Covid - 19 Protocols

As we are all unfortunately aware, the COVID-19 pandemic caused by the SARS-COV-2 coronavirus is as a result of it being a unique or new virus.  Therefore, we not have any immunity or antibodies against this virus and there are no known treatments.  Physicians, scientists, laboratories and corporations are actively working to identify immediate (e.g., drugs) and long-term (e.g. vaccines) solutions.  A recent report identified almost 70 drugs which are FDA approved for other indications, are in clinical trials or in pre-approval that might be active against the coronavirus.  https://bit.ly/3buoYk3 . This was done by identifying 26 or the 29 proteins on the virus and then assessing which of the available drugs might inactive the virus by interacting with the viral proteins.

Two of these drugs, chloroquinone or hydroxychloroquinon, alone or in combination with Zithromax have been highlighted in the press because of the recent statements and tweets by the President. Those statements were obviously a little premature and, unfortunately, even led to the death of people who self-medicated.  Before these drugs can be used clinically, it must be determined if they kill viruses in vitro (outside the body) and then in vivo (in the body).  We know that they work in the lab.  Studies are now being undertaken to determine if they will be clinically efficacious in shortening the severity and length of COVID-19.

The initial report was from China and included 100 patients.  It was very positive, but, unfortunately, it was not a controlled study and presented almost no data to back up the claims.  A second study from France was somewhat more encouraging.  They did have a control group, although patients were not assigned to the treatment and control groups randomly.  Nevertheless, there was an encouraging and demonstrable difference in clearance of the virus from the patients in the treated (70%) vs the control (12.5%) groups.  Clinical studies are beginning to study the effects of these drugs in New York State, as announced yesterday by Governor Cuomo, and elsewhere.

On the other side of the positive effect of commonly taken drugs on the course of COVID-19, there were some reports that classes of drugs frequently prescribed for the treatment of hypertension and heart disease might exacerbate the course of COVID-19.  These two classes of drugs are ARBs, angtiotensin receptor blockers, and ACEs, angiotensin converting enzyme inhibitors. The concerns came out of animal studies performed on a different coronavirus. Human studies did not confirm these reports.  In addition, one must consider what would happen if a patient stopped taking these medications. Their cardiac problems could worsen and make them susceptible to a more severe and critical course, if they became infected with the SARS-COV-2 virus.  The major cardiology associations have all recommended that patients continue with these medications.

The best thing that we can do at the present is to continue to follow the CDC and state guidelines to decrease the chances of contracting COVID-19:  practice good hand hygiene, do not touch your face, avoid contact with people with symptoms, practice social distancing, cover coughs and sneezes, wear a mask if you are sick and clean and disinfect frequently touched surfaces.