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Covid-19 - Treatments & Vaccines

Being among those that will be required to receive the first widely available vaccine...please let’s not over rush the damn thing. Appropriately/relatively safe and effective, please.

You'll probably catch Asperger's from it.
 
A new treatment is being rolled out tomorrow. Everyone should drink four bottles of Trump water and eat at least one Trump steak each day.
 
A vaccine will be the thing that whips this.

In the meantime, one potential treatment I’m intrigued by is interleukin (IL)-6 receptor inhibitors for patients with evidence of elevated cytokine response.

Tocilizumab does seem to help, at least anecdotally. I am involved in setting up a couple of trials to investigate this further. I am an Immunologist who studies acute viral infections, specifically infections which drive potent inflammation and tissue damage/dysfunction as is seen in COVID19.

Canakinumab is another target gaining interest. It is an Il-1b blocking antibody. During COVID19 pathogenesis it is thought that IL-1 production in the lung drives a dysfunctional immune response, overt and progressive tissue damage and this Il-1 ultimately drives the IL-6 and downstream issues associated with cytokine storm. We are looking at this for treating mild patients before intubation/ICU.

Biggest issue with either Toci or Cana will be availability. These aren’t cheap treatments and stocks are not maintained for general use so supply is limited. I’m trying to get some clinicians to look at Anakinra which also blocks IL-1 signaling as an alternate.

People are also considering early interferon therapy to counteract the relative lack of interferon and antiviral immunity the virus seems to induce. I’m skeptical that this will be tolerated well in patients at the early stage and I think it might make conditions worse.

Vaccine will be the gold standard for stopping this from continual spread but time is not on our side. Need to find effective treatments now while we wait.
 
Tocilizumab does seem to help, at least anecdotally. I am involved in setting up a couple of trials to investigate this further. I am an Immunologist who studies acute viral infections, specifically infections which drive potent inflammation and tissue damage/dysfunction as is seen in COVID19.

Canakinumab is another target gaining interest. It is an Il-1b blocking antibody. During COVID19 pathogenesis it is thought that IL-1 production in the lung drives a dysfunctional immune response, overt and progressive tissue damage and this Il-1 ultimately drives the IL-6 and downstream issues associated with cytokine storm. We are looking at this for treating mild patients before intubation/ICU.

Biggest issue with either Toci or Cana will be availability. These aren’t cheap treatments and stocks are not maintained for general use so supply is limited. I’m trying to get some clinicians to look at Anakinra which also blocks IL-1 signaling as an alternate.

People are also considering early interferon therapy to counteract the relative lack of interferon and antiviral immunity the virus seems to induce. I’m skeptical that this will be tolerated well in patients at the early stage and I think it might make conditions worse.

Vaccine will be the gold standard for stopping this from continual spread but time is not on our side. Need to find effective treatments now while we wait.

Somebody get Brad to verify this guy’s credentials.
 
From an article in today's WSJ: "WUHAN, China—Chinese doctors who have for months treated coronavirus patients with chloroquine say there is no clear evidence the anti-malarial drug is effective against the deadly pathogen, raising questions about a remedy President Trump has touted as a potential cure."
Not only that, but it appears chloroquine (severely?) damages the heart in fairly high percentages of patients, according to the French Health Ministry.
https://www.vox.com/covid-19-corona...uine-remdesivir-side-effects-covid-19-studies
 
There is nothing definitive to take from that article and it has an obvious bias. How would we have a better handle on how chloroquine affects people with COVID-19?
 
Randomized trial published today, no real benefit for HCQ

https://www.medrxiv.org/content/10.1101/2020.04.10.20060558v1


o assess the efficacy and safety of hydroxychloroquine (HCQ) plus standard-of-care (SOC) compared with SOC alone in adult patients with COVID-19. Design Multicenter, open-label, randomized controlled trial. Setting 16 government-designated COVID-19 treatment centers in China through 11 to 29 in February 2020. Participants 150 patients hospitalized with COVID-19. 75 patients were assigned to HCQ plus SOC and 75 were assigned to SOC alone (control group). Interventions HCQ was administrated with a loading dose of 1, 200 mg daily for three days followed by a maintained dose of 800 mg daily for the remaining days (total treatment duration: 2 or 3 weeks for mild/moderate or severe patients, respectively). Main outcome measures The primary endpoint was the 28-day negative conversion rate of SARS-CoV-2. The assessed secondary endpoints were negative conversion rate at day 4, 7, 10, 14 or 21, the improvement rate of clinical symptoms within 28-day, normalization of C-reactive protein and blood lymphocyte count within 28-day. Primary and secondary analysis was by intention to treat. Adverse events were assessed in the safety population. Results The overall 28-day negative conversion rate was not different between SOC plus HCQ and SOC group (Kaplan-Meier estimates 85.4% versus 81.3%, P=0.341). Negative conversion rate at day 4, 7, 10, 14 or 21 was also similar between the two groups. No different 28-day symptoms alleviation rate was observed between the two groups.
 
Saw an article today that COVID patients are being placed on their stomach to relieve pressure and allow for more air in their lungs.
 
Saw an article today that COVID patients are being placed on their stomach to relieve pressure and allow for more air in their lungs.

It's called proning. This is a good tweetorial on it

 
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