Scientists are still looking for an effective COVID-19 treatment. We review promising therapies

The entire scientific world is looking for ways to slow the spread of the new coronavirus and treat COVID-19 effectively. We check the most promising therapies.

Antiviral drug EIDD-2801 in the fight against the SARS-CoV-2 coronavirus

A study was published in Science Translation Medicine on April 6 which suggested that an oral drug called EIDD-2801 shows promise in cell line experiments. This drug may be more effective at blocking the SARS-CoV-2 coronavirus than remdesivir, another drug tested for treating COVID-19. EIDD-2801 introduces mutations into the RNA of the coronavirus, so that during replication, they begin to accumulate and the virus is unable to infect cells.

The researchers noted that the drug could act on the RNA of other viruses, not just SARS-CoV-2, making it a multi-purpose antiviral drug, the researchers found. Unlike remdesivir, which must be administered intravenously, EIDD-2801 is an oral drug that can be used by patients who remain in home isolation.

The drug research was completed by scientists at Emory University, UNC Chapel Hill, and Vanderbilt University Medical Center in Nashville. The drug was licensed by Ridgeback Biotherapeutics, which received permission from the US Food and Drug Administration (FDA) to begin human testing over the next few months.

Ivermectin in the fight against SARS-CoV-2 coronavirus

Ivermectin is an active substance that can be obtained in Poland as a cream for rosacea. It is also used in preparations for lice. Previous studies have shown the effectiveness of this drug in fighting the flu, and now Australian scientists are investigating its usefulness in treating COVID-19.

They have shown in laboratory studies that ivermectin has some efficacy against the SARS-CoV-2 coronavirus. Scientists want to continue research on this active substance, but need funding for clinical trials.

Chloroquine and hydroxychloroquine for SARS-CoV-2 coronavirus

Chloroquine and hydroxychloroquine are active substances that are used to treat malaria, lupus and rheumatoid arthritis. Their usefulness is also being investigated in anti-COVID-19 therapy.

Chloroquine was tested in 2005 for its suitability for the treatment of SARS-CoV, the coronavirus that causes SARS. The new coronavirus is related to it. Chloroquine disrupted the ability of SARS-CoV to enter and replicate the coronavirus in the host’s cells. SARS-CoV-2 cell culture studies have shown that chloroquine and hydroxychloroquine interfere with the replication of the coronavirus and allow it to continue to infect.

Some COVID-19 patients are given drugs based on these active substances in China, South Korea, France and the United States. WHO has approved a study on the effectiveness of therapy with these drugs.

See also: Antimalarial drug to treat COVID-19? French scientists are looking for answers

Remdesivir, an Ebola drug to treat COVID-19

Remdesivir, a drug that was supposed to be used to treat Ebola virus but has proved ineffective, can be used to treat SARS-CoV-2. In laboratory studies, it was found to inhibit the replication of SARS and MERS coronaviruses, which belong to the same type of coronavirus as SARS-CoV-2.

The US Food and Drug Administration has approved the use of remdesivir for the treatment of patients with severe COVID-19. Current clinical trials in the United States and China are focusing on whether remdesevir may reduce complications or shorten the course of the disease in patients diagnosed with COVID-19.

Research on remdesivir is also being conducted as part of SOLIDARITY, an action organized by the WHO to widely test the most promising drug therapies for COVID-19.

See also: Remdesivir a cure for Coronavirus COVID-19?

Combination of anti-HIV drugs to treat COVID-19

Scientists also place great hopes on drugs used in the treatment of HIV – lopinavir and ritonavir in combination with interferon beta. Earlier studies without interferon beta did not bring the expected results. Preliminary studies have not shown that the combination of these drugs was effective as an adjunct to the patient’s treatment.

The drugs in question were also included in a large WHO study. As with other antivirals, experts believe they might work if given early in the course of the disease.

See also: HIV drugs help fight coronavirus COVID-19? A patient from Spain is cured

Japanese flu drug to fight SARS-CoV-2 coronavirus

An antiviral drug developed by Fujifilm Toyama Chemical in Japan shows promising results in the treatment of mild to moderate cases of COVID-19. The drug known as Favipirawar or Avigan was used to treat influenza in Japan, but was approved as an experimental treatment for COVID-19 in March.

According to reports, the drug has been tested on 340 people in Wuhan and Shenzhen. Preliminary studies suggest that the drug may prevent viral replication, reduce hospitalization time, and protect the lungs from degradation. The research has not yet been published and peer-reviewed in any scientific journal.

See also: WHO begins global drug research against COVID-19

Immunosuppressants in the fight against COVID-19

Some people develop an overreaction of the immune system after they become infected with the SARS-CoV-2 coronavirus. It comes to the so-called a cytokine storm which is very dangerous and can lead to death. To calm the cytokine storm, doctors are testing an immunosuppressant known as Actemra or tocilizumab. It is a drug approved for the treatment of rheumatoid arthritis and juvenile rheumatoid arthritis.

On March 19, the pharmaceutical company Roche announced the start of studies to see if tocilizumab could improve research outcomes in patients with pneumonia. We still have to wait for the results. Lublin’s doctors also contribute to the research on the impact of tocilizumab on the health of COVID-19 patients. Three patients who were in a serious condition in the infectious diseases ward were given the drug intravenously. The doctors noticed the first positive effects after 24 hours, and even better results 48 hours after the drug administration.

There is a lot of research to be done to find out if the drug is actually helping, but the first results are promising. Tocilizumab is also included in the list of drugs recommended for the treatment of COVID-19 developed by the Polish Society of Epidemiologists and Doctors of Infectious Diseases (PTEiLChZ).

A drug for hypertension in the treatment of COVID-19

Scientists hope that losartan, a drug used in hypertensive patients, may be helpful in treating COVID-19. The University of Minnesota has launched two clinical trials using this inexpensive drug. The first experiment assesses whether losartan can prevent multi-organ failure in patients with COVID-19, and the second whether the drug can alleviate symptoms and thus prevent hospitalization.

Losartan blocks certain receptors, and scientists believe that it may also block the coronavirus from attaching to the host’s cells. The case with losartan is controversial because a study has appeared in The Lancet that suggests that popular antihypertensive drugs such as ACE inhibitors and angiotensin II receptor blockers, such as losartan, can stimulate the body to produce more ACE2, which it will make your body more susceptible to infection.

The SARS-CoV-2 coronavirus binds to the receptor for the ACE2 converting enzyme. For now, however, there is too little research to conclusively say whether ACE2 inhibitors may increase the susceptibility to COVID-19.

See also: Ibuprofen Worsens COVID-19 Disease? WHO and the European Medicines Agency take the floor

Ribavirin in the treatment of COVID-19

Ribavirin is an organic chemical compound from the group of nucleoside analogues. It is used to treat severe infections with RSV, HCV (in combination with alpha-2 interferons), and other viral infections.

The drug was tested in the search for an effective treatment for SARS and MERS. According to the review prepared in the journal JAMA, in vitro activity against SARS-CoV was limited and required high concentrations to inhibit viral replication – a large dose of the drug plus combination therapy was needed.

A systematic review of 30 studies showed inconclusive efficacy results for 26 of them. Four studies have shown possible harm from side effects, including haematological toxicity. In the treatment of MERS, ribavirin, usually in combination with interferons, had no appreciable effect on clinical outcomes.

The problem with ribovirin is the high dose that would have to be administered to stop the virus from replicating. The high doses used in anti-SARS studies caused haemolytic anemia in more than 60% of respondents. patients. Another study found that about 40 percent. patients taking ribovirin with interferon required blood transfusions.

Ribovirin is also a known teratogen and therefore cannot be used by pregnant women. Research to date suggests that ribovirin has limited value in the treatment of COVID-19. It can be used in combination therapy.

Other antiviral drugs to fight COVID-19

Oseltamivir – a drug that is used to treat influenza, has no documented in vitro activity against SARS-CoV-2. In China, patients were treated with oseltamivir because the epidemic coincided with the peak of flu cases, and until the discovery of SARS-CoV-2, doctors treated patients with oseltamivir. Several clinical trials also include this drug, but it is used in a comparator group and not as a proposed therapeutic intervention. It does not currently play any role in treating COVID-19 in patients.

Another antiviral drug, umifenovir, is also being tested in the treatment of COVID-19. It has a unique mechanism of action – it inhibits the fusion of the viral envelope membrane, preventing the viral particle from entering the cell.

Umifenovir is approved for the treatment and prevention of influenza in Our Country and China. Its effectiveness has been tested in vitro in studies against SARS. A dose of 200 mg orally every 8 hours is currently being investigated for the treatment of COVID-19.

Supportive therapies in the treatment of COVID-19

As we read in “JAMA”, in the absence of proven SARS-CoV-2 therapy, supportive care remains the basis of care for COVID-19 patients – from symptomatic outpatient treatment to full support of intensive care. The authors of a study published in this journal mention three adjunctive therapies that could be used to treat COVID-19.

The first is corticosteroids. They are used to reduce the inflammatory response in the lungs that can lead to acute lung injury and acute respiratory distress syndrome (ARDS). The benefits of taking corticosteroids may be offset by the side effects – delayed coronavirus clearance (the time the plasma clears from the coronavirus), and thus an increased risk of secondary infection.

Observational studies in patients with SARS and MERS showed no association between the administration of corticosteroids and improved survival, but a delay in clearing the virus from the respiratory tract and blood, and high complication rates, including hyperglycaemia, psychosis and necrosis, were found.

Corticosteroids were associated with an increased risk of mortality and a double risk of secondary infections in a meta-analysis of 10 studies involving 6548 patients with influenza pneumonia.

The potential side effect and the lack of proven benefit for corticosteroids lead scientists to warn against their routine use in COVID-19 patients, unless there is an accompanying indication, such as exacerbation of chronic obstructive pulmonary disease or resistant shock.

The second adjuvant therapy relies on immunosuppressive drugs that help to silence the cytokine storm, the over-response of the immune system to infection. We previously mentioned tocilizumab.

“JAMA” also mentions sarilumab, a drug approved for rheumatoid arthritis. The medicine is currently being studied in patients with severe COVID-19. Therapies with bevacizumab, fingolimod and eculizumab are also being studied.

Another treatment-supporting therapy worth mentioning is the therapy with antibodies recovered from the plasma of people who have recovered from COVID-19. Antibodies from healthy patients can help both clear the coronavirus and recover faster.

We wrote about the use of antibodies in several articles:

1. Do convalescent antibodies protect against coronavirus? WHO has doubts
2. Scientists want to use passive antibody therapy to protect against COVID-19
3. Warsaw: Plasma of convalescents will be given to the first COVID-19 patients next week

Finding an effective therapy to cure COVID-19 is one of the most important challenges for scientists today.

Have a question about the coronavirus? Send them to the following address: [email protected]. You will find a daily updated list of answers HERE: Coronavirus – frequently asked questions and answers

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