Lisa Lockerd Maragakis, M.D., M.P.H.
As of April 2020, treatment for COVID-19 depend on if the case is mild or more severe. For milder cases, resting at home and taking medicine to reduce fever is often sufficient. The most severe cases require hospitalization, with treatment that might include supplemental oxygen, assisted ventilation and other measures. Fighting the new coronavirus and COVID-19, the disease it causes, is a top priority in medical research and pharmaceutical development. Hundreds of organizations are working on innovations to reduce the impact of the disease and prevent further infection.
What’s in the works, and when might a coronavirus treatment be ready for the general public? Lisa Maragakis, M.D., M.P.H., an expert in infection prevention, provides an overview of what the future might hold.
There is currently no vaccine to prevent infection with the new coronavirus. Vaccine development takes time. Several organizations, including Johns Hopkins, are working on a vaccine. At Johns Hopkins, investigators plan to work with a company to begin testing their version in humans by the end of 2020. Still, it could be many months of testing and refining before a COVID-19 vaccine is deemed safe, effective and ready to be administered to the general public.
What treatments are being tested for coronvirus?
Medications for COVID-19
While work on the vaccines continues, pharmaceutical companies and laboratories around the world are working to develop medicines for COVID-19. Clinical trials are planned or underway to test drugs that are already approved by the Food and Drug Administration (FDA) for other illnesses to see if one or more can impact COVID-19.
Antiviral treatments can help treat several viral disease such as influenza. Antiviral drugs don’t kill a virus but instead limit the production of new virus in host cells. At best, they can shorten the duration of the illness and lessen complications. Since the coronavirus that causes COVID-19 is new, there’s not yet a specific antiviral that is known to work against it. Doctors and scientists are looking at existing antivirals to see if one might be and effective treatment for new disease.
One antiviral drug, called remdesivir, was initially developed for activity against the Ebola virus and is a treatment arm in multiple studies examining whether it has a role treating COVID-19. Since remdesivir is only available as intravenous medication, clinical research studies are limited to hospital settings.
Some organizations are exploring the possible role for monoclonal antibodies — engineered antibodies that are increasingly used in the treatment of center and other diseases.
Tocilizumab and sarilumab drugs used to treat autoimmune illnesses such as rheumatoid arthritis. In patients with severe COVID-19, these drugs are under study to see if the use of such medications may improve the intens immune reaction (aka cytokine storm ) experienced by some to the virus in later phases of illiness.
Chloroquine and Hydroxychloroquine
These compounds have been used for decades to prevent malaria and to treat some autoimmune disorders such as lupus. There is currently no human clinical trial evidence that these drugs are effective for COVID-19. However, some clinicians are using them based on actions against the new coronavirus in test tube studies. Clinical trials are currently investigating whether these drugs may be able to slow or prevent viral infection.
Serum Antibody Therapies
When people become infected and ill from a particular virus and then get better, their immune system has successfully produced antibodies to fight that virus. Doctors have used forms of antibody therapy for over a hundred years in medical treatment.
Researchers at Johns Hopkins and other institutions are exploring whether using antibodies from people who had COVID-19 and recovered could protect those not yet infected.
The Johns Hopkins team, lead by Arturo Casadevall, M.D., M.S., Ph.D., an expert in molecular microbiology and immunology and infectious diseases, is collecting antibodies from the blood serum (plasma) of people who have recovered from COVID-19.
The researchers hope there is a way to use these antibodies so that, when introduced into another person’s bloodstream, the can bind to the new coronavirus and destroy it. The team published its findings in the March 13, 2020, issue of The Journal of Clinical Investigation.
Many Projects May Yield new Treatments
In the midst of the COVID-19 pandemic, people everywhere are concerned about what kind of treatment might be available if they or loved ones get the illness. Researchers and doctors around the world are working hard to develop ways to fight the new coronavirus and reduce the impact of COVID-19