Virus Outbreak Treatment

It’s difficult to keep up with the different studies and emerging drugs to treat coronavirus symptoms or vaccines to prevent it as the pandemic grows. 

Here are some of the key findings reported by the Associated Press and the New York Times: 

June 11, The New York Times

Remdesivir and the cytokine storm

Many coronavirus patients seem to get better at first, then rapidly decline and are overtaken by an overwhelming immune response that causes the body to turn on itself.

This “cytokine storm” was once an arcane phenomenon familiar mainly to rheumatologists who study when and how the immune system’s safeguards fail.

But it has become increasingly clear in the past few months that, at least in a subset of people who have the virus, calming the storm is the key to survival.

At least a dozen candidate drugs to treat the coronavirus rely on this premise. A few devices that purify the blood, as dialysis machines do, are also being tested. 

One promising drug made by Roche is in several clinical trials, including a late-stage trial in combination with the antiviral drug remdesivir. And a recent paper in the journal Science Immunology described preliminary data on a drug that stems the flood of cytokines at its source, and seems to lead to rapid recovery.

Early in the pandemic, doctors in China and Italy recognized the telltale signs of a body in cytokine shock — fever, a racing heart and plummeting blood pressure — and treated patients with the drug tocilizumab. That drug is marketed by Roche as Actemra, which blocks a cytokine called interleukin-6. Several studies have shown that high levels of IL-6 portend respiratory failure and death, and that Actemra lowers these risks.

The Food and Drug Administration has authorized the use of a cartridge device, called CytoSorb, that continually filters excess cytokines from the blood, similar to the way a dialysis machine removes toxins. The purified blood is then pumped back into the body. About the size of a drinking glass, each cartridge can purify an entire body’s blood volume roughly 70 times in a 24-hour period. 

June 15, Associated Press

Use of malaria drugs revoked

U.S. regulators revoked emergency authorization for malaria drugs for treating COVID-19 amid growing evidence they don’t work and could cause serious side effects.

The Food and Drug Administration said the drugs hydroxychloroquine and chloroquine are unlikely to be effective in treating the coronavirus. Citing reports of heart complications, the FDA said the drugs’ unproven benefits “do not outweigh the known and potential risks.”

The two drugs are frequently prescribed for lupus and rheumatoid arthritis, and can cause heart rhythm problems, severely low blood pressure and muscle or nerve damage. 

June 16, Associated Press

Drug can improve survival

Researchers in England say they have the first evidence that a drug can improve COVID-19 survival: A cheap, widely available steroid reduced deaths by up to one third in severely ill hospitalized patients. 

Researchers said they would publish results soon in a medical journal, and several independent experts said it’s important to see details to know how much of a difference the drug, dexamethasone, might make and for whom.

But “bottom line is, good news,” said the United States’ top infectious disease expert, Dr. Anthony Fauci. “This is a significant improvement in the available therapeutic options that we have.”

The drug was given either orally or through an IV for 10 days. After four weeks, it had reduced deaths by 35% in patients who needed treatment with breathing machines and by 20% in those only needing supplemental oxygen. 

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