COVID-19 Treatments

COVID-19 Treatments

As of February 23, 2020,  the US Food and Drug Administration (FDA) has not approved any medication for treating people infected with the novel coronavirus SARS-CoV-2, which causes COVID-19 disease in humans.

COVID-19 Treatment News

  • February 23, 2020 - Japan's health minister Katsunobu Kato said the anti-influenza medication Avigan will be used for COVID-19 treatment, as part of an observational study.

  • February 20, 2020 - WHO Director-General Tedros Adhanom Ghebreyesus said: "Preliminary results from two clinical trials testing potential treatments for the COVID-19 coronavirus are expected in 3 weeks. Even if people are infected, having better outcomes, saving their lives, is really key." One trial combines HIV drugs Lopinavir and Ritonavir, while the other is testing the antiviral Remdesivir.

  • February 18, 2020 - China's National Medical Products Administration has approved the marketing of Favilavir, formerly known as Fapilavir, an antiviral medication that has shown efficacy in treating the novel coronavirus COVID-19. Favilavir was developed by Zhejiang Hisun Pharmaceutical, which is the 1st drug that has been approved for marketing in China. Fapilavir is reported to have demonstrated efficacy with minor side effects in an ongoing 70-patient clinical trial in Shenzhen, Guangdong province.

  • February 17, 2020 - China developed the 5th version for trial implementation of the “Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia" based on the revisions of the previous version.

  • February 15, 2020, the CDC announced it had grown the COVID-19 virus in cell culture, which is necessary for further studies, including for additional genetic characterization. The cell-grown virus was sent to NIH’s BEI Resources Repositoryexternal icon for use by the broad scientific community.

  • February 12, 2020 - Chinese pharma company BrightGene said it has successfully copied Gilead Science's Remdesivir in a Nasdaq-style China disclosure. The Suzhou-based BrightGene also said it has already mass-produced remdesivir's active ingredient and is in the process of turning it into finished doses.

  • February 7, 2020 - A study published in JAMA reported 'Antibacterial agents are ineffective.' All of the patients in this study received antibacterial agents, 90% received antiviral therapy, and 45% received methylprednisolone. The dose of oseltamivir and methylprednisolone varied depending on disease severity. However, no effective outcomes were observed.

  • February 4, 2020 - HHS and Regeneron Collaborate to Develop 2019-nCoV Treatment. BARDA and Regeneron now will leverage their partnership agreement to develop multiple monoclonal antibodies that, individually or in combination, could be used to treat this emerging coronavirus, also known as 2019-nCoV. These monoclonal antibodies are produced by a single clone of cells or a cell line with identical antibody molecules. The antibodies bind to certain proteins of a virus, reducing the ability of the virus to infect human cells. Medicines developed for 2019-nCoV through the expanded BARDA-Regeneron partnership will leverage Regeneron's monoclonal antibody discovery platform called VelocImmune, part of the company's VelociSuite technology.

  • February 4, 2020 - A new study published in Nature reports 'Our findings reveal that remdesivir and chloroquine are highly effective in the control of 2019-nCoV infection in vitro.' Since these compounds have been used in human patients with a safety track record and shown to be effective against various ailments, we suggest that they should be assessed in human patients suffering from the novel coronavirus disease.

  • February 4, 2020 - The Lancet - Baricitinib as a potential treatment for 2019-nCoV acute respiratory disease. 'Because the plasma concentration of baricitinib on therapeutic dosing (either as 2 mg or 4 mg once daily) is sufficient to inhibit AAK1, we suggest it could be trialed, using an appropriate patient population with 2019-nCoV acute respiratory disease, to reduce both the viral entry and the inflammation in patients, using endpoints such as the MuLBSTA score, an early warning model for predicting mortality in viral pneumonia.'

  • February 3, 2020 - Zhang Dingyu, president of Wuhan Jinyintan Hospital, said at the news conference 'that the hospital was the first to use lopinavir/ritonavir, which is sold under the brand name Kaletra and a medication for the treatment and prevention of HIV/AIDS, to treat patients with the novel coronavirus. "It seems that Kaletra is effective in patients with early symptoms. It can help prevent the disease from getting severe and life-threatening, but we still need stronger evidence," said Zhang. Zhang warned people that the side effects of Kaletra include gastrointestinal discomfort, allergy, and hepatic damage. Lopinavir/ritonavir is being investigated (Chinese clinical trial registry identifier: ChiCTR2000029308) based on previous studies suggesting possible clinical benefit in SARS and MERS. The research team of Li Lanjuan, one of China's leading scientists in the fight against the novel coronavirus, announced a major breakthrough on Tuesday, China's Changjiang daily reported. 

    Preliminary tests showed that two drugs - Abidol and Darunavir – can effectively inhibit the virus in vitro cell experiments, according to Li, who is also a professor at Zhejiang University. 

  • February 3, 2020 - AntiCancer Inc. said “Oral recombinant methioninase has high potential to slow or arrest infection of 2019-nCoV in patients, with and without symptoms,” said Dr. Qinghong Han, methioninase project leader at AntiCancer. “We will first test methioninase in cultured lung cells infected with 2019-nCoV in vitro, and then test oral recombinant methioninase in patients infected with the virus. We will carry out these tests in China with the appropriate organizations and safety profiles. Oral recombinant methioninase should be an effective therapy for infections caused by the 2019-nCoV since coronaviruses have a special requirement for methionine,”

  • February 2, 2020 – California-based Gilead Sciences issued a statement announcing Washington State health officials used the unapproved antiviral drug Remdesivir to treat the 1st patient diagnosed with the novel coronavirus 2019-nCoV in the U.S.

  • January 31, 2020 — Gilead Sciences issued a statement from Merdad Parsey, M.D., Ph.D., Chief Medical Officer, Gilead Sciences: "Gilead is working closely with global health authorities to respond to the novel coronavirus (2019-nCoV) outbreak through the appropriate experimental use of our investigational compound remdesivir." Remdesivir is not yet licensed or approved anywhere globally and has not been demonstrated to be safe or effective for any use. Gilead is working with health authorities in China to establish a randomized, controlled trial to determine whether remdesivir can safely and effectively be used to treat 2019-nCoV. We are also expediting appropriate laboratory testing of remdesivir against 2019-nCoV samples.

  • January 27, 2020 - AbbVie’s fixed-dose HIV drug Kaletra—also known as Aluvia, is now recommended as a treatment for pneumonia caused by the new coronavirus known as 2019-nCoV, China’s National Health Commission says in its updated clinical guidance. Kaletra’s 2 antiretroviral components, lopinavir, and ritonavir are protease inhibitors designed to block HIV viral replication. One hypothesis holds that the drugs could do the same with 2019-nCoV, which is believed to have originated from the Chinese city of Wuhan. Although not approved to treat any coronavirus anywhere, it has shown efficacy in at least one case in the current outbreak in China.

  • Thailand doctors combined the anti-flu drug oseltamivir with lopinavir and ritonavir, antivirals used to treat HIV. The ministry was awaiting research results to prove the findings.

Novel Coronavirus Infection Overview

Viruses, such as the novel coronavirus SARS-CoV-2, use human cellular machinery to create proteins that help it replicate, so targeting the viruses while not damaging human cells can prove challenging, says a recent study.

The typical generic coronavirus genome is a single strand of RNA, 32 kilobases long, and is the largest known RNA virus genome. Coronaviruses have the highest known frequency of recombination of any positive-strand RNA virus, promiscuously combining genetic information from different sources when a host is infected with multiple coronaviruses. In other words, these viruses mutate and change at a high rate, which can create havoc for both diagnostic detections as well as therapy (and vaccine) regimens.

When a virus infects the body, it first finds a cell and latches onto a protein on the cell's surface called a receptor. The virus then enters the cell via a vesicle called an "endosome." From inside this vesicle, it releases its RNA into the cell's cytoplasm and two things happen: the virus hijacks the human cell's machinery to produce the viral proteins needed for replication and it uses its own viral enzyme to copy its RNA.

Finally, the viral proteins and RNA assemble into a structure that lets the virus leave the cell and move on to infecting the next cell.

 

Note:  This content was last reviewed on February 18, 2020, by health care professionals, such as Dr. Robert Carlson.