Dexamethasone, remdesivir, Regeneron: explanation of Trump covid treatment

Since testing positive for coronavirus, United States President Donald Trump has been receiving several different medications, as revealed by his doctors.

It is not clear when the president contracted the virus, but there are two broad phases of a coronavirus infection: the first in which the virus is the problem and the second, deadly phase, when our immune system accelerates and begins to cause collateral damage. massive to other organs.

The treatments are divided into two camps: those that attack the virus directly and are more likely to be helpful in the first phase, and drugs to calm the immune system, which are more likely to work in the second.

So what drugs are being used and what do they tell us about their condition?

Dexamethasone

This steroid saves lives by calming the immune system, but it must be used at the right time. If given too soon, the medicine could make things worse by affecting the body’s ability to fight the virus.

This is not a drug that you would normally give in the “mild” stage of the disease.

A test of the drug that took place in the United Kingdom showed that the benefit came at the time when people need oxygen, which Trump received briefly.

The World Health Organization advises the use of the steroid in “serious and critical” cases. Trump’s blood oxygen levels fell below 94%, which is one of the National Institutes of Health criteria for “serious illness.”

However, those low oxygen levels were not sustained and the gap between someone in need of transient oxygen support and advanced Covid is huge.

Some have suggested that the president might be incapacitated due to the effects the steroid can have on the mind. Side effects of dexamethasone include anxiety, altered mood, and cognitive decline, but these are more common with long-term use, rather than the short course Trump is currently receiving.

Monoclonal antibody therapy

It is a combination of antibodies, manufactured by the Regeneron company, that mimic our own immune response.

The antibodies physically stick to the coronavirus, so they cannot enter the cells of the body and make the virus more “visible” to the rest of the immune system.

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Last week, the company posted results on its website showing that the cocktail reduced the amount of viruses in the body and the time it took for patients to recover. However, this was in people who did not need hospital treatment and the data has not been seen by scientists or doctors.

The approach makes scientific sense and there are high hopes that it will be effective. However, the evidence in patients is still very limited and these monoclonals are still classified as an experimental drug; clinical trials are ongoing. The president is one of the few people outside of those trials who undergoes treatment under what is known as “compassionate use.”

Remdesivir

This antiviral drug was first developed as a treatment for Ebola. It works by confusing the virus as it looks chemically similar to some of the raw materials the virus needs to replicate. This disrupts the virus’s ability to make thousands of copies of itself.

Clinical trials have shown that the drug reduces the duration of symptoms from 15 days to 11.

However, there is no evidence that lives were saved by remdesivir.

Like monoclonal antibodies, remdesivir is likely to have its greatest impact early in the course of an infection.

What happens with the rest?

President Trump’s doctors say that the president of the United States is also taking zinc, vitamin D, famotidine, melatonin and aspirin. It is unclear if any of these are deliberately for Covid 19.

Zinc is a mineral that plays a role in the immune system, but there is no evidence that such supplements improve people’s ability to fight the virus.

Vitamin D is known as the sunshine vitamin because it is produced in the skin in response to sunlight. It also has a role in a healthy immune system, but again there is no evidence that taking supplements helps against Covid 19.

Famotidine decreases stomach acid production and is used for people with stomach ulcers or reflux. There are small studies that suggest that it may help, but the quality is considered low and the researchers have called for more research.

Melatonin is a hormone that the body produces at night and helps us sleep. It is sometimes given as a treatment for insomnia.

Aspirin is a pain reliever and blood thinner that is used to reduce the risk of blood clots. Unusual blood clotting has been observed in Covid patients and it can also calm inflammation in the body. There are aspirin trials on Covid, but there is no evidence that it is helpful.

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