In a series of two articles, we talk about the major treatment approaches that are in development currently, beginning with analyzing pharmaceutical drugs and their possible impact
No one had expected the Coronavirus Disease 2019 (COVID-19) would turn out to be such a headache to researchers and governments alike when it first surfaced. More than six months into the pandemic and the world is still struggling to find a medicine that can prove to be the magic bullet against this virus. As of June 2020, the treatment of COVID-19 depends on the severity of the case. For mild cases, staying at home and taking any medicine to reduce fever is almost always sufficient. But on the other hand, severe cases require immediate hospitalization, with treatment that includes supplemental oxygen, assisted ventilation, and other measures.
Fighting and getting over this virus is the top priority for researchers and governments all over the world right now. More than hundreds of organizations all over the world are working towards finding an effective solution to this menace, and some efforts are actually yielding positive results. Let’s do an overview of what is in development in the drug research domain, what major antiviral drugs are being researched upon, and by when we might expect a truly effective medicine in the near future.
Remdesivir is an antiviral drug and one of the four primary drugs under research for effects on COVID-19 mentioned under the ‘solidarily’ clinical trial by WHO. It was initially studied for its effects in battling the Ebola virus but showed limited results. Remdesivir has been shown to inhibit replication to a huge extent of other human coronaviruses associated with high morbidity in tissue culture, including severe acute respiratory syndrome coronavirus (SARS-CoV) in 2003 and Middle East respiratory syndrome coronavirus (MERS-CoV) in 2012.
An initial study conducted in China did not show any benefit on COVID-19 patients, but the National Institutes of Health (NIH) reported that in one US clinical trial, remdesivir helped patients with COVID-19 recover faster as compared with patients who did not receive the drug. An in-vitro study showed that the antiviral activity of remdesivir plus interferon beta was better than that of lopinavir/ritonavir. Other major studies also showed that this helps patients recover faster as compared to other antiviral drugs, and thus, this remains one of the primary subjects of research.
Hydroxychloroquine is one of the primary medicines under research. Both chloroquine and hydroxychloroquine were selected as potential drugs to be tested within the Solidarity trial, but then only hydroxychloroquine was pursued under this study by WHO. They have been used for decades to prevent malaria and to treat some autoimmune disorders as well.
Hydroxychloroquine along with a combination of a second-generation macrolide was being used in some parts of the world to treat the novel coronavirus. Indian Council of Medical Research (ICMR), India issued a revised advisory for using hydroxychloroquine for healthcare workers but with caution. Some of the studies found that each of these medicines was often associated with the decreased in-hospital time of survival, and risks of other diseases as well. As of now, medicine has been retracted from most medical researches all over the world. Future clinical trials may give more light to this drug.
One of the most underrated contesters in the war against COVID-19, ibuprofen, a major non-steroidal anti-inflammatory drug has shown relatively positive results in its clinical studies. Lipid-ibuprofen at low doses has seemed to be effective in the clinical trials until now, and it could be a potential game-changer because of its low cost and easy availability. I did an in-depth analysis of the chemistry of this drug and its effect on easing pain and inflammation.
Other drugs under research
Monoclonal antibodies like tocilizumab and sarilumab which are used to treat autoimmune diseases like rheumatoid arthritis are being studied if they can be used to improve the cytokine storm (an intense immune reaction) experienced in later phases of illness by the virus. Lopinavir/ritonavir which are licensed treatments against HIV, are also being tested for any positive signs. Studies till now have been pretty much inconclusive of their effect on COVID-19.
In the concluding article, we will discuss the other forms of treatment under consideration, like blood plasma therapy and vaccine development.