The ongoing global pandemic caused by SARS-CoV-2, also known as novel coronavirus or COVID-19, has infected nearly six hundred thousand people and poses a significant health threat worldwide. The rapid spread of the virus and the devastating impact on human health have resulted in an unprecedented race for a potential treatment. However, the World Health Organization (WHO) cautions that the development of a vaccine or licensed drug treatment will take at least 18 months, even if the process is expedited.
Efficacy of Known Drugs
In the search for a treatment, WHO and other global health agencies are revisiting the potential of existing drugs and therapies, such as Anti-Malaria Medications (Chloroquine and Hydroxychloroquine), HIV Drugs (Lopinavir and Ritonavir), Antiviral Compound (Remdesivir), and Convalescent plasma therapy.
Anti-Malaria Medications: Chloroquine and Hydroxychloroquine
The Indian Council of Medical Research (ICMR) suggests the use of hydroxy-chloroquine to control the spread of SARS-CoV-2 in restricted populations. Early results from a small study conducted in France showed a significant reduction in viral load in COVID-19 patients. However, Hydroxychloroquine can have serious side effects and may damage organs such as the heart in some cases.
HIV Drugs: Lopinavir and Ritonavir
The combination drug ritonavir/lopinavir was first introduced to treat HIV infections. This medication was tested on COVID-19 patients in China with no significant difference observed. The drug is generally safe, but it can interact with other medications typically administered to critically ill patients and cause significant liver damage.
Antiviral Compound: Remdesivir
Remdesivir, developed to treat Ebola and related viruses, is currently under investigation for its potential use against COVID-19. The WHO suggests that this drug can help prevent COVID-19 viral replication and could potentially be administered in high doses without causing toxicities.
Convalescent Plasma Therapy
This therapy leverages the antibodies developed by recovered COVID-19 patients. Plasma from these individuals is extracted and injected into critically ill patients in an attempt to bolster their immune response. Studies suggest that administering such plasma at an early stage of infection could potentially mitigate the severity of the illness. However, the effectiveness of convalescent plasma therapy in saving lives remains unknown.
Guidelines and Applications for Convalescent Plasma Therapy
2014 WHO guidelines mandate patient consent before extracting plasma. The guidelines specify that only plasma from recovered patients should be used and donors must not have infectious diseases such as HIV, hepatitis, or syphilis. In India, blood banks would need approval from the Drug Controller General of India to remove plasma from recovered COVID-19 patients.
Reinfection in Recovered COVID-19 Patients
Patients who test positive for COVID-19 develop protective antibodies. However, there have been cases of relapse even in patients who have antibodies. This can be due to factors such as mutations of the virus, unknown behavior of the virus, or false negative RT-PCR test results. Since the behavior of the novel coronavirus is still under study, it is not fully understood how long the antibodies provide protection against the viral infection or whether the immunity acquired is permanent.
Last Modified: February 7, 2024