COVID-19. Are there any effective medicinal products?
Since December 2019, the world has been struggling with a new infectious disease COVID-19 (COrona VIrus Disease 2019). This disease is caused by a virus belonging to the Coronaviridae family. The family includes two subfamilies and five genera which bring together more than 10 species that cause lesions of respiratory organs, gastrointestinal tract, nervous system in humans and animals. On the surface of the viral particle there were detected protrusions — spikes in the form of a crown. For the first time, the coronavirus was isolated by D. Tyrrellatas from a patient with acute rhinitis in 1965.
The new virus, which is the cause of COVID-19, is called SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2). The name of the virus is encrypted with its taxonomic identity and ability to cause severe acute respiratory syndrome. Chinese scientists have found that SARS-CoV-2 interacts with the APF2 receptor in the alveolar epithelial cells, which contributes to increased production of angiotensin-converting enzyme 2. This can lead to damage to alveolar cells and trigger a cascade of systemic biochemical reactions capable of causing death.
Currently, the Ministry of Health of the Russian Federation has approved temporary guidelines for the prevention, diagnosis and treatment of new coronavirus infection (COVID-19). According to the recommendations for drugs of etiotropic therapy (aimed at eliminating the virus itself) include lopinavir+ritonavir, ribavirin and interferon preparations. As a rule, they are used in combination. The combined drug lopinavir+ritonavir is used to treat HIV infection and is an inhibitor of virus protease. Studies have shown that it is also capable of suppressing coronavirus protease activity. This drug has found its use in the treatment of MERS-CoV infection and is currently used for the treatment of infection caused by the new coronavirus SARS-CoV-2.
The combination of the above drugs can be more effective compared to their use as monotherapy. The experience of using the following therapy schemes is described: three-component (ribavirin, lopinavir+ritonavir, IFN-α2b) and two-component (ribavirin, lopinavir+ritonavir; lopinavir+ritonavir, IFN-α2b; ribavirin, IFN -α2b).
The use of drugs IFN-β1b, ribavirin and lopinavir+ritonavir, as well as their combination is justified in the case of moderate and severe course of infection, when the estimated benefit exceeds the potential risk of undesired phenomena.
Pathogenetic approaches (aimed at eliminating or suppressing the mechanisms of disease development) are recommended in the initial (feverish) period and include conducting detoxification, antioxidant therapy with severe intoxication.
Symptomatic treatment involves the use of anticough, mucolytic and expectorant drugs, also recommended the use of antipyretic drugs.
Read more about the recommendations of Minzdav on the link .
It is worth noting that the world Pharma is also actively developing new drugs for the treatment of COVID-19. So, it became known that the company “TAKEDA” begins the development of a drug for the treatment of COVID-19, obtained from blood plasma. In addition, the company plans to explore the possibility of using existing drugs in the fight against this disease.
It also became known about conducting in the USA clinical trials of the vaccine against coronavirus produced by the company Moderna Therapeutics. However, the effectiveness of the drug can be judged only in a few months . Work on vaccine development is also under way in China, Russia and a number of other countries.
- “Temporary guidelines “Prevention, diagnosis and treatment of new coronavirus infection (COVID-19). Version 3 (03.03.2020)” (Apptoved by Ministry of Health of Russia)
- Medical microbiology, virology and immunology: study for students of medical universities/A.A. Vorobyev, A.S. Bykov, M.N. Boychenko et al.; ed. A.A. Vorobyova. – 2nd ed., sp. and additional. – M.: Med. inform. agency, 2008. – 702 p.: il. – Predm. decree.: p. 695-702. Code V M 422
- https://www.pharmjournal.ru/jour/announcement/view/237 #
- Sun, P, Lu, X, Xu, C, Sun, W, Pan, B. Understanding of COVID‐19 based on current evidence.J Med Virol. 2020; 1— 4.vs 160;https://doi.org/10.1002/jmv.25722