At home: there is not only a vaccine, an effective drug against the coronavirus is lacking

The protocol used to treat the coronavirus is constantly changing as more and more research results come to light. However, there is no consensus on the details at any given time, according to the statements of the experts interviewed by hvg.hu.

However, this is not a Hungarian feature. András Süle, president of the Regional Hospital-Clinic Organization of the Hungarian Chamber of Pharmacists, told hvg.hu

in the absence of direct and universal causal therapy, there is no definitive international or national procedure on which drugs patients should receive.

Since, in the classical sense of the word, no drug is approved for the treatment of coronavirus diseases, it is always up to the treating physician to decide which drug to choose at what stage of the disease.

According to infectologist András Csilek, president of the Borsod-Abaúj-Zemplén county of the Hungarian Medical Chamber, patients with serious illnesses have tried so many drugs that they could use them.

then neither the patient nor the doctor have much to lose.

In any case, based on international experience, the first protocol to treat hospitalized coronavirus patients without a specific drug against the virus was signed on March 27, as stated by infectologist János Szlávik, chief physician of South Pest Central Hospital in an interview with hvg360 Terrace. . Initially, well-known antimalarial drugs were used (Donald Trump also took hydroxychloroquine at the same time), as well as drugs against AIDS and hepatitis C. There have been quite a few drugs, now it has become extremely crystallized that the antimalarial drug is less cash and we are also using them less.

A Japanese drug (favipiravir) has also been shown to be effective in the early stages of infection, and an intravenous drug, remdesivir, has been reported to be effective in treating critically ill patients, János Slavik added.

The Hungarian protocol is reviewed by experts every 2-3 months to make it uniform in Hungary, and everyone knows how to treat a coronavirus patient. We know that the list of recommended drugs will also change soon in Hungary, more products may be removed.

For the treatment of critically ill patients, the currently available scientific evidence is promising for dexamethasone (an anti-inflammatory steroid), a so-called corticosteroid, and the previously mentioned remdesivir, an antiviral drug originally developed against hepatitis C and Ebola. There are also several studies with a flu medicine called favipiravir.

Serious side effects require serious consideration

The National Institute of Pharmacy approves which active ingredients can be used. OGYÉI is in line with the position of the European Medicines Agency, which is largely based on WHO guidelines.

András Süle emphasized that the expected benefits and risks of an unregistered experimental therapy must be considered in light of the given phase and severity of the disease.

For example, favirapir is particularly contraindicated in pregnant women because it can cause serious harm to the fetus. Many other drugs damage the liver.

These drugs are expected more in the most serious phase of the disease when treated in the hospital. Remdesivir, for example, is linked to a specific impairment of respiratory function and should be used at this stage. And at the beginning of the inflammatory phase, you may want to think about steroids.

There is a different approach

A characteristic symptom of severe Covid-19 disease is pneumonia, a form of it with characteristic lesions. During hospital treatment, its development and spread should be prevented if possible, András Süle explained. This requires monitoring the patient’s condition with multiple lab tests, X-rays, or CT scans. Blood counts of interest and lung images with characteristic lesions can be considered alarms. In such cases, appropriate drug therapy (such as steroids) should be started without delay. Regarding treatment, Béla Merkely, rector of Semmelweis University, is RTL Klub He told a reporter: now there is a different attitude, they are trying to prevent patients from connecting to a ventilator, rather they are trying to improve their condition with medications. According to Merkely, this is the reason why, although there will be more infected people, the death rate may be much lower compared to the spring wave. Which drug can be used for prophylaxis in the early stages of the disease or as a contact person for a coronavirus patient is also being investigated, but the results are not yet known.

János Szlávik said that of the drugs that appear to be effective, fortunately there are also in Hungary (the protocol also lists only drugs available in Hungary), but András Csilek finds that remdesivir is hardly available.

Currently favipiravir is available, I don’t know if it is good or not. We also give patients a cure, but we don’t know if it is because they received the drug or because their immune system defeated the disease. It still takes time to decide.

On the same basis, the effect of other antivirals is difficult to assess at the moment.

András Süle said that since there is no drug that can be administered against coronavirus in general, supportive care is the main treatment for patients admitted to the hospital, and the protocol for this is uniform. This mainly means helping circulation and respiration and reducing inflammatory processes.

When asked how confidently coronavirus patients are now treated, András Süle said: “We must be sure that we are aware that there is still no clear and scientifically proven answer, if the situation is very bad, we will further help the patient”. we have to deal with difficult duality. “

Sometimes it’s just a cold

According to data on Monday, there are just over 4,000 active confirmed coronavirus infections in Hungary, although Béla Merkely estimates that the number of infected people may be 100,000 across the country. The course of the virus is mostly mild or asymptomatic, in many cases it is very difficult to distinguish it from other respiratory diseases and colds, which can cause problems, especially in the autumn period, adds András Süle. In these milder cases, patients do not require hospital care and can expect medications to relieve their symptoms.

In such cases, in addition to contacting the family doctor by phone, the most important thing is isolation and the use of a mask, as well as bed rest and the use of antipyretics and traditional analgesics.

In case of more severe symptoms (shortness of breath, severe vomiting, extreme feeling of falling, an unprecedented type of pain), your GP may consider hospitalization necessary for a more detailed examination.

Although it is difficult to predict accurately, András Csilek says that if the chest CT is fine, the lungs are not full of spots, and the laboratory results are good, there is little chance that the disease will become really serious. By the way, doctors’ attitudes have now changed: After hardly knowing about the virus in the spring, those with mild symptoms were also admitted to hospital because they did not know where the disease was progressing.

Although the average age of those infected is currently 26 years old, the elderly and chronically ill are still at higher risk.

Is in the middle

For now, experts don’t understand why the virus causes different symptoms in three otherwise healthy people of the same age. “One has no symptoms, the other has a fever for a day and the third connects to a ventilator and dies. I hope that one day it will be answered why this discrepancy exists,” explains András Csilek. This, he says, like other respiratory viruses, is difficult to understand.

András Süle says that if we think of the chronology of the virus’s career as a number line, then the middle section, that is, how the virus infects, is already quite well understood. The picture is less clear about the origin of the disease for humanity, but in all probability, a virus that infects animals has become a human pathogen. And, from an epidemiological point of view, one of the most dangerous events is when a virus or other pathogen crosses the limits of the species, since without being prepared it reaches the “collective memory” of the human immune system.

The end of the imaginary straight line, that is, the long-term effects of the virus, is just beginning to be understood and explored. As a result, even more complications can arise.

In some cases, the recovery time appears to be very long. There are more and more examples of months of loss of taste and smell, chronic fatigue that makes daily activity and work impossible, and heart and nervous system symptoms.

András Csilek believes that sooner or later we will get used to the virus, as we have gotten used to the flu.

While you won’t have such great PR and you may be able to get it more than once, the point is that you will have immunity and hopefully you have a vaccine as well, which is good.

Experts predict that the vaccine will be available before a drug taken specifically against the coronavirus. According to András Csilek, the solution will not be the solution anyway, but the vaccine, since with it we defeat most viruses.

It’s Béla Merkely InfoRadio In his Arena program, he calculated that he could receive the vaccine in 2 months. She also said breakthrough medication is not seen and is

most likely it won’t.