Current Treatment Options for COVID-19 Illness

Possible Treatments for COVID-19

There are no proven methods to treat COVID-19, the illness caused by the novel (new) coronavirus. When the infection is mild, it causes sore throat, cough and low-grade fever.  It is often self-limited and does not require prescription medication. However various treatment options are being discussed in the media. Here is a summary of what was presented by the New York City Health and Hospitals Corporation, Office of Population Health on 4/5/2020.

Some of the following drugs are FDA approved, others are not. Some of these drugs are very costly and like all drugs, have potential serious side effects. Although some side effects are universally known, they may vary in intensity based on the individual’s physiology, underlying diseases and health status. It is highly advised that none of these should be taken without being prescribed and without the supervision of a knowledgeable physician.

Remdesivir

This anti-viral drug has yet not been approved by the FDA. It is undergoing clinical trials for the treatment of hospitalized patients with moderate to severe COVID-19 illness in the USA and other countries. (3 clinical trials in US for moderate and severe

disease, 2 clinical trials in China, 1 in Europe).

The trials are based on the animal studies done in the past that have shown that this drug stops the replication of SARS and MERS virus by inserting itself into the viral RNA. SARS and MERS viruses belong to the coronavirus family and as such, are cousins of the current novel coronavirus.

Further information is available on the website of the drug manufacturer at

https://rdvcu.gilead.com/

Actemra (tocilizumab) and Kevzara (sarilumab)

These two drugs are already approved by the FDA and are used to treat certain types of arthritis. They work by blocking the release of strong chemicals (called cytokines) that cause severe inflammation similar to inflammation caused by coronavirus. It is hoped that by blocking severe inflammatory reaction, the severity of the COVID-19 illness can be reduced. The clinical trials of these two drugs were started in the USA in mid-March. These can be accessed at:

https://clinicaltyrilas.gov

Hydroxychloroquine (Plaquenil) and Chloroquine

These two drugs are typically used to treat lupus, other rheumatologic conditions and malaria. Earlier laboratory studies have shown that these medications may prevent the virus from entering human cells. Some lab studies have also suggested that the medications may directly stop the growth of the virus. They also exert anti-inflammatory effects and may reduce inflammation that leads to heart and lung problems, as well as other organ failure in severe COVID-19 infections.

The following is the status of the research for these two drugs in the treatment of infected patients:

● Approved by FDA for use in COVID-19 on 3/29, although trials to prove effectiveness

are still underway.

● Several clinical trials underway in China and Europe

● Lab study recently showed higher potency of hydroxychloroquine compared to

chloroquine against the COVID-19 virus.

● Some expert scientists have expressed skepticism that these will work in humans;

specifically, that the doses needed to achieve lab results are likely not safe for humans.

There are 53 Hydroxychloroquine trials underway. For the listing use this link:

https://clinicaltrials.gov/ct2/results?cond=&term=Hydroxychloroquine+%2B+Covid&cntry=&state=&city=&dist=

Recently a trial of hydroxychloroquine as a prophylactic agent (to prevent COVID-19) in those who are known to have been exposed to the novel coronavirus, was started in NYC. 

Plasma from the Recovered Patients

The blood plasma of people who were infected with the novel coronavirus and now are fully recovered, is being used to treat severe disease in the hospitalized patients. Such plasma contains special proteins that the body has made to ward off future coronavirus infection. The plasma is obtained in the blood bank. A needle is inserted in the vein of the donor (just like blood donation procedure). The blood flows out into a machine that separates the plasma from the blood cells, which are returned to the donor through another vein at the same sitting. The donated plasma is tested and purified and made available for infusion to any COVID-19 patients. The donor and the recipient do not have to have matching blood types. The FDA has approved this treatment as of 3/24/2020 for serious or immediately life-threatening COVID-19 infections.