Updated: Apr 23, 2020
Hello everyone another week here and today we will talk about treatments! As you know things are always changing and we recorded this episode a couple of weeks back. The medication options still stand but new recommendations have been added to some of them so we will have some updates here and you can check out our YouTube lecture from last week that covers all the current treatment guidelines (https://www.youtube.com/watch?v=F-ry3W5HDI0).
Either way, this will give you a quick summary about what experimental treatment options there are because we all know that there is NO specific treatment at this time! We hope you enjoyed this episode and we ask that you stay safe as well as, clean! Oh yeah, by the way don’t forget to stay home, please. Let’s not forget we’re trying to save each others lives here! Here goes:
Current treatment: Supportive care
- We know that about 80% of people have mild symptoms so supportive care will usually be enough for treatment
- The typical things you want to do is stay hydrated, get enough sleep or rest, and boost your immune system, with vitamins (i.e.: Vitamin C and Zinc)
- If you are experiencing fevers you want to use acetaminophen as there is some concern over the use of NSAIDs like ibuprofen due to its inflammatory response (although there is no data suggesting an association between COVID19 outcomes and NSAIDS).
- In the hospitals supportive care revolves around supplemental oxygen (keeping the oxygen saturation above 92%) and mechanical ventilation
Experimental treatment options:
Remember: No specific regimen has been approved by the FDA and no vaccine available to date
- This is an IV drug, not readily available YET
- It's a broad spectrum antiviral which is supposed to inhibit viral replication
- Originally designed against ebola
- One clinical trial recently approved by the FDA in the US, and two trials implemented in China which has been showing promise in people that are acutely sick
- Since the episode this is becoming a top runner! See Gilead's stock for details haha (they are doing a clinical trial on hospitalized patients in Chicago).
Hydroxychloroquine and Choloroquine
- Under investigation for pre and post exposure prophylaxis as well as, treatment
- Prophylactically used for malaria and for the treatment of lupus, rheumatoid arthritis, among others
- Lots of ethical/political issues revolving around this... so that's all we will say for now
- It is no longer used on an outpatient basis but is given to patients on an inpatient basis (aka if hospitalized)
- FDA issued an EUA which is a way to authorize the use of these medications for treatment of hospitalized adults and adolescents (weight ≥50 kg) with COVID-19 who cannot be a part of a clinical trial
- Please await formal information regarding studies (as there are limitations to studies that may not be reported in the media) from WHO or CDC.
- The prescribing physician needs to submit any outcomes and adverse reactions/events to the FDA
Lopinavir and Ritonavir aka Kaletra
- Is an HIV treatment
- Some questionable trials have been done in isolated cases that showed that it can reduce the viral load
- Not as promising as it was originally thought to be and also expensive
- France has done clinical trials with concurrent use of hydroxycholorquine with azithromycin
- Cure rates seemed to be higher with the combination therapy then hydroxychloroquine alone
- Questionable benefit for coronavirus itself but it can help with superimposed bacterial infections which is what it is commonly used for
High dose Vitamin C and Zinc
- Unclear of it's effectiveness, but may help with boosting your immune system
- Note: these are way higher doses than the ones you would be taking at home
Some new ones that were not discussed on the episode:
- Trial to start soon in China, targets the ACE2 protein
- ACE 2 proteins protect the lungs from injury due to respiratory distress
- It has been shown that other/prior SARS illnesses use this protein to infect cells in humans
- Approved in China for symptom management,
- Initially used for inflammation
- Questionable benefit
- Avoid unless using for ARDS or indicated for other reasons (aka its usual use in COPD exacerbations or in septic shock)
- Was initially used in those with severe illness in China but there has since been some concern that it can prolong viral replication, lead to need for ventilation and lead to higher mortality rates
We're hoping that there will be a treatment that REALLY works soon and also that a vaccine will be available at some point as this may very well become a seasonal issue. In the meantime, we can #FlattentheCurve and stay home to protect ourselves and our loved ones.
That's all for this week, don't forget to leave us feedback, rate, review, subscribe and send in your questions so we can continue to improve as well as, provide you high quality content.
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