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Remdesivir: cure for COVID-19? More studies needed

The race is on to find a cure for COVID-19 as the pandemic continues to wreak havoc on countries, shuttering economies, straining public health systems and taking many lives. As of this writing there are 2, 160, 207 confirmed cases with 146, 088 deaths worldwide.

The World Health Organization has taken the lead in a global “Solidarity trial” of at least four candidate drugs that could potentially cure the disease: Remdesivir; Lopinavir/Ritonavir; Lopinavir/Ritonavir with Interferon beta-1a; and Chloroquine or Hydroxychloroquine.

First to grab headlines was Hydroxychloroquine which US President Trump has mentioned on many of his earlier briefings to the press.

Remdesivir
Chemical structure of Remdesivir.

Now, attention has shifted to remdesivir which has shown promising results based on a few studies in the US. The drug is made by Gilead Sciences and was initially tested against Ebola but had little success. Multiple studies in animals showed the drug could both prevent and treat coronaviruses related to COVID-19, including SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome).

The US NIH came out with a report that remdesivir prevented COVID-19 from progressing in rhesus macaque monkeys based on mild- to-moderate cases of the human disease.

Although the “solidarity trial” is unprecedented and groundbreaking as it has never been done before, experts are saying that more rigorous studies are needed as the urgency to find a cure may compromise the global effort.

Dr. Rahul Ganatra, director of Continuing Medical Education at Brigham and Women’s Hospital in Boston, Massachusetts has scrutinized a paper published in the New England Journal of Medicine on the use of remdesivir for patients with severe COVID-19. His initial appraisal is that the study was based on a population of small size – only 61 patients, there were missing data like the definition of what is “standard care”, and perhaps most importantly, it lacked a control group. To his mind, these threaten the promise of remdesivir being a cure for COVID-19. His conclusion: more well-designed trials like ones with control-groups are needed.

It is hoped that indeed researchers would bear in mind that a cure for COVID-19 would only be found through good science and that the goal is not only to be the first in finding it, rather finding a cure that really works.

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Daily dose

How vulnerable am I to the COVID-19?

The SARS-CoV-2 continues to spread throughout the world and there’s now talk of the COVID-19 reaching pandemic levels. It’s not going to be the end of the world or the start of a zombie breakout but one cannot avoid getting anxious. I myself have been worrying ever since reading about it back in December last year. Primarily because I have not been of the greatest of health; underweight, prone to allergic rhinitis which would easily develop into upper respiratory infection. That alone is enough to make life very hard for at least a couple of weeks until it gets resolved. To top it all off, I work in an office building where there’s a lot of foreign nationals on a daily basis.

So the worry is real. Thankfully most of the answers to the question in the title of this post, can be found on an article by Dr Edsel Maurice Salvaña, M.D., DTM&H, FPCP, FIDSA on Esquire Magazine:

Early data is showing that about 80% of people who get sick with COVID-19 will develop only mild symptoms, while 20% can develop more severe disease. The ones at highest risk for a bad outcome are the elderly and those with chronic illnesses such as diabetes, heart disease, and lung disease. A greater percentage of men compared with women with COVID-19 have died in China, and this may have been partly because more males smoke in China. Protecting your loved ones means avoiding unnecessary travel and practicing social distancing. Elderly people should avoid crowds and crowded places. Make sure everyone’s vaccinations for influenza and bacterial pneumonia are up to date since these can prove fatal if they occur at the same time as a COVID-19 infection. Now is also the best time to stop smoking.

Dr Edsel Maurice Salvaña, M.D. A Coronavirus Pandemic Isn’t the End of the World

I may not be young anymore but certainly not too old to be considered an ‘elderly’ just yet. Heart disease and diabetes free. However, I do have a history of lung disease and that’s where the worry really comes from. On the other hand some level of comfort comes from the fact that I don’t smoke cigarettes and having been on a drinking hiatus since last October, my exposure to second-hand smoke has been practically eliminated.

The real trick now is to keep my self in better health. Wash my hands more often and minimize travel. I even started to use my elbows in pushing the elevator buttons and consciously avoid touching door handles and the overhead bar at jeepneys.

In addition, I regularly keep myself updated with news & information about the COVID-19 from credible sources. Hopefully it would be enough to be spared from this disease along with my family. Hoping even more that a local outbreak would not happen even though the recent moves of the government in response to SARS-CoV-2 spread does not inspire confidence and even adds to our worries, there’s only so much that we can do.

Categories
Daily dose

New coronavirus in China similar to those found in bats – just like in the movie Contagion

Have you seen the movie Contagion? Released in back in 2011, it showed how a deadly disease could easily spread throughout the world thanks to the convenience of air travel. How that deadly disease started was accurately shown in the film’s final scene:

Pathogens crossing from animals to humans has long been established by science. The recent outbreak of a pneumonia-like illness in China and the discovery that the virus closely resembles those found in bats just made the movie a lot more scarier. It just happened in real life, in our present times.

ScienceMag has details from a transcript of an interview with Xu Jianguo, head of an evaluation committee advising the Chinese government on what we know so far of this outbreak:

Q: The virus has been isolated from one patient, is that correct?

A: Correct. Two groups isolated the virus from samples from one patient. The viruses are nearly identical in morphology under electron microscopy. Researchers did laboratory investigations of 34 patients. A total of 15 were positive for the novel virus, [based on] sequencing samples of [fluid injected into the lung and collected for examination]. The teams got complete genome sequence data from about 10 patients. They are now attempting to isolate the virus from those samples as well. There are 19 cases with no evidence of the virus. There is no information available for the results of the remaining 25 cases.

Q: How close is this new virus to the SARS coronavirus?

A: The virus is similar to some of the published viruses collected from bats. But it is not close to SARS and not close to MERS.


Q: Is there any progress in tracing the original source of the virus?

A: I have no information. Personally, I’m interested, too. The virus looks like viruses isolated from bats, but how it was transmitted from bats to people is still a question. Several groups in China have been working on bat coronaviruses for years. I imagine they’re working on this but so far there is no information.

Q: Are other live animal markets being checked?

A: The Wuhan market has been closed. I have no information about other [markets]. Wild animals carry the risk of exposing people to new viruses. I think we should have more strict regulations and inspections of markets that sell wild animals, especially since the source of the new coronavirus has not been identified and eliminated.

One fatality has already been linked to the outbreak. Airports in Hong Kong, Singapore and the Philippines has imposed screenings of travelers from mainland China. Hopefully the disease is contained and there won’t be a repeat of the SARS or MERS epidemic a few years ago.