Supervisors info:
Καρολίνα Ακινόσογλου, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, Πανεπιστήμιο Πατρών, Επιβλέπουσα
Αντιγόνη Κωτσάκη, Παθολόγος, Επιμελήτρια Β΄, Δ΄ Παθολογική Κλινική, ΠΓΝ «ΑΤΤΙΚΟΝ»
Ελένη Καρακικέ, Παθολόγος – Λοιμωξιολόγος, Επιμελήτρια Β’, Β΄ Κλινική Εντατικής Θεραπείας, ΠΓΝ «ΑΤΤΙΚΟΝ»
Summary:
COVID-19, caused by the SARS-CoV-2 virus, is an infectious disease that first emerged in late 2019 and evolved into a global pandemic. The virus is mainly transmitted through respiratory droplets and primarily affects the respiratory system, causing symptoms that range from mild (fever, cough, fatigue) to severe (shortness of breath, acute respiratory distress syndrome). Certain groups, such as the elderly and individuals with underlying health conditions, are at higher risk for severe illness. Published data suggest that this is due to the excessive activation of the host's immune system in response to the virus. As a result, research interest shifted towards treatments that regulate the host's immune response.
Immunomodulatory therapies for COVID-19 aim to regulate the immune response in order to reduce complications caused by excessive inflammation and overactivity of the immune system, known as a "cytokine storm." These therapies include the use of corticosteroids (e.g., dexamethasone) to control inflammation, antibodies targeting specific cytokines such as interleukin-6 and interleukin-1. The goal of these treatments is to reduce the likelihood of severe complications, such as acute respiratory distress syndrome (ARDS), and improve patient survival. Despite the progress made, research data do not currently indicate the existence of fully validated effective treatments.
Based on research findings, a clinical study is currently being conducted in Greece aimed at implementing a strategy that links the increase of a biomarker with timely intervention, under the assumption that early treatment may modify the host's immune response and prevent the hyper-inflammatory reaction, thus preventing severe respiratory failure and sepsis. Relying on the anti-inflammatory and immunomodulatory properties of clarithromycin and guided by the suPAR biomarker, which is used as a tool to identify patients at risk of developing severe respiratory failure and sepsis, the REACT clinical trial aims to study the clinical benefit of early initiation of clarithromycin therapy, guided by the suPAR biomarker, to prevent the progression to sepsis in patients with community-acquired pneumonia.
However, this study was unable to include and record positive COVID-19 cases, as we are currently in a period of pandemic decline and, consequently, low epidemiology of the disease.
