Tag: covid treatment

Categories : COVIDTags :

New Treatment for Severe COVID with Tocilizumab and Sarilumab

On By ModernMedia

Following clinical trials, the NHS is to use tocilizumab and sarilumab, two anti-inflammatory drugs for severe COVID treatment. The treatments can cut the risk of death from severe COVID by a quarter, saving one patient for every 12 treated. Dexamethasone, the first drug found to effectively treat severe COVID, was found to cut deaths by a third if on ventilators and by a fifth if on oxygen.

The UK government is working with the drugs’ manufacturer to ensure an adequate supply for its patients – currently standing at 30 000 COVID cases in hospitals. It has also placed an export ban on the medicines, preventing its purchase and resale overseas for a profit.

Using an innovative adaptive trial design, the REMAP-CAP trial involved 4858 total patients, 4089 of which had suspected or proven COVID and over 800.

Compared to dexamethasone at £5 per dose (R100), the drugs are extremely expensive, however, at £750 to £1000 (R15 000 to R20 000) per patient – but this is less than half the cost of an ICU bed per day in the UK.Prof Stephen Powis, national medical director of the NHS, said: “The fact there is now another drug that can help to reduce mortality for patients with Covid-19 is hugely welcome news and another positive development in the continued fight against the virus.”

As a result of the successful trial, UK doctors are being advised to administer  tocilizumab and sarilumab should dexamethasone prove insufficient for treating severe COVID cases. The anti-inflammatory drugs reduce the damaging lung inflammation caused by severe COVID.

UK Health and Social Care Secretary Matt Hancock said: “Today’s results are yet another landmark development in finding a way out of this pandemic and, when added to the armoury of vaccines and treatments already being rolled out, will play a significant role in defeating this virus.”

Source: BBC News

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Vitamin D to Treat COVID: No Time for Perfect Evidence

On By ModernMedia

An Op-Ed in MedPage Today highlights the evidence for the potential role of vitamin D in the fight against COVID. Low vitamin D levels are being linked to COVID fatality and ICU admission.

Some 40% of the US population is vitamin D deficient, while in Africa, some 20% are thought to be vitamin D deficient. With South Africa’s seasonal variations, vitamin D levels in adults and children may be adequate in summer and autumn but deficient in the winter, even given its ethnically diverse population.

The article reviews the evidence in favour of and against administering Vitamin D as an acute treatment. Causality can be inferred from correlational data by satisfying various criteria which includes consistency, specificity, temporality, and dose-responsiveness. This same approach was used to draw the link between lung cancer and smoking in 1964.
Studies have shown some striking associations between vitamin D sufficiency and COVID outcomes. In a study of 154 patients, patients with vitamin D deficiency (serum 25-OH-D <20 ng/mL) had a fatality rate of 21%, compared to a rate of 3% for those with higher levels. Firming up the case for causation, there is some randomised experimental data.

In a study of 76 COVID patients in Spain, 1 of 50 of patients who were given open-label calcifediol, a potent vitamin D analogue, were admitted to ICU whilst 13 of 26 who did not receive vitamin D were admitted to ICU.
Nursing homes in France often give vitamin D injections, and a quasi-experimental study showed that only 10% of nursing home residents receiving vitamin D progressed to severe COVID, compared to 31% who were not.

The authors conclude that doctors cannot always wait for perfect evidence as they have a duty of care, and given vitamin D’s safety profile, the evidence for its protective role should be acted upon.
Source: MedPage Today

Categories : COVIDTags :

Steroids Indicated Only for Most Severe COVID Patients

On By ModernMedia

According to new research, treating COVID patients with steroids to manage inflammation and stave off a cytokine storm may only be useful in patients with severe COVID.

Most patients with moderate to severe COVID in fact have a suppressed immune system, suggesting that treatment with steroids such as dexamethasone should only be applied to patients with most severe COVID. Severe COVID patients develop a hyperinflammatory reaction known as a cytokine storm.

The researchers measured cytokine levels in 168 adults with COVID, 26 with flu and 16 that were healthy volunteers. When dexamethasone or other steroids are administered to patients with already lowered immune system, they can backfire.

“We did identify a subset of Covid-19 patients with the broadly upregulated array of cytokines.. But, overall, the average person with Covid-19 had less inflammation than the average person with flu,” said study co-author Paul Thomas of St Jude Children’s Research Hospital.

The study authors thus believe that steroids should only be directed at the small subset of COVID patients with an overactive immune response. What they say is an urgent requirement now is a fast, reliable and cheap test to measure cytokines, thereby identifying those patients that are likely to benefit from dexamethasone.

Source: Times of India

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Melatonin: Possible New Drug in COVID Fight

On By ModernMedia

Medical Xpress reports that results from a study Cleveland Clinic indicate that melatonin may be of value in treating COVID. The urgency of the need to treat COVID has resulted in a “fall surge”, where currently available drugs are being assessed for repurposing in treating the pandemic.

The study used artificial intelligence to sift through patient data to uncover possible candidates for use in treatment, and turned up a surprising one – melatonin. The patient data showed that taking melatonin resulted in a 30% decreased chance of contracting COVID after adjusting for confounding variables, with an even greater decreased chance of 52% in African Americans.

The study sifted through clinical manifestations and pathologies COVID and other diseases had in common. They measured the proximity between host genes/proteins and those well-associated with 64 other diseases across several types of disease, with closer proximity indicating a higher likelihood of pathological associations between the diseases.

One of their findings was that proteins associated with respiratory distress syndrome and sepsis, two major mortality causes in severe COVID patients, were strongly connected with multiple SARS-CoV-2 proteins.

“Recent studies suggest that COVID-19 is a systematic disease impacting multiple cell types, tissues and organs, so knowledge of the complex interplays between the virus and other diseases is key to understanding COVID-19-related complications and identifying repurposable drugs,” said Dr. Cheng. “Our study provides a powerful, integrative network medicine strategy to predict disease manifestations associated with COVID-19 and facilitate the search for an effective treatment.”

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Controversy Reigns over Remdesivir FDA Approval

On By ModernMedia

According to an article by Science, the approval of remdesivir by the US Food and Drug Administration (FDA) has shown irregularities in the approval process.

Remdesivir is particularly well-remembered for being approved by the FDA for emergency use, and again for the results of the Solidarity trial, which was organised by the WHO across the world. The Solidarity trial had shown no benefit for mortality benefit for remdesivir – or any other measures. There were high hopes for remdesivir initially: early on, an NIH trial found that it shortened the disease – but a similar Chinese study found no evidence of that. A later study sponsored by remdesivir’s manufacturer, Gilead, found that it reduced recovery time for a 5 day course – but not for a 10 day course. Gilead was aware of the Soldiarity results early on, and then when they became public because they were conducted across multiple countries with different standards of care.

Meanwhile, the FDA went ahead with its approval process. The Solidarity researchers described the results to the FDA on Oct. 10, and in a preprint paper five days later, but the FDA still gave approval, apparently ignoring the Solidarity results in favour of those of the NIH and other studies. Furthermore, the FDA had not convened a key advisory group – yet it had for all of the COVID vaccine approvals.

Meanwhile, the European Commission signed a procurement for 500 000 doses of remdesivir worth $1.2billion. A European Commission spokesperson confirmed that it only received word of the failure of remdesivir in the Solidarity trial the following day.

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Improved Treatment Results in 18% Fall in COVID Death Rates

On By ModernMedia

In a piece for The Conversation, Professor Monica Gandhi at the University of California, writes how, thanks to improved treatment as a results of experience gained, survival rates for COVID patients have dramatically risen.

In three New York hospitals, out of 1724 patients hospitalised for COVID in March, 430 died. In August, 134 hospitalised and five died. However, this may have been due to more vulnerable patients being infected. Therefore, to avoid bias, the researchers accounted for age of patients at hospitalisation, race, amount of oxygen support individuals needed on arrival and such risk factors as being overweight, smoking, high blood pressure, diabetes, lung disease. Even so, they found that patients were three times as likely to survive when admitted in August as compared to March, which indicates that this is due to improved treatment resulting from research into and experience with the disease.

A similar study in the UK looked at COVID patient survival rates in high-dependency units (HDU) and ICU, and found a continuous improvement in survival rates of 12.7% per week in the HDU and 8.9% per week in ICU.

Prof Gandhi attributes this to a better understanding of the disease, and the regular use of remdesivir and dexamethasone as treatments.

Source: The Conversation

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Rights Group Supports No Patents for COVID Vaccines

On By ModernMedia

Business Live reports on the recent call by South Africa and India for COVID vaccines not to be patented. Human Rights Watch added its support by stating that vaccines obtained by public funding should be shared as widely as possible, and their intellectual property status waived.

Some 44 vaccine candidates are being trialled around the world. Wealthy countries have placed orders in order to secure stockpiles of the vaccines. South Africa has no vaccine scheme of its own and is instead has expressed interest in (without signing up to) the global Covax scheme, which involves the World Health Organization and which aims to have two billion doses to be shipped out by the end of 2021.

HRW researcher Margaret Wurth said, “You can’t fight a global pandemic by allowing publicly funded vaccines to go to the highest bidder, at whatever price pharmaceutical companies set. When a safe and effective vaccine is found, it should be available and affordable for everyone, everywhere.”

Categories : COVIDTags :

SA Medicinal Plants Show a COVID Treatment Promise in New Study

On By ModernMedia

Researchers at the Durban University of Technology and the University of KwaZulu-Natal have been examining plants used in traditional African medicine to see if they have any application in treating COVID.

There has been increasing interest in investigating medicinal plants for compounds to use in the treatment of COVID, which still lacks an effective treatment despite effective vaccines being demonstrated.

The researchers began with 29 compounds from medicinal plants known to be effective in treating the common cold, flu, other respiratory conditions, as well as their antimalarial, antiviral and antioxidant activity.

Using a biocomputational approach that does simulated “molecular docking” with various compounds and the known molecules of SARS-CoV-2, the researchers found a number of plants, including the Rooibos bush, contained useful compounds. These displayed favourable binding orientations and were thus identified as being potential inhibitors of the SARS-CoV-2 receptor binding domain and SARS-CoV-2 RNA-dependent polymerase. Four compounds showed extremely good binding to the virus, indicating that they may prevent viral replication.

The next stage of their work will be an in vitro study, before moving onto animal models but is contingent on the team being able to secure funding.

Source: The Conversation