3. Anti-COVID Drugs
Ultimately, the solution for the COVID-19 pandemic lies in the development of an effective vaccine and specific treatments. Governments and pharmaceutic companies across the world are in a race against time – whether to use a currently available drug, or whether a new cure needs to be developed – the overarching concern is that time is of the essence. Potentially useful drugs include Remdesivir (anti-EBOLA drug), Hydroxychloroquine (anti-malarial drug), Ivermectin (anti-parasitic drug). The urgency to find a cure needs to be balanced with the need to test the safety and efficacy of such drugs, as they are currently being examined in clinical trials.
3.1 Anti-COVID drugs
Reducing and managing fear is a major challenge for governments who are facing the COVID-19 outbreaks. Pharmaceutic companies and researchers around the world are racing to develop new effective treatments against the disease. Hundreds of thousands of compounds, and currently available drugs used for treating other diseases have been screened for their inhibitory effects against the SARS-CoV-2. Potentially useful drugs include Remdesivir (anti-EBOLA drug), Hydroxychloroquine (anti-malarial drug), Ivermectin (anti-parasitic drug), among which ≥ 5 of them have entered phase IV clinical trial stage in China!
Recent randomized controlled trial found no benefit in the time to clinical improvement in lopinavir–ritonavir compared to the standard of care in hospitalized adult patients with severe COVID-19.
Hydroxychloroquine and chloroquine phosphate are approved to treat rheumatological disease such as systemic lupus erythematosus and respectively. Both drugs have shown efficacy in laboratory studies against SARS-CoV-2. Anecdotal reports suggest that these drugs may be beneficial in the treatment of hospitalized COVID-19 patients. US President Donald Trump has pitched anti-malarial drug as the “game changer” against novel coronavirus. The U.S. Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) on March 30, 2020 to allow these drugs to be donated to the Strategic National Stockpile (SNS) and to be distributed and used for certain hospitalized patients with COVID-19. Ever since it was named as a possible treatment for COVID-19, assessing and using these drugs have become restricted; India has imposed a ban on their export of hydroxychloroquine.
Ivermectin, an FDA-approved anti-parasitic was recently shown to anti-viral activity in vitro against SARS-CoV-2. Researchers at Monash University infected Vero/hSLAM cells with SARS-CoV-2 isolate followed by the addition of ivermectin. At 24 hours, a 93% reduction in viral RNA was observed in the supernatant (indicative of released virions) in the ivermectin treated cells. Likewise, a 99.8% reduction in cell-associated viral RNA (indicative of unreleased and unpackaged virions) was found. This effect increased to an approximately 5000-fold reduction of viral RNA in the treated sample after 48 hours.
As of today, there are no proven safe and effective treatment against COVID-19. There are claims that Traditional Chinese Medicine is useful in treating the disease. Further studies to assess its safety and efficacy are warranted.
1. Sandro GVR, Wilson CS. Clinical trials on drug repositioning for COVID-19 treatment. Rev Panam Salud Publica. doi: https://doi.org/10.26633/RPSP.2020.40
2. Leon C, Julian DD, Mike GC, et al. (2020): The FDA-approved Drug Ivermectin inhibits the replication of SARS-CoV-2 in vitro. Anti Viral Research. In press.
3. Cao B, Wang Y, Wen D, et al. (2020): A Trial of Lopinavir–Ritonavir in Adults Hospitalized with Severe Covid-19. New England Journal of Medicine: In press.
3.2 Compassionate Use of Remdesivir for Patients with Severe Covid-19
3.3 Remdesivir in Adults with Severe COVID-19: A Randomised, Double-blind, Placebo-controlled, Multicentre trial
3.4 Hopes Rise on Coronavirus Drug Remdesivir
3.5 Association of Treatment with Hydroxychloroquine or Azithromycin with In-Hospital Mortality in Patients With COVID-19 in New York State
3.6 Another Study Shows Hydroxychloroquine Doesn’t Work Against Covid-19
3. Traditional Chinese Medicine
3.7 Traditional Chinese Medicine Treatment of COVID-19
3.8 Chinese Medicine vs. COVID-19
3.9 Scientists Create Antibody That Defeats Coronavirus in Lab
3.10 Antibody Treatments May Be the Best Hope Against the Virus Until a Vaccine
5. Convalescent Plasma
3.11 Treatment of 5 Critically Ill Patients With COVID-19 With Convalescent Plasma
3.12 Effectiveness of Convalescent Plasma Therapy in Severe COVID-19 Patients
3.13 COVID-19: Don’t Forget About Plasmapharesis
7. Nitric Oxide
3.14 Clinical Trial on Nitric Oxide at Massachusetts General Hospital
8. Stem Cells
3.15 Are Mesenchymal Stem Cells a Promising Treatment for COVID-19?
3.16 Mesenchymal Stem Cell Therapy for COVID-19: Present or Future
3.17 Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis
3.18 WHO Pauses Trial of Hydroxychloroquine as Coronavirus Treatment Amid Safety Concerns
3.19 New Drug Combination Being Tested to Conquer Covid-19
3.20 Coronavirus: Eli Lilly Launches First Human Trial of a New Type of Treatment
3.21 Gilead, AstraZeneca Not in Active Deal Discussions
3.22 Who’s to Blame? These Three Scientists Are at the Heart of the Surgisphere COVID-19 Scandal
3.23 FDA Revokes Emergency Use of Hydroxychloroquine
3.24 Scientists Hail Dexamethasone as ‘Major Breakthrough’ in Treating Coronavirus
3.25 Gilead Says Remdesivir Coronavirus Treatment Reduces Risk of Death in Severely Sick Patients
3.26 Dexamethasone in Hospitalized Patients with Covid-19 — Preliminary Report
3.27 Nature Study Identifies 21 Existing Drugs That Could Treat Covid-19