As the world battles the SARS-CoV-2 pandemic, doctors and researchers are in a race against time to find the best treatment. When the virus first hit, it was new and not well understood by doctors. But as time passes and the cases surge past three million, new research continues to come to light on how the virus takes over the body, what can be done to battle it, and what possible treatments are available.
Recently, the International Lyme Disease and Associated Disease Society (ILADS) has set up a group for doctors who have experience in treating SARS-CoV-2 so that health professionals can share what has worked for them and what hasn’t. The group is specifically dedicated to helping doctors who have treated patients who contracted the virus while battling chronic illnesses such as Lyme disease. This network will help share ideas and treatments that have worked, and it is expected that the sharing of this information will assist in the hunt for the best possible SARS-CoV-2 treatment.
How do you treat COVID-19?
Currently, there is no one specific treatment for SARS-CoV-2, but different countries have begun testing various medications in relation to the virus. The World Health Organisation has recently launched what they call the ‘Solidarity’ trial. This specific trial will test not one, but four different medications across the world for their efficacy against the SARS-CoV-2 virus. The META study is currently looking for 10,000 volunteers from countries across the world.
Doing the study on several different medications in different areas around the world should help doctors test not only whether the specific medications work, but also if there are outlying factors that contribute to the severity of the illness in different populations. Currently, the only treatment available in the combat against SARS-COV-2 is over-the-counter pain and cold medications, breathing assistance apparatus such as ventilators and oxygen, and rest and fluids. The bottom line is that recovering from the virus is still heavily reliant on the patient’s immune response.
What are the different medicines being used to treat SARS-CoV-2?
The medications being used in the WHO study include Remdesivir, an Ebola treatment; Lopinavir/Ritonavir, an HIV treatment; Interferon beta-1a, an MS treatment; and chloroquine and hydroxychloroquine, treatments for malaria and rheumatology conditions.
Remdesivir has been successful in treating Ebola because of its ability to cause premature termination of the virus cells. It does this by inserting the virus cell with an adenosine analogue, which spells certain death for that specific cell. Researchers are hopeful that the medication will have the same effect on SARS-CoV-2 cells, as it showed promise against both SARS and MERS virus cells in animal studies.
Lopinavir/Ritonavir works by inhibiting protease, which is thought to help combat viruses. In terms of treatment for SARS-CoV-2, the WHO has included it in the trials because of its inhibition abilities, but one study published in late March showed that the medication didn’t have any conclusive evidence that would assist in combating SARS-CoV-2.
Interferon beta-1a is a cytokine (a cell produced by the immune system). Due to its efficacy in inducing a heightened immune response in patients with MS, the medication was included in the study to see if it could achieve the same result in patients suffering from SARS-CoV-2.
The fourth and final drugs on the WHO’s list are chloroquine and hydroxychloroquine. Chloroquine and hydroxychloroquine work by inhibiting the virus cell’s ability to replicate. The drugs have also been used in some areas to treat SARS-CoV-2 and have had some success, but since the studies done are not completely definitive, more information is needed, and thus more trials are commencing on whether or not chloroquine and hydroxychloroquine can be used as a SARS-CoV-2 treatment.
Promising treatments for SARS-CoV-2
Although the most promising treatment for the virus appears to be chloroquine and hydroxychloroquine because of its current positive results, other promising treatments for SARS-CoV-2 that have not been included in the WHO study include disulfiram in conjunction with zinc; other antimalarials; and azithromycin, a strong antibiotic.
Disulfiram has been FDA-approved for roughly 70 years and is widely used in the treatment of alcohol addiction. The medication works by inhibiting the production of certain enzymes that could lead to a speedier recovery from the virus. A study from 2018 showed promising results when tested against the SARS and MERS strains of coronavirus, and researchers hope that the medication has the same effect on SARS-CoV-2. Azithromycin has also been used in studies in combination with chloroquine and hydroxychloroquine, and in one study showed promising results when used as a course of treatment with the other two medications.
Natural treatments for SARS-CoV-2
Some doctors have begun to test natural treatment options for patients suffering from SARS-CoV-2 because they are much safer than traditional medications that have not been fully vetted. One such treatment is vitamin C, introduced into the body intravenously. Vitamin C is known to help boost the immune system in otherwise healthy individuals, and those who suffer from chronic illness can also benefit from regular dosing of the essential vitamin. In one study, it was shown that intravenous vitamin C had positive effects on the recovery of patients at doses of 2 to 10 mg per day. The study showed that the introduced vitamin C helped to reduce oxidative stress on the body, which led to recovery in 50 patients. More studies do need to be conducted to help achieve treatment status, but it shows promise.
For patients who are palliative, the treatment of painful symptoms is of the utmost importance. Ensuring that the patient has enough fluids, is able to drain their lungs properly, and is practising breathing techniques is important for end-of-life care. At a certain point, when treatment is not available or the patient is not responding to treatment, ensuring comfortability and quality of life is at the top of the priority list for patients with SARS-CoV-2.