IF AT THE MOMENT AND THERE IS SOMETHING that worries everyone, without exception, then this is a new coronavirus infection and its consequences. Doctors and scientists around the world are not only developing a vaccine that would help prevent a second pandemic, but are also looking for drugs that can neutralize the virus. Let’s see what they offer to treat COVID-19 right now, what options are the most promising and what problems may arise.
How did the pandemic start?
In most of us coronavirus infection has been, and no time. As it may be hard to believe, if only coronavirus, about which you have heard, – SARS-CoV-2. However, coronaviruses are a family of hundreds of species, most of which are not life-threatening, and some of which can cause a common cold in humans – that is, SARS.
The coronavirus was first discovered in chickens in the 1930s, and the human coronavirus was discovered thirty years later . The common cold is believed to be caused by the four most common coronaviruses: 229E, NL63, OC43, HKU1. Sometimes viruses mutate, which makes them much more dangerous – this was the case with the causative agents of SARS in 2003 and the Middle East respiratory syndrome in 2012; and at the end of 2019 , a new virus became unexpectedly dangerous, which was named SARS-CoV-2. It is believed that all of them appeared as a result of mutation of viruses that previously only affected animals.
Previous outbreaks of coronavirus infections (in 2002 , 2012 , 2015 and 2018 ) did not turn into pandemics: then the symptoms were much more severe, and it was easier for doctors to identify and isolate patients. The new coronavirus is dangerous precisely because the infection can proceed with minimal symptoms or generally asymptomatic, which does not prevent the carrier of the virus from spreading it further.
Vaccines We Already Have
The list of over a hundred possible candidates for a vaccine against the new coronavirus looks impressive. And can I use some of the plurality of already licensed vaccines? Potentially – yes, one of the known vaccines will be able to protect the body from the SARS-CoV-2 virus, which causes COVID-19. You just need to prove it.
Scientists are currently considering two options: the BCG vaccine and the MMR vaccine. The first, designed to protect against tuberculosis and has been in existence for 80 years , may be able to reduce the severity of the infection and reduce the damage it causes to the body. The second, a combination vaccine against measles, mumps and rubella, researchers at the University of Cambridge suggest , may be useful in stimulating the immune response. This is quite consistent with the fact that children are surprisingly resistant to COVID-19 compared to other age groups: most of them received vaccinations relatively recently.
The problem with these vaccines is that for every study that supports their unique antiviral capabilities, there is research that denies those capabilities . To be sure about something, detailed studies in large samples are needed .
Repurposing drugs
At first, the treatment of pneumonia caused by the new coronavirus was limited to supportive therapy – from antibiotics to cope with an associated bacterial infection, to mechanical ventilation in the most severe cases. It can take decades to develop a completely new antiviral drug – but there is a chance that some of the existing drugs will be effective .
Generally speaking, doctors often prescribe drugs to patients with certain diseases that have been created to treat or correct other conditions. This approach is called off-label use and sometimes becomes the only available therapy (for example, when a drug for the treatment of a rare disease is not developed by pharmaceutical companies due to economic inexpediency). On average, over the fifteen years of the drug’s existence , five alternative options for its use appear on the market . It happens that in the future these new testimonies are officially approved.
In such a situation, there are risks: the safety profile of a drug may differ for different diseases and patient groups. Moreover, there is evidence that undesirable effects are observed in patients 44% more often when the drug is not used according to the instructions. On the other hand, there are success stories of their own. Botox is a good example of repurposing: originally approved for the treatment of abnormal contractions in the muscles of the eyelids, it showed excellent results when used for cosmetic purposes, and later was used to relieve spasticity in patients with cerebral palsy and migraines .
A little more positive statistics: sometimes repurposing leads to real scientific breakthroughs, as happened with mustard gas – this poisonous gas became the first FDA-registered drug for the treatment of leukemia. Then doctors noticed that soldiers poisoned with mustard gas in the Belgian Ypres during the First World War had lower white blood cell counts. This property ultimately helped to contain the abnormal growth of white blood cells characteristic of leukemia.
It also works in our favor that today medical specialists have more advanced technologies in their arsenal, which allow, if not eliminate, then significantly reduce risks. In particular, graph theory and artificial intelligence are involved in assessing the safety of drugs that can be used in COVID-19 .
What kind of drugs will they be?
At the end of March, WHO announced assistance with the launch of research aimed at finding the most suitable drugs for the treatment of COVID-19 from among the existing ones. Already, patients with this disease are included in clinical trials of the antiviral drug remdesivir , although the data are still contradictory ; if in preclinical studies (in animals) its effectiveness against the new coronavirus was noted, then in humans a clear effect is not yet visible. Other drugs that are much talked about now are derivatives of chloroquine and hydroxychloroquine , which are used to treat malaria and autoimmune diseases. They must block proteins involved in making new copies of the virus in the body.
Anti-SARS-CoV-2 drugs are also being used to treat HIV infection: theoretically, they can work if the new virus has similar “targets” (proteins or enzymes). However, the combination of lopinavir and ritonavir, used against HIV, do not live up to expectations. It is worth to say that “Arbidol” even minimally not improved the clinical outcomes of patients hospitalized with COVID-19 light and medium gravity.
Information filter
The placebo effect, forcing a person to recover from ascorbic acid, has a vicious counterpart – the nocebo effect . With him, everything happens exactly the opposite: the expectation of something bad leads to a deterioration in the patient’s condition due to the production of neurotransmitters that contribute to increased sensitivity. So, in 2010 in Australia, for example, was recorded ” wind turbine syndrome “, which caused people to have a rapid heart rate, headaches and nausea for no real reason. And in 2018 , it was found that the more often patients in a particular region googled information about the negative effects of statins (drugs to lower blood lipids ) on the body , the more pronounced side effects of statins were recorded in that region. Scientists think that in a pandemic it is important to keep in mind the nocebo effect – and not to do tests ” just in case.” A positive test result for the novel coronavirus by itself can make breathing difficult and pain worse, which certainly will not speed up recovery.
Plasma transfusion
and UV rays
Talking about promising methods of treating coronavirus, doctors often mention manipulation of the blood of recovered patients. First of all, this is passive immunization , which involves the transfer of antibodies to coronavirus from a person who has successfully recovered to a person who has become infected or is at risk. Experiments have shown that serum is able to block SARS-CoV-2 in vitro – and positive effects have already been obtained in people with severe COVID-19.
As for the ultraviolet radiation, then it is known to be doing well with the inactivation of the coronavirus in the premises. That is why the method is widely used in hospitals where patients with COVID-19 are admitted in order to reduce the risks both for themselves and for medical personnel. Why, if the method is so good, cannot it be used more widely? UV light in the optimal range for disinfection is just as harmful to human skin as sunlight (and we know about these risks too well). That is why the rooms must be completely empty during processing.
Garlic, lemons, keto diet
In stores, prices for lemons, ginger and garlic have skyrocketed as the most famous folk remedies with supposedly antiviral effects. Only these products do not create any miracles .
Yes, garlic has some antibacterial properties (the active compounds in it are able to protect at least Salmonella and Staphylococcus aureus ), but its antiviral effect is small . It’s the same story with lemon : while it is still a great source of vitamin C, which is essential for proper immune cell function, it is far from the only one (remember strawberries and broccoli), and secondly, it has no proven benefits for fight against viruses.
Let’s not forget to mention the ketogenic diet. While keto has indeed demonstrated the ability to prevent influenza, these studies were conducted in mice, and therefore it cannot be argued that the effect in humans will be the same. To summarize, foods or supplements are not capable of protecting us from COVID-19 , but keeping track of your diet and eating a balanced diet is still good for supporting your body.
Nicotine patches
A study from a major Parisian hospital suggested that some component of tobacco (probably nicotine, but this still needs to be tested) could protect cells from virus penetration and reduce the body’s overwhelming immune response characteristic of COVID-19. At the same hints Chinese study, during which it was found that only 12.6% of patients treated with the new coronavirus were smokers, while the average number of smokers in China is 28 %.
French doctors say they are ready to conduct clinical trials if approved by the French health ministry. But they separately note that they do not encourage people to smoke: when infected with the same new coronavirus, smokers develop much more serious symptoms due to the constant toxic effects of tobacco smoke on the lungs; Yes , and smoking itself currently carries a multitude of deadly health risks.
Well, some good news instead of a conclusion: Japanese scientists are confident that the current pandemic may have a positive impact on the incidence of influenza. Right now, people wash their hands more frequently than ever before (and in this case, as studies show , we were not particularly good), are additionally protected with masks and observe the social distance. And they, of course, will not stop doing this – at least not immediately – when the crisis period is over.
Conflicting data
There is still a lot of unclear about the new virus: the data that the infection is less common in smokers are being challenged, and even with its transmission, everything is still not clear. As soon as we learned that the virus lives on plastic, wood and cardboard for several days, German scientists reported that they could not cultivate a live virus even from material taken from door handles and drain buttons in the apartments of obviously infected people. Apparently , any data obtained now is only material for accumulation, processing and analysis. Don’t start smoking, stop washing your hands, or buy prescription drugs – just follow directions from medical and government agencies.