https://chemrxiv.org/articles/COVID-19_Disease_ORF8_and_Surface_Glycoprotein_Inhibit_Heme_Metabolism_by_Binding_to_Porphyrin/11938173/5

Is COVID-19 a hematological disease?

Important study by chinese scientists !!

The novel coronavirus pneumonia (COVID-19) is an infectious acute respiratory infection caused by the novel coronavirus. The virus is a positive-strand RNA virus with high homology to bat coronavirus. In this study, conserved domain analysis, homology modeling, and molecular docking were used to compare the biological roles of certain proteins of the novel coronavirus. The results showed the ORF8 and surface glycoprotein could bind to the porphyrin, respectively. At the same time, orf1ab, ORF10, and ORF3a proteins could coordinate attack the heme on the 1-beta chain of hemoglobin to dissociate the iron to form the porphyrin. The attack will cause less and less hemoglobin that can carry oxygen and carbon dioxide. The lung cells have extremely intense poisoning and inflammatory due to the inability to exchange carbon dioxide and oxygen frequently, which eventually results in ground-glass-like lung images. The mechanism also interfered with the normal heme anabolic pathway of the human body, is expected to result in human disease. According to the validation analysis of these finds, chloroquine could prevent orf1ab, ORF3a, and ORF10 to attack the heme to form the porphyrin, and inhibit the binding of ORF8 and surface glycoproteins to porphyrins to a certain extent, effectively relieve the symptoms of respiratory distress. Favipiravir could inhibit the envelope protein and ORF7a protein bind to porphyrin, prevent the virus from entering host cells, and catching free porphyrins. Because the novel coronavirus is dependent on porphyrins, it may originate from an ancient virus. Therefore, this research is of high value to contemporary biological experiments, disease prevention, and clinical treatment.

Yes

https://epidemio.wiv-isp.be/ID/Documents/Covid19/COVID-19_InterimGuidelines_Treatment_ENG.pdf

I think that two fundamental errors are being done in COVID-19 therapeutics:

Treating patients with possible antiviral drugs only in late phase disease and using also in this step high dose medicaments in toxic level.

A recent report of Brazilians pathologists showed severe SARS lesions in lungs at the late stage of disease, reports with kidney, heart and skeletal muscle lesions have been also done. At this point recovery is very improbable.

We know the natural history of this disease. Why not try to prevent this severe lesions BEFORE they install ?

Yes some clinical trials are addressing this!

In February 2020, favipiravir was being studied in China for experimental treatment of the emergent COVID-19.[14][15] Trials are also being planned in Japan.[16]

A study on 80 people in comparison to lopinavir/ritonavir found that it reduced viral clearance time, and that 91% of people had improved CT scans with few side effects. The limitation of this study was that it was not randomized double-blinded and placebo-controlled.[17][18]

The drug has been approved for use in clinical trials of coronavirus disease 2019 in China.[13] In March 2020, Italy approved the drug for experimental use against COVID-19 and has begun conducting trials in three regions most affected by the disease.[19] The Italian Pharmaceutical Agency, however, has reminded the public that the existing evidence in support of this drug is scant and preliminary.[20]

https://en.wikipedia.org/wiki/Favipiravir

https://www.chinadaily.com.cn/a/202002/17/WS5e49efc2a310128217277fa3.html

https://www.nature.com/articles/d41573-020-00016-0

Article Therapeutic options for the 2019 novel coronavirus (2019-nCoV)

https://fr.reuters.com/article/healthcareSector/idUSL4N2AH0C8

https://www.aifa.gov.it/-/aifa-precisa-uso-favipiravir-per-covid-19-non-autorizzato-in-europa-e-usa-scarse-evidenze-scientifiche-sull-efficacia

New Outcomes of hydroxychloroquine usage in United States veterans hospitalized with Covid-19