This is now a burning question worldwide- which drug can specifically minimize the severity of COVID-19?
Thanks in advance!
At the moment, a number of investigational agents are being explored for antiviral treatment of COVID-19, however there are no controlled data supporting the use of any of these agents, and their efficacy for COVID-19 is unknown.
● Remdesivir – Several randomized trials are underway to evaluate the efficacy of remdesivir for moderate or severe COVID-19 . Remdesivir is a novel nucleotide analogue that has activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in vitro and related coronaviruses (including SARS and MERS-CoV) both in vitro and in animal studies. The compassionate use of remdesivir through an investigational new drug application was described in a case report of one of the first patients with COVID-19 in the United States. Any clinical impact of remdesivir on COVID-19 remains unknown.
● Chloroquine/hydroxychloroquine – Both chloroquine and hydroxychloroquine have been reported to inhibit SARS-CoV-2 in vitro, although hydroxychloroquine appears to have more potent antiviral activity .
Use of chloroquine is included in treatment guidelines from China's National Health Commission and was reportedly associated with reduced progression of disease and decreased duration of symptoms. However, primary data supporting these claims have not been published.
Other published clinical data on either of these agents are limited. In an open-label study of 36 patients with COVID-19, use of hydroxychloroquine (200 mg three times per day for 10 days) was associated with a higher rate of undetectable SARS-CoV-2 RNA on nasopharyngeal specimens at day 6 compared with no specific treatment (70 versus 12.5 percent) . In this study, the use of azithromycin in combination with hydroxychloroquine appeared to have additional benefit, but there are methodologic concerns about the control groups for the study, and the biologic basis for using azithromycin in this setting is unclear.
Despite the limited clinical data, given the relative safety of short-term use of hydroxychloroquine, the lack of known effective interventions, and the in vitro antiviral activity, some clinicians think it is reasonable to use hydroxychloroquine or chloroquine in hospitalized patients with severe or risk for severe infection if they are not eligible for other clinical trials. The possibility of drug toxicity (including QTc prolongation and retinal toxicity) should be considered prior to using hydroxychloroquine, particularly in individuals who may be more susceptible to these effects.
● Tocilizumab – Treatment guidelines from China's National Health Commission include the IL-6 inhibitor tocilizumab for patients with severe COVID-19 and elevated IL-6 levels; the agent is being evaluated in a clinical trial.
● Lopinavir-ritonavir – Lopinavir-ritonavir appears to have little to no role in the treatment of SARS-CoV-2 infection. This combined protease inhibitor, which has primarily been used for HIV infection, has in vitro activity against the SARS-CoV and appears to have some activity against MERS-CoV in animal studies. However, there was no difference in time to clinical improvement or mortality at 28 days in a randomized trial of 199 patients with severe COVID-19 given lopinavir-ritonavir (400/100 mg) twice daily for 14 days in addition to standard care versus those who received standard of care alone.
Article Acquired Long QT Syndrome: A Review of the Literature
This review discusses the points I outline below.
Several medications that have been recommended for the treatment of Covid-19 are associated with prolongation of the QTc interval and therefore torsade de pointes and sudden cardiac death.
The evidence of the potential benefit of chloroquine and hydroxychloroquine in the treatment of Covid-19 is increasing.
Other medications which may be used in this cohort include the macrolide antibiotics (e.g. azithromycin). These can also prolong the QTc interval. Administering several medications that may prolong the QT interval is associated with a high risk of complications.
In medicine risks and benefits must be balanced. Safety netting is important whenever there is a great potential benefit but also a very significant risk. In that context QTc intervals, renal and liver function must be monitored closely in patients treated with chloroquine and or macrolides. They should probably not be started if the baseline QTc is more than 450 ms. It should probably be stopped if the QTc increases 25% above baseline. It should definitely be stopped if QTc is above 500 ms. This is an evolving situation and recommendations may change as the potential risks and benefits become clearer.
Beta-blockade is used in the treatment of congenital and acquired long QT syndrome, so may be beneficial in this setting.
Homeopathic drug Gelsemium 30C, once a week as a preventive, for pneumonia stage, every half an hour to commence with up to 12-24 hours, then as improvement set in less frequently Carbo vegetabilis 30C - coldness and bluish skin, Antimonium tartaricum 30C- accumulation of excessive phlegm and Arsenicum album 30c - patient feeling burning sensation and is anxious and restless. Expect to mitigate symptoms and reduce fatality rate.
Still now only one Japanese drug AVIGAN. Please go through the links for details...
1. www.clinicaltrialsarena.com/news/fujifilm-avigan-covid-19-trial-japan/
2. https://www.fiercepharma.com/pharma/white-house-asks-fda-to-approve-fujifilm-s-avigan-for-covid-19-should-agency-follow
Emetinum hydrochloricum is blocking the reverse transscriptase at concentratioons of
10-7 molar
14-7 molar
21-7 molar
In vitro...
Has anyone considered the use of anti-viral peptides? There is a specific hepatitis c isolated peptide (HCV) that targets cholesterol enriched membranes, couldn't that be used in liposomes and be delivered as an injection? I see peptides as our maybe only medicine that can be delivered safely to kill or inhibit COBVID-19. I believe these peptides may be our only safe and effective medicine. Although I do not hold a degree, I have some knowledge in this area. What are your thoughts on this idea?
In Saudi Arabia the lock down has resulted in depletion of medications. There is no warfarin available. Antimicrobials are in very short supply. The situation is likely to be similar in other countries. We must urgently determine which medications are effective for this condition to avoid wastage.
IVIG, hydroxychloroquine, remdesir and anti-flu drugs like oseltamivir are under clinical trial now. We have to wait for COVI-19 indication approval by FDA and Health Canada.
Latest is the Homeopathic drug CAMPHORA 1M twice daily as a preventive and as treatment according to an international study.
Radix ipecacuanhae is blocking the reverse transscriptase and so blocking the replication of rna viruses in the affected cells. Low dose! In a concentration of 10minus molar.
IV Dexamethasone has been working pretty well as applied for 5 days in patients with COVID19. I have seen patients in very bad condition on first day and recovered in 14 days. On job again in 2 weeks.
- Badges
- Science topic
- Similar topics
- Chemistry
- Pharmacology
- Pharmaceuticals
- Drugs