Potential Treatments for COVID-19

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As of today doctors have no proven effective treatment for COVID-19. However, many studies are being conducted all over the world. Here are some of the reported studies:

• Vitamin D: People who have blood levels of hydroxy vitamin D below 30 ng/mL probably should be treated with vitamin D. We have no controlled studies to show that vitamin D helps to treat COVID-19, but lack of vitamin D was a common cause of death in tuberculosis 100 years ago. There is evidence that lack of vitamin D increases risk for cytokine storm in which a person’s own immune system that is trying to kill the virus becomes so active that it tries to attack and destroy your own lungs, heart, and other organs (Aging Clinical and Experimental Research, April 2020; BMJ Feb 28, 2020;368:m810).

• Remdesivir: Already approved by the FDA to treat COVID-19 even though the evidence is very weak. It has been shown to help treat ebola virus infections, and some early studies show promising results for COVID-19. It blocks RNA-dependent RNA polymerase that helps the virus reproduce (J Biol Chem, April 13, 2020).

• Hydroxychloroquine and chloroquine: The FDA has approved these drugs temporarily for emergency use, but no controlled data yet show clear benefits. The FDA cautions that hydroxychloroquine and chloroquine, alone or with the antibiotic azithromycin, should not be used outside a hospital or clinical trial because of the very real risk of irregular heartbeats that can be fatal.

• Interferon-beta: This protein is produced by your own immune system to fight invading germs and it has been approved to treat severe infections, but we do not have controlled data yet to show that it treats COVID-19.

• Lopinavir and Ritonavir: These drugs have been shown to treat HIV, but have shown conflicting results when tried against COVID-19. They are protease inhibitors that block an enzyme necessary for HIV to produce new viruses, but probably will not work in COVID-19 cases because that virus does not use that same enzyme to reproduce new viruses.

• Interferon-beta 1b, lopinavir/ritonavir, and ribavirin: A randomized Chinese trial in patients with mild to moderate COVID-19 infections found that a 14-day course of lopinavir 400 mg and ritonavir 100 mg every 12 hours, ribavirin 400 mg every 12 hours, and three doses of 8 million international units of interferon beta-1b on alternate days, got rid of the virus in the nose in seven days for 86 patients, compared to 12 days for patients treated with lopinavir/ritonavir alone (Lancet, May 8, 2020).

• Drugs to dampen down the immune system to prevent a cytokine storm: Most of the sickest patients with COVID-19 have elevated levels of an inflammatory protein called interleukin-6 (IL-6). Chinese studies have reported that Roche’s drug, Actemra (tocilizumab), blocks IL-6 and may treat COVID-19. Sarilumab, approved for treating rheumatoid arthritis, is also being tested in hospitalized patients.

• Convalescent blood from recovered patients: The FDA recently issued guidance on the research to use blood from people who have been “cured” of COVID-19 because it contains antibodies for that virus. A major problem with this treatment is shortage of donors who have been shown to have high antibody titers against COVID-19 in their bloodstreams.

These are only the most publicized studies. There are many more treatments being tried but they have not been approved by the FDA and have not yet been reported in the scientific literature to be successful.

I spent a lot of time discussing these studies and other aspects of COVID-19 on the radio show I did this week on WRTA in Altoona PA; you can listen here: https://soundcloud.com/talkradio985/dr-gabe-mirkin-may-2020-wrtas-the-11th-hour-with-doug-herendeen