What’s in development to treat coronavirus?

TREATMENT for Covid-19 depends on if the case is mild or more severe. For milder cases, resting at home and taking medicine to reduce fever is often sufficient.

The most severe cases require hospitalisation, with treatment that might include supplemental oxygen, assisted ventilation and other measures.

Two drugs may have a role for severe Covid-19 infection: the antiviral remdesivir or the corticosteroid dexamethasone.

Fighting the Covid-19 pandemic is a top priority in medical research and pharmaceutical development.

Hundreds of organisations are working on innovations to reduce the impact of the disease and prevent further infection.

What is in the works, and when might a coronavirus treatment be ready for the general public?

Dr Paul Gisbert Auwaerter, a professor of medicine at the Johns Hopkins University School of Medicine in the US an expert in infection prevention, believes that vaccine development takes time.

At Johns Hopkins, investigators are working with companies to begin testing their versions in humans before the end of the year.

Still, it could be many months of testing and refining before a Covid-19 vaccine is deemed safe, effective and ready to be administered to the general public.

Medications for coronavirus

While work on the vaccines continues, pharmaceutical companies and laboratories around the world are working to develop medicines for Covid-19.

Clinical trials are planned or underway to test drugs, including investigational compounds, which are already approved by the US’s Food and Drug Administration (FDA) for other illnesses to see if one or more can have an impact on Covid-19.

Antiviral treatments are available to treat several diseases such as influenza.

Antiviral drugs do not kill a virus but instead limit the production of new viruses in host cells.

For most people, the best these treatments can do is shorten the duration of the illness and lessen complications.

Since the coronavirus that causes Covid-19 is new, there is limited evidence regarding specific antivirals that may work against it.

Doctors and scientists are looking at both existing and experimental antivirals to find effective treatments for the new disease.

One antiviral drug called remdesivir was initially developed for activity against the Ebola virus. Researchers are testing remdesivir to see how it might help patients with Covid-19, and results of some of these studies are available.

One study conducted in China did not show any benefit in treating patients with Covid-19.

However, the National Institutes of Health reported that in one US clinical trial (ACTT-1), remdesivir helped patients with Covid-19 recover faster when compared with patients who did not receive the drug.

Preliminary (unpublished) results show a 31 percent shorter recovery time in patients who were treated with remdesivir (11 days versus 15 days).

In the study, patients who were able to leave the hospital or return to their normal activities were considered recovered.

The patients who appeared to benefit most were those who needed supplemental oxygen but who were not so ill as to require intensive care unit stays or mechanical ventilation.

At present, remdesivir is available to patients in research trials or if they are hospitalised in institutions that have received drug.

The drug is an intravenous medication that can only be given to patients in a hospital setting.

The course of treatment lasts five to 10 days.

Dexamethasone

Preliminary results from the recovery clinical trial information shows that a steroid drug called dexamethasone reduces deaths in hospitalised patients with

Covid19. The benefit of this drug appears to be most for patients who require mechanical ventilation and to lesser degree patients who need supplemental oxygen.

For patients who do not need oxygen and are less ill, the study showed a trend toward worse outcomes, so the drug is not meant for all hospitalised Covid-19 patients.

Dexamethasone, which has been used to treat inflammation and swelling, may be processed differently in black people.

Johns Hopkins researchers note that this difference, along with other considerations, means more research on this drug will be helpful to more solidly confirm its role as a safe, effective treatment for Covid-19.

Chloroquine and hydroxychloroquine

These compounds have been used for decades to prevent malaria and to treat some autoimmune disorders such as lupus.

On June 15 2020, the FDA revoked its authorisation to use hydroxychloroquine to treat Covid-19, based on a large scientific study that showed no benefit to patients who were treated with this drug.

The FDA reports that use of hydroxychloroquine is associated with serious heart rhythm problems and other safety issues.

Other studies worldwide have halted their clinical trials with these drugs for Covid-19.

The World Health Organisation (WHO) last month stopped clinical trial of the anti-malaria drug (hydroxychloroquine) to treat coronavirus patients for the second time.

It noted that “hydroxychloroquine and lopinavir/ritonavir produce little or no reduction in the mortality of hospitalised Covid-19 patients when compared to standard of care”.

In May, the WHO said that due to safety concerns, it was temporarily halting a clinical trial of hydroxychloroquine for Covid-19 patients.

Can survivors’ blood treat coronavirus?

People who survive an infection should have antibodies in their blood that can attack the virus. The idea is to extract blood plasma (the part which contains the antibodies) from those who have recovered.

This “convalescent plasma” is then given to a sick patient as a therapy.

The approach has been proven to work in other diseases, but not yet in coronavirus.

How long until we have a cure?

We may never get a “cure” for coronavirus. We do not have one for flu or the common cold or other similar infections.

However, there is now one treatment that works and others that look promising.

Doctors are testing drugs that have already been developed and are known to be safe enough to use, so more trial results can be expected relatively soon.

This contrasts with trials for vaccines (which protect against infection rather than treating it) where researchers are starting from scratch.

Some completely new experimental coronavirus drugs are also being tested in the laboratory, but are not yet ready for human tests.

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