACE inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) have immunometabolic activities that (among other things) maintain or restore endothelial cell function. For this reason, we undertook an observational study in four Belgian hospitals to determine whether in-hospital treatment with these drugs could improve survival in 959 COVID-19 patients. We found that treatment with statins and ACEIs/ARBs reduced 28-day mortality in hospitalized COVID-19 patients. Moreover, combination treatment with these drugs resulted in a 3-fold reduction in the odds of hospital mortality (OR=0.33; 95% CI 0.17-0.69). These findings were in general agreement with other published studies. Additional observational studies and clinical trials are needed to convincingly show that in-hospital treatment with statins, ACEIs/ARBs, and especially their combination saves lives.

Background: Statins are progressively accepted as being associated with reduced mortality. However, few real-world statin studies have been conducted on statin use in older people and especially the most frail, that is, the nursing home residents. Objective: The aim of this study was to evaluate the impact of statin intake in nursing home residents on all-cause mortality. Method: This is a cross-sectional study of 1,094 older people residing in 6 nursing homes in Flanders (Belgium) between March 1, 2020 and May 30, 2020. We considered all residents who were taking statins for at least 5 days as statin users. All-cause mortality during the 3 months of data collection was the primary outcome. Propensity score overlap-weighted logistic regression models were applied with age, sex, functional status, diabetes, and cardiac failure/ischemia as potential confounders. Results: 185 out of 1,094 residents were on statin therapy (17%). The statin intake was associated with decreased all-cause mortality: 4% absolute risk reduction; adjusted odds ratio 0.50; CI 0.31–0.81, p = 0.005. Conclusions: The statin intake was associated with decreased all-cause mortality in older people residing in nursing homes. More in-depth studies investigating the potential geroprotector effect of statins in this population are needed.

The interaction between obesity, cardiometabolic disorders and COVID-19 represents a syndemic that requires both social intervention and a multipharmacological approach [...]

Objectives Angiotensin-converting enzyme inhibitors (ACEi), angiotensin II receptor blockers (ARB) and HMG-CoA reductase inhibitors (‘statins’) have been hypothesised to impact COVID-19 severity. However, up till now, no studies investigating this association were conducted in the most vulnerable and affected population groups, i.e. older adults residing in nursing homes. The objective of this study has been to explore the association of ACEi/ARB and/or statins with clinical manifestations in COVID-19 infected older adults residing in nursing homes. Design We undertook a retrospective multi-centre cohort study to analyse the association between ACEi/ARB and/or statin use with clinical outcome of COVID-19. The outcomes were 1) serious COVID-19 defined as long-stay hospital admission or death within 14 days of disease onset, and 2) asymptomatic, i.e. no disease symptoms in the whole study-period while still being PCR diagnosed. Setting and participants A total of 154 COVID-19 positive subjects was identified, residing in one of two Belgian nursing homes that experienced similar COVID-19 outbreaks. Measures Logistic regression models were applied with age, sex, functional status, diabetes and hypertension as covariates. Results We found a statistically significant association between statin intake and the absence of symptoms during COVID-19 (OR 2.91; CI 1.27-6.71), which remained statistically significant after adjusting for covariates (OR 2.65; CI 1.13-6.68). Although the effects of statin intake on serious clinical outcome were in the same beneficial direction, these were not statistically significant (OR 0.75; CI 0.24-1.87). There was also no statistically significant association between ACEi/ARB and asymptomatic status (OR 2.72; CI 0.59-25.1) or serious clinical outcome (OR 0.48; CI 0.10-1.97). Conclusions and Implications Our data indicate that statin intake in old, frail adults could be associated with a considerable beneficial effect on COVID-19 clinical symptoms. The role of statins and renin-angiotensin system drugs need to be further explored in larger observational studies as well as randomised clinical trials., Statin intake is associated with beneficial effects on COVID-19 clinical symptoms in elderly nursing home residents. Statin intake, mostly if combined with an ACEi or ARB, is possibly associated with less severe clinical outcomes.

Objectives. Recent publications on dual program spinal cord stimulation (SCS) system demonstrate more flexible electrode programming, which helps to steer paresthesias towards all of the affected areas including the low back area. Materials and Methods. The following data were retrospectively sought from 20 nonrandomized failed back surgery patients at two centers treated by a dual quadripolar surgically implanted SCS lead: pain and paresthesia, VAS ratings, medication use, sleep patterns, daily activities, hardware problems, and willingness to repeat the procedure. The data were analyzed by the Wilcoxon signed rank test (p value < 0.05). Results. The average paresthesia coverage was 76%. After SCS implantation, analgesic use was decreased in 59% of the patients, sleeping time augmented, and quality of sleep improved. The number of patients taking benzodiazepines decreased. Sixty percent reported increased participation in social activities. Conclusions. This dual program surgical SCS technique is simple, respects patients’ autonomy, and provides adequate analgesia with an increase in quality of life.

Amitraz, 1,5 di-(2,4-dimethylphenyl)-3-methyl-1,3,5-tria za-penta-1,4-diene, a formamidine pesticide, is used worldwide. It causes side-effects in animals that resemble those caused by pure α2-adrenergic agonist drugs such as clonidine. Data on poisonings in humans are scanty. We report on a case of human poisoning with amitraz with typical signs of α2-adrenoreceptor stimulation.