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Vienna – Research to establish better treatment options for patients with Covid-19 is increasingly expanding. Antiviral strategies, improved options to prevent severe lung damage, and prevent further complications should complement each other.
A few days ago it was in the specialized magazine. Lancet A study appeared by scientists from Hong Kong that could at least show an improvement in known experimental therapies: Ivan Fan-Ngai Hung and his co-authors from the Queen Mary Hospital Medical Clinic and other hospitals and research centers in Hong Kong used Covid 19 patients At the onset of illness, a triple combination of interferon beta, the AIDS drug lopinavir / ritonavir, and the static viral agent ribavirin (previously used in hepatitis) or the AIDS drug alone.
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Both ribavirin and lopinavir / ritonavir were thought to have a rather weak effect on SARS-CoV-2 infection at the onset of the Covid 19 pandemic. Studies so far have provided no convincing evidence. The study was conducted between February 10 and March 20. A total of 127 patients were treated for 14 days.
The main result: with the combination therapy, the patients had no more SARS-CoV-2 virus in swab samples after seven days; with lopinavir / ritonavir this took an average of twelve days. The difference was statistically significant. “Triple early antiviral therapy was safe, and one with lopinavir / ritonavir alone was superior in relieving symptoms and reducing the duration of virus excretion (…) in patients with mild to moderate Covid-19 disease,” the authors wrote. scientists. This strategy needs to be further examined.
Blood cancer drug for severe lung damage
Other strategies specifically deal with the prevention of life-threatening lung damage, which can apparently occur due to an excessive immune response in the course of a severe course of Covid-19 disease. Steven Treon and his co-authors from the Dana-Farber Cancer Institute in the US USA They have recently gained initial experience with the drug ibrutinib, which has recently been used in the treatment of blood cancer.
Six had taken this medication daily due to their underlying hematologic condition and contracted SARS-CoV-2 infection, causing symptoms. Although they were high-risk patients, five of them showed no respiratory problems and did not have to be admitted to the hospital. The sixth patient on a reduced dose of ibrutinib, on the other hand, became seriously ill and survived Covid-19 only after increasing the amount of the drug taken.
One explanation for the effect could be that ibrutinib, as a bruton tyrosinase inhibitor, hinders the maturation of aggressive immune cells, for example macrophages (phagocytes). This could prevent or alleviate the dangerous immune reaction in the lungs. The rheumatism drug tocilizumab, which is being tested in clinical trials with Covid-19, could also act in a similar way: it interferes with inflammatory reactions by blocking the interleukin-6 receptor.
Prevent thrombosis and embolism
Patients with severe Covid 19 disease who need to be admitted to an intensive care unit also often develop circulatory disorders. This may be due to increased blood clotting. Hamburg pathologists, for example, have found deep vein thrombosis in seven out of twelve patients (58 percent) in autopsies of Covid-19 victims. In these cases, venous thromboembolism was not suspected before death. In four patients, pulmonary embolism had even been the direct cause of death.
This could indicate a coagulopathy caused by SARS-CoV-2. Increased laboratory blood clotting values (D-dimer test) are, for example, an indication of a severe course of a SARS-CoV-2 infection. Therefore, the Covid 19 treatment recommendations regularly contain information on the often necessary prophylaxis of thromboembolism. This can prevent life-threatening complications. (TT.com, APA)
