There are no medicines available to treat COVID-19—yet. That hasn't stopped hundreds of studies from being launched in the first months of the COVID-19 global pandemic. Read on to learn what approaches scientists think might work to relieve COVID-19 symptoms, what drugs may cure serious cases, and other drugs that might prevent infection. See what these investigational drugs may have to offer in the fight against COVID-19.
For centuries people have turned to hydroxychloroquine and chloroquine to fight malaria. Now these drugs, often sold under the brand names Plaquenil and Aralen, are being sent to clinical trial for fighting COVID-19. These drugs had been used during the SARS crisis and showed promise, but were never widely used. They may be useful for both preventing infection and treating people with infections. Chloroquine has been shown to inhibit the growth of the novel coronavirus in lab settings, and has been used in China to treat critically ill patients.
However, people should not take this medication without a doctor's supervision. In Nigeria, three people were reported to have overdosed on chloroquine after the U.S. president made positive comments about it in relation to COVID-19. Publicity of these drugs long before the president's comments had already led to a nationwide shortage of these drugs in the U.S. Pharmacists began running out of their supply of a drug that can be lifesaving in the event of lupus flares. Many people with rheumatoid arthritis also rely on hydroxychloroquine for their flares.
The HIV drug Kaletra (generic names lopinavir and ritonavir) was studied early to great fanfare as a possible COVID-19 treatment. In theory, this medication could be helpful by reducing the viral load of those infected. It had been studied in the treatment of both SARS and MERS coronaviruses, but the studies were flawed. Unfortunately, an important study of 199 COVID-19 patients in China treated with this drug showed the pharmaceutical provided no additional benefit compared to standard care.
The anti-flu drug Avigan (generic name favipiravir) won early approval in China for treating symptoms of COVID-19. It is also approved in Japan for investigational use into the novel coronavirus. Favipiravir was reported to help infected patients recover more quickly and with milder chest symptoms, according to Chinese officials. Still, parent company Fujifilm Pharmaceuticals, Japan has not yet confirmed the drug's efficacy in treating COVID-19.
"There is only one drug right now that we think may have real efficacy and that's remdesivir," WHO Assistant Director-General Bruce Aylward said at a March press briefing.
One of the most promising antiviral drugs for Ebola got quick NIH approval for testing on COVID-19 patients. Remdesivir trials for coronavirus are taking place in both the United States and China, and include 13 of the Americans who first became ill onboard the Diamond Princess cruise ship. Tests are ongoing.
Another drug that showed promise fighting SARS, Interferon Beta is being tested for COVID-19. This antiviral drug is a common choice for doctors when the cause of an infection is unknown. It may inhibit replication of respiratory coronaviruses, and has shown promise fighting MERS in mice. Those mice studies showed that an injection of Interferon Beta within a day of MERS infection protected mice from death. This drug has also shown antiviral activity in combination with remdesivir.
The only antibody currently available for treating COVID-19 is found in the blood plasma of disease survivors. That's why the FDA and other federal agencies are investigating blood plasma therapies from recovered COVID-19 patients to treat the disease. These antibodies may be generated on a greater scale eventually, for instance by genetically engineered cows to produce the human antibody. But until that can be developed, human blood remains the only source.
There are 44 potential COVID-19 vaccine candidates as of late March, according to the WHO. Two have moved past the pre-clinical phase and have begun phase 1 clinical evaluations. One is a U.S. study that began March 3, sponsored by the National Institute of Allergy and Infectious Diseases (NIAID). The other trial, funded by the Ministry of Science and Technology of China, was registered March 17. Anthony Fauci, the director of the NIAID, has stated that any successful vaccine will not be available to the public for at least one year due to the rigorous safety and efficacy standards applied to new vaccine trials.
While many of these medications are being tested to treat serious, life-threatening cases of COVID-19, the CDC says that most people who are infected will be able to make a full recovery from home. For this reason, the health agency recommends that people have fever-treating over-the-counter medicines available during the outbreak.
There are many over-the-counter fever remedies, including acetaminophen (Tylenol) and NSAID painkillers like ibuprofen (Advil, Motrin). Read the labels carefully and make sure the medicine you choose can treat your symptoms. Be careful not to combine two medicines with the same active ingredient, as this can lead to overdosing. Always check the label before giving medicine to yourself or to minors, and remember that children and adolescents have different needs and dosage requirements.
Along with the pharmaceuticals being studied to fight COVID-19, some home remedies may help protect from respiratory infections or reduce the duration of symptoms.
Zinc in sufficient amounts has been shown to reduce the length of some viral infections when taken right away. Studies have shown this using zinc lozenges, syrups, and tablets. The NIH notes that the body needs zinc to create white blood cells that fight infections. However, overdoses can do more harm than good, and this along with all supplements should be taken with the consent of your doctor.
Vitamin D has been studied many times for respiratory infections. The WHO says that people who develop respiratory diseases like tuberculosis and pneumonia are more likely to be deficient in vitamin D.
Vitamin C was put into a phase 2 clinical trial at one Chinese hospital during the outbreak. Researchers hope that as an antioxidant, the vitamin may reduce the lung inflammation COVID-19 can cause, a symptom that may lead to death.
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- Along with the pharmaceuticals being studied to fight COVID-19, some home remedies may help protect from respiratory infections or reduce the duration of symptoms.
- The BMJ: "Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data."
- ClinicalTrials.gov: "Vitamin C Infusion for the Treatment of Severe 2019-nCoV Infected Pneumonia."
- NIH: "Zinc Fact Sheet for Professionals."
- WHO: "Vitamin D supplementation and respiratory infections in children."
- CDC: "Coronavirus Disease 2019 (COVID-19): Get Ready for COVID-19."
- FDA: "Medicines in My Home: Know Your Medicines for Colds, Fever, and Pain."
- Center for Infectious Disease Research and Policy: "Fauci: Vaccine at least year away, as COVID-19 death toll rises to 9 in Seattle."
- Chinese Clinical Trial Registry: "A phase I clinical trial for recombinant novel coronavirus (2019-COV) vaccine (adenoviral vector)."
- ClinicalTrials.gov: "Safety and Immunogenicity Study of 2019-nCoV Vaccine (mRNA-1273) to Prevent SARS-CoV-2 Infection."
- WHO: "DRAFT landscape of COVID-19 candidate vaccines -20 March 2020."
- The Journal of Clinical Investigation: "The convalescent sera option for containing COVID-19."
- NPR: "Transcript: Full Transcript with FDA Commissioner Stephen Hahn."
- Journal of Clinical Investigation: "IFN-I response timing relative to virus replication determines MERS coronavirus infection outcomes."
- Medscape: "Coronavirus Disease 2019 (COVID-19) Treatment & Management."
- NIH News Release: "NIH clinical trial of remdesivir to treat COVID-19 begins."
- Medscape: "Coronavirus Disease 2019 (COVID-19) Treatment & Management."
- Reuters: "Fujifilm shares jump 15% on China coronavirus drug trial boost."
- New England Journal of Medicine: "A Trial of Lopinavir-Ritonavir in Adults Hospitalized with Severe Covid-19."
- Cell Research: "Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro."
- CNN: "Nigeria records chloroquine poisoning after Trump endorses it for coronavirus treatment."
- NBC News: "'Lifesaving' lupus drug in short supply after Trump touts possible coronavirus treatment."