Of patients admitted to an internal medicine ward with internistic diagnosis/es together with COVID-19, substantial proportion has elevated liver enzymes. silymarin / silibinin (milk thistle extract) has been approved as an add-on therapy in various acute and chronic liver diseases; moreover, there is evidence to suggest that it's dual effect (anti-viral and immune-modulatory) might be of benefit in patients infected with SARS-CoV-2. As there is no effective/approved pharmacotherapy for COVID-19, a pilot study with Silymarine in hospitalised patients has been undertaken
According to the Bosch-Barrera et al. paper of 2021, silibinin in a daily dose of more than 1000 mg could improve clinical course of COVID-19 by its dual action: 1.direct inhibition of SARS-CoV-2 replication as well as 2.modulation of innate immune response - 2a. its initial (hyper)inflammation as well as 2b. later reparative phase, respectively. Moreover, the drug is known for its safety and has been approved and widely used in the region for liver diseases. Therefore, the investigation was set out to determine the efficacy of silymarin (compound closely related to Silibinin which is available in the region) in improving the outcome of a liver disease and of COVID-19, respectively.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
30
Silymarine tablets will be provided irrespective of meal by a registered nurse T.I.D
F.D.Roosevelt Teaching Hospital
Banská Bystrica, Slovakia
University Hospital Bratislava
Bratislava, Slovakia
Improvement in the COVID-19 stage of at least 1 point
Evolution of COVID-19 will be recorded according to a WHO criteria and reported as worsening (including death) / no change / improvement
Time frame: During the hospital stay - up to around 21 days
Improvement in the activity of aminotranspherases
Change in the level of ALT
Time frame: During the hospital stay - up to around 21 days
Improvement in the diabetes control
Change in the glycemia
Time frame: During the hospital stay - up to around 21 days
Improvement in the blood inflammatory markers
Change in C-reactive protein levels
Time frame: During the hospital stay - up to around 21 days
Improvement in the dyspnea
Improvement of at least one point in the NYHA classification
Time frame: During the hospital stay - up to around 21 days
Improvement in the acute kidney injury
Any improvement in the serum creatinine level
Time frame: During the hospital stay - up to around 21 days
Improvement in the blood inflammatory markers
Improvement in the interleukin - 6 level
Time frame: During the hospital stay - up to around 21 days
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