Coronavirus Treatment: What's In Development
As of April 2020, treatment for COVID-19 depends on if the case is mild or more severe. For milder cases, resting at home and taking medicine to reduce fever is often sufficient. The most severe cases require hospitalization, with treatment that might include supplemental oxygen, assisted ventilation and other measures.
Fighting the new coronavirus and COVID-19, the disease it causes, is a top priority in medical research and pharmaceutical development. Hundreds of organizations are working on innovations to reduce the impact of the disease and prevent further infection.
What’s in the works, and when might a coronavirus treatment be ready for the general public? Paul Gisbert Auwaerter, M.B.A., M.D., an expert in infection prevention, provides an overview of what the future might hold.
Is there a coronavirus vaccine?
There is currently no vaccine to prevent infection with the new coronavirus. Vaccine development takes time. Several organizations, including Johns Hopkins, are working on a vaccine. At Johns Hopkins, investigators plan to work with a company to begin testing their version in humans by the end of 2020.
Still, it could be many months of testing and refining before a COVID-19 vaccine is deemed safe, effective and ready to be administered to the general public.
Can coronavirus be treated? What treatments are being tested for coronavirus?
Medications and Vaccines for Coronavirus
While work on the vaccines continues, pharmaceutical companies and laboratories around the world are working to develop medicines for COVID-19. Clinical trials are planned or underway to test drugs, including investigational compounds, which are already approved by the Food and Drug Administration (FDA) for other illnesses to see if one or more can have an impact on COVID-19.
Antiviral Medication and Treatment
Antiviral treatments are available to treat several diseases, such as influenza. Antiviral drugs don’t kill a virus but instead limit the production of new viruses in host cells. For most people, the best these treatments can do is shorten the duration of the illness and lessen complications. Since the coronavirus that causes COVID-19 is new, there is limited evidence regarding specific antivirals that may work against it. Doctors and scientists are looking at both existing and experimental antivirals to find effective treatments for the new disease.
One antiviral drug called remdesivir was initially developed for activity against the Ebola virus. Researchers are testing remdesivir to see how it might help patients with COVID-19, and results of some of these studies are available.
One study conducted in China did not show any benefit in treating patients with COVID-19. However, the National Institutes of Health (NIH) reported that in one U.S. clinical trial, remdesivir helped patients with COVID-19 recover faster when compared with patients who did not receive the drug.
Preliminary (unpublished) results show a 31% shorter recovery time in patients who were treated with remdesivir (11 days versus 15 days). In the study, patients who were able to leave the hospital or return to their normal activities were considered recovered.
At present, remdesivir is available to patients in research trials or if they are hospitalized in institutions that have received drug under an FDA Emergency Use Authorization. The drug is an intravenous medication that can only be given to patients in a hospital setting. The course of treatment lasts 5 to 10 days.
Some organizations are exploring the possible role of monoclonal antibodies — engineered antibodies that are increasingly used in the treatment of cancer and other diseases.
Tocilizumab and sarilumab are drugs used to treat autoimmune illnesses such as rheumatoid arthritis. In patients with severe COVID-19, these and similar drugs that combat inflammation are under study to see if the use of such medications may improve the intense immune reaction (aka cytokine storm) experienced by some to the virus in later phases of illness.
Chloroquine and Hydroxychloroquine
These compounds have been used for decades to prevent malaria and to treat some autoimmune disorders such as lupus. There is currently no human, high-quality clinical trial evidence that these drugs are effective for COVID-19. However, some clinicians are using them based on outcomes in test tube studies and small human studies. Clinical trials are currently investigating whether these drugs may be able to slow or prevent viral infection.
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Convalescent Blood Plasma Therapy
When people become infected and ill from a particular virus and then get better (convalesce), their immune system has successfully produced antibodies to fight that virus. Doctors have used forms of antibody therapy for over a hundred years in medical treatment.
Researchers at Johns Hopkins and other institutions are exploring whether using antibodies from people who had COVID-19 and recovered could protect those not yet infected.
The Johns Hopkins team, led by Arturo Casadevall, M.D., M.S., Ph.D., an expert in molecular microbiology and immunology and infectious diseases, is collecting antibodies from the blood plasma of people who have recovered from COVID-19. Plasma is the clear, straw-colored fluid portion of the blood that carries blood cells, platelets and proteins, including antibodies.
The researchers hope there is a way to use these antibodies so that, when introduced into another person’s bloodstream, they can bind to the new coronavirus and destroy it. The team published its proposal in the March 13, 2020, issue of The Journal of Clinical Investigation.
In some hospitals, doctors are using convalescent blood plasma therapy to treat patients who have COVID-19 and are at a high risk for serious illness or death. The benefit of the treatment is not yet proven.
Many coronavirus projects may yield new treatments
In the midst of the COVID-19 pandemic, people everywhere are concerned about what kind of treatment might be available if they or their loved ones get the illness. Researchers and doctors around the world are working hard to develop ways to fight the new coronavirus and reduce the impact of COVID-19.
What you need to know from Johns Hopkins Medicine.