With the toll of deaths from the coronavirus exceeding 20,000 this week, accelerated efforts to develop treatments for COVID-19 are primarily focused on adapting existing medications to combat the disease.
“The shortest path to treatment, we believe, is to reuse something that already exists based on our knowledge of its mechanisms of action,” said Dr. Hana Akselrod, an assistant professor of communicable disease at the George Washington University School of Medicine.
This new variety of coronavirus, which produces a respiratory disease called COVID 19, which can prove fatal to approximately two percent of the population, especially the elderly and those with underlying conditions such as diabetes or high blood pressure. The new coronavirus is linked to other life-threatening influenza viruses, such as SARS AND MERS.
Infectious disease experts are confident that a vaccine can be developed to prevent coronavirus infections, but the tests to develop a safe and effective vaccine, and organize its production globally, could take a year or more.
There is currently no treatment for infected patients, but a wide variety of medications are being tested. These fall into three categories: they neutralize the virus, relieve some of the most dangerous symptoms, and strengthen the patient’s immune system.
Neutralize the virus
The old anti-malaria drugs, chloroquine and hydroxychloroquine, are being studied in several countries to possibly prevent the coronavirus, or to kill the virus in the early stages of infection. This is a combination of drugs that President Donald Trump said would “change the game,” but scientists say more studies are missing to verify the results.
How do chloroquine and hydroxychloroquine work?
The heaviest theory is that this drug interferes with the virus’s ability to enter a host cell and makes that cell less welcoming to the virus. And if the virus is not infecting the cell, it will not be as effective in reproducing and creating copies of itself, etc., ”said Dr. Akselrod.
This cocktail of malaria drugs has been tested in small groups in France and China with mixed results. Larger studies are underway.
Even if chloroquine and hydroxychloroquine are effective against the coronavirus, there are possible serious side effects to consider, including possible cardiac arrhythmias or irregular heartbeat, and could be toxic if taken in a very high dose.
“We also know that there have been cases where people thought they could be risk-free from the coronavirus by taking these medications and tragically ended up poisoning themselves,” said Dr. Akselrod.
Another drug called Remdesivir that was shown to be effective in treating patients infected with the deadly Ebola virus, has shown promise for the treatment of coronavirus. Like the malaria medication, Remdesivir also inhibits the coronavirus from entering the host cell and reproducing. Large-scale tests are also done for this drug.
Relief of symptoms
COVID-19 adheres to the lungs, causing in many cases severe inflammation, congestion, respiratory problems, pneumonia, and respiratory arrest. A rheumatic arthritis medicine called Kevzara is among the drugs being tested to treat coronavirus symptoms. The drug targets a part of the human body’s immune system.
Does Kevzara work?
“It interferes with an important part of the inflammatory processes, which is a part of the defense mechanisms against infectious processes, and this is after the infection took place and has developed, perhaps the severity of the effects of the virus and the severity symptoms can be reduced by blocking this part of the immune response, “said Akselrod.
While Kevzara and other anti-inflammatories may help reduce congestion and respiratory problems, there is concern that it could also interfere with the immune system’s ability to fight infection.
Chloroquine and hydroxychloroquine also have anti-inflammatory characteristics that can help alleviate coronavirus-related congestion.
The Food and Drug Administration (FDA) this week approved plasma-based therapies from already recovered patients. This involves removing antibodies from the plasma of the blood of fully recovered patients and injecting them into patients who are still ill.
“What we are doing is this low-tech treatment, an old-fashioned solution to taking the blood of recovered patients, just as they did before antibiotics were invented,” said Dr. Shmuel Shoham, a professor of medicine at the John Hopkins University, who is part of a team that has experimented with recovered plasma against various types of influenza viruses.
Using convalescent plasma in critically ill patients may warrant testing, Shoham said, but earlier tests at later stages of infection have not been effective. Instead, he said, “it makes more scientific sense” to use this process for prevention or initial treatment.
A recent test failure was for a drug to treat acquired immunodeficiency syndrome (AIDS), which did not give positive results.
Some 70 existing medications have been identified as possible vaccines or treatments for coronavirus, according to the scientific website bioExiv.
Infectious disease experts are reluctant to speculate how long it will take for a vaccine or treatment to go through the entire study and testing process, and for pharmaceutical companies to reach a level of production to meet global demand, but they say that at least , it will take months.