Promises and Pitfalls of Calcineurin Inhibitors in COVID-19: A Systematic Review and Meta-analysis of Controlled Trials

  • Authors: Heydari B.1, Sahebnasagh A.2, Omrani M.A.3, Azimi S.4, Dehghani M.H.5, Salehi-Abargouei A.6, Farman F.3, Saghafi F.7
  • Affiliations:
    1. Department of Clinical Pharmacy, School of Pharmacy, Shahid Sadoughi University of Medical Sciences and Health Services
    2. Department of Internal Medicine, Clinical Research Center, North Khorasan University of Medical Sciences
    3. Pharmaceutical Sciences Research Center, School of Pharmacy, Student Research Committee, Shahid Sadoughi University of Medical Sciences and Health Services
    4. Student Research Committee, Department of Clinical Pharmacy, Faculty of Pharmacy, Shahid Beheshti University of Medical Sciences
    5. Department of Anesthesiology and Critical Care, Shahid Rahnemoun Hospital, Shahid Sadoughi University of Medical Sciences
    6. Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services
    7. Department of Clinical Pharmacy, Faculty of Pharmacy and Pharmaceutical Sciences Research Center, Shahid Sadoughi University of Medical Sciences and Health Services
  • Issue: Vol 31, No 29 (2024)
  • Pages: 4745-4755
  • Section: Anti-Infectives and Infectious Diseases
  • URL: https://cijournal.ru/0929-8673/article/view/645012
  • DOI: https://doi.org/10.2174/0109298673264362231022150520
  • ID: 645012

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Full Text

Abstract

Objective::Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes a violent attack on the body that leads to multi-organ failure and death in COVID-19 patients. The aim of this study was to systematically review the existing literature on the potential benefits of calcineurin inhibitors (CIs) as anti-vascular endothelial growth factor (VEGF) agents in improving the clinical outcomes of COVID-19 patients.

Methods::We searched various databases, including PubMed, Scopus, ISI Web of Science, Google Scholar, Cochrane databases, and ClinicalTrials.gov from 31st December, 2019, to 3rd February, 2023, for relevant controlled trials. The quality of the evidence was assessed using the Cochrane Collaboration tool. Comprehensive Meta-Analysis Software was used for the statistical analyses using a random-effects model.

Results::Three trials enrolling 293 participants were reviewed in the present systematic review and meta-analysis. The results showed CIs to lead to a significant reduction in mortality rate [risk ratio (RR): 0.598, 95% CI: 0.404-0.885, P-value = 0.010] with a low between-study heterogeneity (Cochrane Q test: I2 = 0.000%, P-value = 0.371). Pooled analysis of two studies (84 patients) illustrated that CIs could not significantly increase the rate of hospital discharge (RR: 1.161, 95% CI: 0.764-1.764, P-value = 0.485) and heterogeneity was not significant (Cochrane Q test: I2 = 26.798%, P-value = 0.242).

Conclusion::CIs are able to inhibit the virus nucleocapsid protein so that they can prevent replication and respiratory tract tissue damage caused by SARS-CoV-2. Based on the characteristics mentioned in detail, CIs can play a potential therapeutic role for COVID-19 patients.

About the authors

Behrooz Heydari

Department of Clinical Pharmacy, School of Pharmacy, Shahid Sadoughi University of Medical Sciences and Health Services

Email: info@benthamscience.net

Adeleh Sahebnasagh

Department of Internal Medicine, Clinical Research Center, North Khorasan University of Medical Sciences

Email: info@benthamscience.net

Mohammad Ali Omrani

Pharmaceutical Sciences Research Center, School of Pharmacy, Student Research Committee, Shahid Sadoughi University of Medical Sciences and Health Services

Email: info@benthamscience.net

Saeed Azimi

Student Research Committee, Department of Clinical Pharmacy, Faculty of Pharmacy, Shahid Beheshti University of Medical Sciences

Email: info@benthamscience.net

Mohammad Hossein Dehghani

Department of Anesthesiology and Critical Care, Shahid Rahnemoun Hospital, Shahid Sadoughi University of Medical Sciences

Email: info@benthamscience.net

Amin Salehi-Abargouei

Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services

Email: info@benthamscience.net

Farnoosh Farman

Pharmaceutical Sciences Research Center, School of Pharmacy, Student Research Committee, Shahid Sadoughi University of Medical Sciences and Health Services

Email: info@benthamscience.net

Fatemeh Saghafi

Department of Clinical Pharmacy, Faculty of Pharmacy and Pharmaceutical Sciences Research Center, Shahid Sadoughi University of Medical Sciences and Health Services

Author for correspondence.
Email: info@benthamscience.net

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