The fight against the coronavirus has been a tough one. While we may be over the peak, hundreds still die every day, and often few doctors can do anything to save those affected by this mysterious disease.
But the long-awaited results from a groundbreaking medical trial have brought new hope.
American researchers have published early data suggesting that a drug called remdesivir could effectively treat people with Covid-19.
Some have called it a “miracle cure” and say it is a groundbreaking sign of progress in the fight against the disease.
US researchers have published early data suggesting that a drug called remdesivir, pictured, could effectively treat people with Covid-19
Dr. Anthony Fauci, head of the U.S. National Institute of Allergy and Infectious Diseases, who led the trial, said the findings “prove that a drug can block this virus.”
While there have been other small studies of the potential benefit of the treatment given to patients via an IV, it has been the largest and most powerful to date.
It involved more than 1,000 patients in 75 hospitals around the world – including 46 people in the UK – and the results are more promising than any other treatment to date.
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The drug is already available in the UK on a compassionate basis for pregnant women and children who are critically ill from the disease, and has just been accelerated for emergency use on their most critically ill patients by US health chiefs. So what exactly is it – and should we all celebrate?
Remdesivir attacks an enzyme that a virus needs to replicate in cells. Laboratory and animal studies have previously shown that the drug is effective against other coronaviruses such as SARS.
These viruses are structurally similar to SARS-CoV-2 – the one that causes Covid-19.
The drug was originally developed for use during the 2014 Ebola outbreak in West Africa. When other treatments for that disease turned out to be more promising, the study was halted.
But for this coronavirus, it could be much more effective. According to results of the study published last week, hospitalized Covid-19 patients who received remdesivir for ten days saw a third of their recovery time, compared to a group of patients who received a dummy treatment. In practice, this meant that the average recovery time was reduced from 15 days to 11 days.
The drug also seemed to boost survival. About eight percent of the Remdesivir group died, compared to nearly 12 percent of those in the placebo group.
It’s a small difference that could have occurred for other reasons, so scientists don’t consider it statistically significant. However, data is still being collected.
If so, the difference between the two groups may turn out to be wider, says Brian Angus, professor of infectious diseases at Oxford University, who is involved in British studies. “It’s not significant so far, but it’s getting close,” he says.
Dr. Stephen Griffin, a virologist at the University of Leeds School of Medicine, agrees that the results are promising, especially considering how sick the patients were beforehand.
“These are encouraging results and show a significant difference in recovery,” he says.
“By the time the drug was given, the virus was well established, so it has to catch up a lot. It is asked to make it very difficult. ‘
The shortening of recovery time may seem small, but given the number of Covid-19 cases worldwide, this could have a huge impact as it means intensive care beds, fans being freed and hospitals being relieved.
“We have many Covid-19 patients who have been in intensive care for a long time and need support, such as supplemental oxygen,” said Prof. Angus. “So if you accelerate recovery by five days, it can be very helpful.”
It can also protect patients from long-term damage.
“We’re not sure yet, but it seems likely that if they recover faster, there may be less damage to their lungs,” Dr. Griffin. “And if it also means getting them out of intensive care three or four days earlier, that’s good for the NHS.”
While the trial involved hospital patients who received the drug intravenously, it may even be more effective if given earlier – before the disease becomes severe.
Despite the hopeful results, some experts say we should use “cautious optimism.” The results of a much smaller brake desivir study in Wuhan, China, in the photo, where the outbreak first started, showed no significant difference in patient recovery time or mortality
“We know from other viral diseases, such as the flu, that early treatment with antivirals can keep the infection nearly dead,” said Peter Openshaw, an experimental medicine professor at Imperial College London.
“But if you wait until the virus is well established, you may shorten the time you have symptoms by a few hours.
“If you start treatment very early with medications such as remdesivir, you are much more likely to have a greater effect.”
There is also the potential to increase the potency of remdesivir by combining it with other treatments. “We know from many infections that you need combination treatment to take advantage of it,” says Prof. Angus.
The next study being considered is to give people braking desivir and something else to dampen their immune response.
“Because it’s been suggested that much of the damage done in this disease is due to the immune response to the virus, not just the virus itself.”
Despite the hopeful results, some experts say we should use “cautious optimism.”
The results of a much smaller brake desivir study in Wuhan, China – where the outbreak first started – showed no significant difference in patient recovery time or mortality.
And the full data from the international trial has not yet been published, which means we don’t know how sick patients should benefit from remdesivir – it is possible that those who benefited most would have recovered after all.
And there is also the difficulty of obtaining the drug – currently there is a global shortage.
But at least remdesivir offers hope. “This drug does not heal immediately,” warns Prof. Angus. “But it’s a step in the right direction.”
Arthritis remedy can be a lifesaver
A drug used to treat painful, swollen joints caused by rheumatoid arthritis may be able to save the lives of some Covid-19 patients.
Tocilizumab dampens inflammation in severe arthritis caused by a protein that is pumped out when the immune system breaks down – known as a cytokine storm.
In some severe Covid-19 cases, the same immune system overreaction occurs when the virus has settled in the lungs. It is this reaction that causes inflammation and blood clots, which in many cases leads to organ failure and death.
The trial is said to be responsible for many Covid-19 deaths. But a small French study of 129 critically ill Covid-19 patients found that those who received the arthritis drug died less quickly and were less likely to receive life support than a control group who received antibiotics. Larger trials are now underway in the US and France to further investigate and check for side effects.
Dr. Stephen Griffin, a virologist at the University of Leeds School of Medicine, says, ‘It would be used when Covid-19 patients really went downhill. It doesn’t really treat the virus – it instead dampens the immune system.
“We need further investigation to see if this means it actually takes longer to actually remove the virus.”