by The ongoing coronavirus pandemic has impacted lives worldwide. While prevention remains the best approach through vaccination and following safety protocols, medical research is also actively exploring treatment options for those already infected. Here is an overview of the current status of various drugs being investigated or used to treat coronavirus.
Remdesivir
One of the early drugs that showed promise is remdesivir, an antiviral medication originally developed to treat Ebola. Clinical trials found that it helped reduce recovery time for hospitalized Covid-19 patients. In October 2020, remdesivir received full approval from the US Food and Drug Administration for the treatment of hospitalized patients based on positive trial results.
However, some recent studies have questioned its effectiveness. A large World Health Organization (WHO) study found no significant benefits of remdesivir for reducing mortality or the need for ventilation. The drug is also very expensive and requires intravenous administration over multiple doses, limiting its accessibility. Some countries are still using it as one treatment option based on earlier positive data. Overall, remdesivir is considered a second-line option after corticosteroids.
Corticosteroids
Corticosteroids like dexamethasone have emerged as an inexpensive but highly effective treatment. Several large randomized controlled trials confirmed that corticosteroids reduce deaths in hospitalized patients requiring oxygen or ventilation support. A WHO guideline strongly recommends corticosteroids for severe and critical cases based on this strong evidence. Corticosteroids help control the exaggerated inflammatory response or “cytokine storm” seen in severe Covid-19 infections. They are now a standard part of hospital treatment protocols worldwide.
Monoclonal Antibody Therapies
Given early in the illness, monoclonal antibodies can help prevent worsening and reduce hospitalization risk. These lab-made antibodies mimic the body’s natural immune response. Two therapies have received emergency use authorization from the FDA – bamlanivimab from Eli Lilly and the combination of casirivimab-imdevimab from Regeneron. Both have proven effective in reducing symptoms if given within 10 days of initial symptoms in high-risk patients. However, their availability remains limited due to the complexity of manufacturing. Ongoing research also evaluates their use post-exposure in individuals not yet infected.
Antiviral Drugs Beyond Remdesivir
Several drugs already approved for other viruses are under investigation for COVID-19 as well. Favipiravir showed promise in early Chinese trials but failed to achieve significant benefits in subsequent large studies. Molnupiravir is an experimental oral antiviral that has demonstrated ability to minimize virus transmission in preclinical studies. Its Phase 3 trails are ongoing. Other antivirals in trials include umifenovir, brilacidin, and aviptadil. There is hope that some of these existing drugs, if proven effective for coronavirus in large trials, could be rapidly authorized. But most are still in the experimental stage of evaluation.
Convalescent Plasma Therapy
Using antibody-rich blood plasma from recovered Covid-19 patients, known as convalescent plasma therapy, was one of the earliest experimental treatments. It aimed to transfer antibodies to infected patients and help boost their immune response. However, results from clinical trials so far have been underwhelming. A large WHO-sponsored study found no significant benefits to this approach for reducing mortality or progression to severe disease. Some localized benefits were seen in specific subgroups in some studies but overall, it is not considered a core treatment currently.
Novel Drug Combination Strategies
Since Covid-19 affects multiple body systems, combining drugs that target different disease mechanisms is an attractive strategy. Some innovative approaches being investigated include combining:
– Antivirals like molnupiravir or remdesivir with anti-inflammatory Coronavirus Treatment Drugs like baricitinib (an arthritis treatment) to reduce both viral replication and cytokine release syndrome.
– Anti-coagulants or blood thinners along with other treatments to prevent potentially fatal blood clots in serious cases.
– Nutraceuticals or herbal medicines that boost immunity along with approved treatments. For instance, curry compound curcumin or Chinese herb jinhua qinggan granule are being studied alongside antivirals.
Such drug cocktails aim to achieve better therapeutic synergy than single agents alone. Preliminary results are promising but large controlled trials are still evaluating these creative combination regimens.
Promising New Additions
Several new drugs have shown promise in initial clinical or pre-clinical evaluations for Covid-19 and their role may get clearer with ongoing research. These include:
– Sotrovimab – A monoclonal antibody therapy from GlaxoSmithKline found effective against variants in Phase 3 trials.
– Aspirin – Recent studies reported reduced mortality in hospitalized patients on low-dose aspirin. Its anti-clotting effects may benefit.
– Protease inhibitors like nirmatrelvir – Developed for Hepatitis C and HIV, they block viral replication and show potential against SARS-CoV-2 in lab studies.
– Fluvoxamine – This antidepressant could reduce cytokine levels and prevent severe disease as suggested by early findings.
– Inhaled interferons – Genetically engineered forms of these natural antiviral proteins may help if delivered directly into the lungs.
Challenges in Covid Treatment Research
While research efforts have yielded some effective therapies, developing drugs for a new virus is an ongoing challenge. Key difficulties include virus mutations reducing drug effectiveness over time, lack of animal disease models for pre-clinical testing, and the sheer scale of studies needed given worldwide impact. Treatment research also needs to evolve to address variants of concern. Overall, successful Covid-19 treatment will likely involve strategic drug combinations tailored to the stage and severity of disease. Targeted drug delivery methods further hold promise. There is optimism that ongoing work can discover additional safe and effective therapies for both prevention and treatment of this ongoing health crisis.
This covers some of the major treatment drugs and approaches currently under investigation and utilized for Coronavirus based on the latest research data. Clinical management of the virus continues to evolve as our understanding improves. Further positive results from ongoing trials could uncover new effective treatment options in the coming months. Continued global cooperation is essential to overcome this public health challenge through both prevention and tailored patient care strategies.
