Exploring Current Treatments for COVID-19: An Overview
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Current COVID-19 Treatment Strategies
As of March 10, 2020, the global impact of COVID-19 has reached over 460,000 confirmed cases, severely affecting economies and placing immense strain on healthcare systems worldwide. While curfews in some regions have helped mitigate outbreaks, the threat of a pandemic looms large. Although I am a scientist rather than a virologist without access to intensive care units or high-security labs, I've observed even seasoned doctors seeking advice from their peers. This article is intended to provide insights for both experts and the general public, though it should not be viewed as an official guideline. Additionally, I declare no conflicts of interest with the companies mentioned below. For further information, please see the references at the end.
At this point, no definitive treatment has been established; however, over 70 drugs are currently being investigated, primarily derived from past research on Ebola, HIV, and SARS. Below are some of the most frequently discussed treatments undergoing evaluation. For those unfamiliar, there are four clinical trial phases that a drug must go through before receiving approval. Concurrently, the FDA has issued warnings to companies promoting fraudulent cures, often involving essential oils.
Virus Blockers
Remdesivir (Stage: Phase 3)
Among the most well-known treatments is Remdesivir, developed by Gilead Sciences Inc. (USA), which is currently in Phase 3 clinical trials for COVID-19. This antiviral drug belongs to the nucleotide analog class. Many are hopeful about the outcomes of these trials, as the drug disrupts the virus's replication by creating a flawed version of the nucleotides it requires to reproduce. This method is known as nucleotide analog therapy, which mimics the essential genetic building blocks but leads to the virus's failure. Promising results have been observed in trials with mice, rhesus monkeys, and patients with Ebola and MERS.
We await the outcomes of a blinded study that involves some participants receiving the treatment while others receive a placebo. This phase requires around 1,000 patients, with further steps leading to Phase 4 and potential commercialization, contingent upon successful results in both phases. For more details, see Gilead's official announcement regarding the clinical trial.
In addition, physicians are exploring the possibility of combining Remdesivir with Eculizumab (Soliris) to mitigate the cytokine storm in the lungs or with Sarilumab and Tocilizumab (both IL-6 blockers) in cases of excessive immune response.
Chloroquine Phosphate (Stage: Preclinical)
This longstanding anti-malaria medication has shown more effectiveness than Remdesivir in laboratory experiments, though this remains to be proven in human trials. A clinical trial is currently in the recruitment phase. Initial results from China have been somewhat underwhelming, as noted in the article "A pilot study of hydroxychloroquine in treatment of patients with common coronavirus disease-19 (COVID-19)." However, if it proves successful in larger populations, it could be a significant breakthrough, given that large supplies of Chloroquine phosphate are already available. Bayer has produced it under the brand name Resochin and has shipped 300,000 tablets to the Guangdong provincial government. Many generic versions are also accessible.
A typical treatment protocol has been proposed, which has been sourced from the CDC Global Rapid Response Team. You can find the diagnostic protocol from the CDC here.
Vaccines
Vaccines represent a long-term solution, as their development and approval can take longer than treatments. They are typically created using weakened strains of viruses. Nevertheless, previous studies on SARS and MERS have provided valuable insights, although those diseases are no longer active.
mRNA-1273 (Stage: Phase 1)
Developed by Moderna Therapeutics, this vaccine uses a novel method of introducing short segments of genetic material from COVID-19 into individuals.
CureVac (Stage: Preclinical)
Similar to Moderna, CureVac's vaccine is based on mRNA fragments aimed at generating proteins that provide immunity.
Sanofi (Stage: Preclinical)
Sanofi is working on a "chimera" vaccine that combines COVID-19 DNA with harmless viral genetic material to instruct the immune system of healthy individuals. They have announced that human trials could begin within one to 18 months.
TAK-888 & Plasma Therapy (Stage: Preclinical)
Chinese medical professionals are utilizing plasma therapy for COVID-19 patients. The World Health Organization endorses this approach as "very valid." Surviving patients have blood rich in antibodies, and infusing this plasma into infected individuals can sometimes save lives. Takeda, a Japanese company, is developing TAK-888, an intravenous immunoglobulin derived from survivor plasma.
Anti-Arthritis Medications
At first glance, there may not seem to be a link between arthritis treatments and COVID-19. However, certain infections can trigger excessive immune responses, leading to a potentially life-threatening "cytokine storm." Drugs originally developed to manage arthritis may help temper the immune response during a COVID-19 infection. Reports indicate that 14 critically ill patients treated with Actemra, an anti-arthritis drug from Roche, experienced positive outcomes in a hospital affiliated with the University of Science and Technology of China (USTC). Currently, there is limited data on the safety and efficacy of this approach.
High-Dose Intravenous Vitamin C: A Controversial Option?
Given that COVID-19 primarily causes lung injuries due to overactive immune responses, high-dose intravenous vitamin C may provide immunosuppressive effects. This method has generated considerable debate regarding its validity. However, a clinical trial is also currently underway. It is essential to distinguish this treatment from regular vitamin C supplementation.
References and Contacts
Remdesivir:
- Gilead official announcement of the clinical trial
- Gilead contacts
- NIH official page for Remdesivir clinical trials
- Recruiting contact: Professor Bin Cao +01084206264 caobin[at]zryhyy.com.cn
Chloroquine Phosphate:
- Wang et al. 2020, seminal paper
- Resochin generic supplier from India
HIV-Related Treatments:
- NIH official page for Lopinavir/Ritonavir/Arbidol clinical trials
- Contact: Dr. Yueping Li, MD, 020-36052117 lipipi007[at]163.com
Anti-Cytokine Storm Treatments:
- NIH official page for Eculizumab (Soliris) clinical trials
- Contact: Dr. Thomas C Pitts, M.D. 6465967386 Drpitts[at]hudsonmedical.com
High-Dose Intravenous Vitamin C:
- High-dose IV vitamin C clinical trial
- Contact: Professor Zhiyong Peng +8618672396028 pengzy5[at]hotmail.com
For further inquiries, feel free to DM me on Twitter.
The first video provides insights into therapeutic options for COVID-19, emphasizing what clinicians need to know about ongoing treatments.
The second video offers a comprehensive guide for patients on managing long COVID, detailing various treatment strategies and considerations.