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Coronavirus Treatments and Tests: The Latest Developments

Coronavirus Treatments and Tests: The Latest Developments - Featured Image - Amy Myers MD

There’s some good news at last about COVID-19. In case you missed it, I’d like to point out the progress on possible coronavirus treatments. And since so many people have asked me about this, I also want to address the issue of the efficacy of at-home tests for coronavirus.

Let’s dive into the news on the preliminary yet encouraging trials conducted on coronavirus patients.

Coronavirus Treatments

Medical professionals and researchers around the world are working tirelessly on innovative techniques to treat the illness. They have had promising results from approaches including hydroxychloroquine sulfate and azithromycin, antibody treatments, and convalescent plasma treatments. 

My goal is to bring you all hope while you continue to stay home that this quarantine will come to an end eventually, and we will soon have treatment for this virus. This will help save countless lives! Let’s take a look at each treatment more closely.

Acetaminophen & NSAIDS

One common remedy for aches and pains are NSAIDS such as ibuprofen and aspirin. Initial reports from French doctors indicated that treatment with ibuprofen led to severe illness with pneumonia. However, this was solely based upon observations and not on scientific studies. 

However, the World Health Organization (WHO), states that either acetaminophen or ibuprofen can be used to treat the early symptoms, with a total dose not exceeding 3,000 milligrams per day.1

Vitamin C

According to Dr. Andrew Webber of New York’s Northwell Health Facilities Hospital, COVID-19 patients there have been treated with 1,500 milligrams of intravenous vitamin C three to four times per day. The patients who received the vitamin C did significantly better than those who did not receive the supplement. These patients were also given the hydroxychloroquine and azithromycin discussed below. China is currently conducting three clinical trials on the use of vitamin C for patients with COVID-19.2

Antimalarials and Azithromycin

You may have heard the buzz about the medications called chloroquine (CQ), and a version of that drug called hydroxychloroquine sulfate (HCQ) as possible treatments for COVID-19. These are existing drugs, used to treat malaria, have proven safe and effective for use against that disease.

In a randomized trial in Wuhan, China, 62 men and women with mild cases of COVID-19 participated. They were split into a control group of 31 people who were not given any hydroxychloroquine and 31 people who were given a 5-day course of the antimalarial drug. 

Hydroxychloroquine was administered at a rate of 400 mg per day, and then results were evaluated according to CT scans (chest X-rays), the patient’s fever and presence of cough and pneumonia. All patients fully recovered and in particular those with pneumonia who received the HCQ recovered 80.6% more quickly.

In France, 20 patients with COVID-19 were included in a trial published March 20. They were given 600 mg of chloroquine daily, and in some cases, azithromycin, an antibiotic, was added to the treatment. Untreated patients from another center and cases refusing the protocol were used as a control group.

The six who received both drugs were symptom-free in five days3 and the remainder showed a significant reduction of the presence of the virus as compared to the control group. 

Although both the French and Chinese studies were very small, they were so promising4 that the FDA initidally released hydroxychloroquine and chloroquine for use against COVID-19.5

However, recent tests at Veterans Administration hospitals as well as other facilities have not proved successful. The National Institutes of Health now does not recommend this treatment except as part of clinical trials.

Warning: Do not take any form of hydroxychloroquine at home that is not prescribed by your doctor. All forms are not alike. This drug is NOT preventative, so do not take any form of this drug unless your doctor prescribes it to you.

Antibodies

Progress is very promising in the realm of antibody drug treatments for COVID 19. Vir Biotechnology is a San Francisco-based biotechnology firm. It is conducting laboratory testing that shows two of its antibody drugs based on a human antibody to the sudden acute respiratory syndrome (SARS) virus appeared to neutralize the virus. They will embark on testing these drugs in people in three to five months. 

Another company, Regeneron, based in Tarrytown, NY, is also set to start trials on a similar medication for the virus in early summer, and if successful, the company projects a fall release of the drug.6

Convalescent Plasma

Convalescent plasma simply refers to blood plasma taken from recovered patients. This plasma donation contains antibodies their bodies produced to fight the virus and make a full recovery. This treatment has been used for more than 100 years to treat diseases from measles to polio, chickenpox, and SARS.7 China had success with a small trial of this treatment.8

The Food and Drug Administration (FDA) announced recently that they will lead a national  project to make use of plasma from recovered patients to treat patients infected with the coronavirus. The Mayo Clinic and the American Red Cross will spearhead the project. 

A consortium of 50 hospitals and universities called the National COVID-19 Convalescent Plasma Project already has 1,200 people ready to donate blood plasma. This type of treatment is most effective in the early stages of the disease. The FDA already cleared some health care practitioners to give plasma to severely ill patients.9

Testing Options

We’ve all been instructed to call our healthcare professional for instructions if we suspect we have COVID-19. She or he may order COVID-19 testing at a clinic or drive-through facility if you have symptoms. 

However, we’re learning that many people have COVID-19 for up to two weeks before they even display symptoms. Some people have it and never get sick enough to even really notice. Yet, they may be able to spread it to others. So, you may wonder if there are other ways besides a doctor-ordered test to find out if you have it.

As of April 26, 2020, there are no at-home coronavirus tests or antibody tests for the general public that have been approved by the FDA for use in the United States. However, as a functional medicine practitioner, there were many tests I used in my clinic that were not FDA-approved. That said, this is a very new area and there hasn’t been much time to conduct studies on the tests themselves. Here’s what we do know.

However, just this past week the FDA approved a kit developed by LabCorp that allows for at-home sample collection through a nasal swab, which is then sent to the company for analysis. This process takes one to two days. In the initial rollout, the kits will be reserved for healthcare workers. Two other companies initially believed they had received permission to market tests that relied on saliva, however the FDA has indicated these test are not approved.10

At least four other companies in the US are working with test developers to develop at-home test kits.11 As the general population is able to test themselves quickly and accurately from home, those who are ill can self-quarantine. This gives hope for returning to normal routines again sooner rather than later.

Yet this is not a simple process. Testing to find out if you have the virus currently requires a very large amount of antibodies to show a “positive.” Right now that means the tests are only truly effective on those who’ve had significant symptoms for at least 12 hours. That’s because only those who are truly ill will show a “positive” for both IgG and IgM antibodies, consistent with an active infection.

Also, these tests don’t work well for immunity assessment because they can’t determine slightly to moderately elevated antibodies, which is what you need to see patterns of post-infection attained immunity. In other words, they need high viral load and antibody production to show positive. They can’t really discern the lower levels that are necessary for long-term immunity assessment.

There are some healthcare companies that are tackling these issues. One such company is Everlywell, based in Austin, Texas. Their test will be available for $135, and will be covered by participating HSA and FSA providers. Everlywell will receive no profits for the test.12

Scanwell Health has created what it calls the first clinical-grade at-home test for COVID-19. It can be done in 15 minutes. Scanwell is waiting to obtain Emergency Use Authorization (EUA) from the FDA for at-home use for this new test.

The technology for their version of an at-home test was developed by Chinese diagnostic technology company INNOVITA, which was approved by China’s equivalent of the FDA. This test is in active use by many people in China. The test provides results within hours with the guidance of a medical professional via telehealth.13

San Diego startup Cue Health is adapting an influenza test kit already in development for at-home use. It projects test results would be available within 25 minutes with no need to send samples to a lab for analysis.14

As of March 27, Medstar paramedics in Tarrant County, Texas are now able to test at-risk individuals, or individuals who have previously contracted the virus in their own homes. This partnership would send specifically trained MedStar personnel into the homes of residents who are being monitored for COVID-19.15

These efforts are not confined to the US. Singapore’s Biolidics has announced its rapid test kits will be available in April and the UK’s Medbelle are rolling out test kits at cost to support Britain’s National Health Service. These cost about $275 and are limited to two per household.

Cause for Hope

The news in this article gives us a reason to remain optimistic. Amidst the tragedy of so many lives lost, our best minds are racing to perfect new treatments and tests, to stop this pandemic in its tracks. 

China is opening back up; both Italy and Spain may have turned a corner according to recent reports. Some US states are considering reopening nonessential businesses as well. 16 Faculty and students at Rice University are working on inventing a new and inexpensive type of ventilator.17 Many US companies are jumping into manufacturing necessary medical supplies.18 

This pandemic is affecting our entire world. As we all work together, staying home, supporting each other with phone calls and video chats, and maintaining our healthy habits, we can stay strong and come out on the other side.

Article Sources

  1. https://www.health.harvard.edu/diseases-and-conditions/treatments-for-covid-19
  2. https://www.nutraingredients.com/Article/2020/03/25/Hospital-turns-to-high-dose-vitamin-C-to-fight-coronavirus#
  3. https://www.the-scientist.com/news-opinion/is-hype-over-chloroquine-as-a-potential-covid-19-therapy-justified–67301
  4. https://www.physiciansweekly.com/hydroxychloroquine-azithromycin-for-covid-19-new-clinical-trial-results/
  5. https://www.medicinenet.com/azithromycin/article.htm#what_is_azithromycin_zithromax_z-pak
  6. https://www.statnews.com/2020/03/25/vir-biotechnology-reports-early-progress-in-antibody-treatment-for-covid-19/
  7. https://www.health.harvard.edu/diseases-and-conditions/treatments-for-covid-19
  8. https://ccpp19.org/_docs/scientific-papers/CP-IN-COVID-19/CP-USE-COVID-19-IN-CHINA—SHEN-et-al.pdf
  9. https://www.npr.org/sections/coronavirus-live-updates/2020/04/03/826638981/hospitals-universities-push-for-treatment-using-plasma-from-recovered-covid-pati
  10. https://www.statnews.com/2020/04/21/fda-clears-covid-19-test-home-sample-collection-labcorp/
  11. https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-alerts-consumers-about-unauthorized-fraudulent-covid-19-test-kits
  12. https://www.fiercehealthcare.com/tech/everlywell-offering-first-at-home-testing-kits-for-covid-19-amid-testing-lag
  13. https://www.fiercehealthcare.com/tech/everlywell-offering-first-at-home-testing-kits-for-covid-19-amid-testing-lag
  14. https://www.mobihealthnews.com/news/latest-covid-19-testing-fda-updates-ready-responders-land-48m-administer-covid-19-tests-home
  15. https://www.nbcdfw.com/news/coronavirus/medstar-partners-with-tarrant-county-to-do-in-home-covid-19-testing/2340396/
  16. https://www.bbc.com/news/world-europe-52100153
  17. https://news.rice.edu/2020/03/27/ventilator-costing-less-than-300-developed-by-rice-university-and-metric-technologies/
  18. https://www.cnbc.com/2020/04/01/coronavirus-update-us-manufacturers-answer-gms-call-for-ventilator-parts.html

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