What we know so far about drug therapy for novel coronavirus
The containment and isolation efforts carried out all over the world are crucial from a public health perspective. The objective is to limit transmission as much as possible to not overwhelm the healthcare infrastructure. While these steps seem to have paid off in countries such as South Korea, they are still not curative and a lack of medical remedies leaves us vulnerable in these difficult times.
Currently, no antiviral treatment has been approved for treating Covid-19. Those with mild symptoms are advised to stay home, self-quarantine and stay well hydrated and well-rested. For more severe cases, hospitalization is required which involves treating for symptoms such as high fever and difficulty breathing.
Certain antiviral, anti-HIV, and even antimalarial drugs have shown limited hope in easing symptoms. Since studies are still in their early stages and data is limited, it is premature to remark on the overall effectiveness of these drugs. However, trials and experimentation are taking place at breakneck speed to come up with a solution.
Vaccines are still further down the pipeline - experts estimate that it will be at least 12-15 months before a viable vaccine is introduced in the market. Encouragingly, however, a small human vaccine trial was initiated earlier this week in Seattle. The results from that small study will set the foundation for the way ahead.
Here is a list of drug treatments being experimented with right now, along with their effectiveness.
The HIV drug Kaletra, made of a combination of lopinavir and ritonavir, presented high hopes of a solution. However, research published yesterday in the New England Journal of Medicine (NEJM) suggests that the drug does not work as expected. In a randomized control trial of 199 patients, no benefits from the drug were observed. It failed to prevent deaths or curtail the duration of illness when compared to control settings of supportive care.
The researchers said, however, that the results were not conclusive and more research needs to be done to corroborate these findings. They said the sample included many people who were already severely sick, which may have impeded the findings. The WHO, in a massive multi-country study dubbed 'Solidarity', will also test Kaletra - along with other drug combinations - for effectiveness.
Chloroquine - the malaria drug
A French study involving 25 COVID-19 patients looked at the effect of chloroquine in reducing viral load. According to the findings, the number of positive cases went from 90% to 25% within six days. Further, when the drug was combined with azithromycin, a broad-spectrum antibiotic, the results were even more favourable.
While this study was very small, the findings have created a stir in the research community and further studies have been planned. Chloroquine will be included in the 'Solidarity' study as well.
The advantage of chloroquine is that it is relatively easy and cheap to manufacture, meaning that it can reach the masses more easily and have a more immediate impact.
It is not known yet what the mode of action of the drug is, but researchers hypothesize that it is the basic nature of the compound, which hampers the ability of the virus to enter healthy cells that could play a role in its function.
Other available drugs
A Japanese drug used to treat influenza, favipiravir, may enter the race to combat COVID-19 as well. A study consisting of 80 people found that those treated with the drug shed the virus faster than those in the control group. Favipiravir turned patients negative for the infection in 4 days on average as compared to 11 days for the control group. Chest X-rays also confirmed that patients treated with the drug had fewer lung lesions post-treatment. Again, this was a very small trial that was not blinded, so the results must be taken with a pinch of salt. Further, other practitioners have commented that favipiravir is not effective in treating those with severe symptoms.
Remdesivir, another drug that has got a lot of attention of late, is involved in several large clinical trials. It works by preventing viruses from replicating, and initial studies have shown cautious evidence of effectiveness. The coming weeks and months will tell us more about the drug’s applicability.
Various other organizations are trying other methods as well. CRISPR and drugs targeting proteins expressed by SARS-CoV-2 are also under investigation. While the times ahead are uncharted, one can take some solace from the fact that the medical and health community is working at unprecedented speed to help the afflicted world.
For more tips, read our article on Coronavirus Infection: Symptoms, Types, Diagnosis and Treatment.
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Updated Date: Mar 19, 2020 17:18:26 IST
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