Optimism grows that drugs from past outbreaks may treat coronavirus

Antivirals and other medicines created for past outbreaks like malaria, AIDS, and Middle East respiratory syndrome (MERS) are being tested and showing early signs of success in treating the new coronavirus, experts say.

If the progress continues, medical experts in the United States could have a new regimen from drugs that are readily available and generally cheap to treat the most seriously infected patients and provide prophylactic protection for healthcare workers. 

When the Chinese first reported the pneumonia cases to the World Health Organization on December 31, 2019, the new coronavirus’ full genome, which defines its pathogen, was forwarded to researchers on public databases. 

What was discovered in early January 2020 was that the COVID-19 is in the same family as the coronaviruses that caused the outbreaks of both MERS and severe acute respiratory syndrome (SARS) . 

Since then, scientists and pharmaceutical researchers across the globe have been laser-focused on antiviral drugs already approved and used to fight MERS and SARS as well as HIV. 

Karla Satchell, a microbiologist and immunologist at Northwestern University Feinberg School of Medicine in Chicago, says “finding new uses for old drugs is a good strategy.” 

The emerging studies, trials and medicinal applications are expected to prove these drugs to be effective although not the cure-all. Still, the UK government has banned the export of some of these drugs so that they have enough medicines for their own citizens if needed. 

For instance, UK has banned AbbVie’s Kaletra/Aluvia, a combination of lopinavir and ritonavir, the generic drug chloroquine phosphate and the generic drug hydroxychloroquine. 

More than 300 tests in China alone have shown success in using these drugs against the new coronavirus. And over the weekend South Korea officially recommended two such antiviral medications be used to treat the most seriously ill patients infected with COVID-19. 

The Korean Society of Infectious Diseases, Korean Society for Antimicrobial Therapy, Korean Society of Pediatric Infectious Diseases and a tuberculosis association recommended the use of the HIV-fighting Kaletra.

The Koreans have also recommended the use of the well-known malaria drug hydroxychloroquine (HCQ) with Kaletra. Malaria is caused by a parasite.

Just the News reviewed several studies related to the MERS-fighting remdesivir, chloroquine and hydroxychloroquine, lopinavir and ritonavir and kaletra (aluvia).

Remdesivir

At a February 26, 2020 White House briefing, Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Disease, an arm of the National Institute of Health, stated “there are a number of antiviral drugs that are being tested. A few days ago, we initiated a randomized controlled trial of a drug called remdesivir, which has an antiviral activity in-vitro and in-animal models.”

The University of Nebraska Medical Center in Omaha in partnership with the Chinese and sponsored by the National Institute of Allergy and Infectious Disease is conducting these trials. Forty more sites in the U.S. will be joining this project. 

The first participant had been quarantined on the Diamond Princess cruise ship that was docked in Yokohama, Japan.

Remdesivir previously was administered to patients with Ebola and has shown promise in animal models for treating MERS and SARS. 

Since the first of this year, Gilead Sciences has partnered with Chinese health authorities to conduct randomized Phase III clinical trials to assess the use of antiviral remdesivir. Germany also plans to test remdesivir. U.S. Department of Defense is also making remdesivir available to its military and civilian employees. 

Chloroquine and Hydroxychloroquine

Although chloroquine is an anti-malaria prophylaxis, and hydroxychloroquine is a less toxic form of chloroquine and known to be administered to those with rheumatic diseases like lupus and rheumatoid arthritis, patients inflicted with COVID-19 are responding to these drugs. 

In December 2019, China’s Department of Science and Technology of Guangdong Province and Health Commission of Guangdong Province reached an experts’ consensus and recommended “chloroquine phosphate tablet, 500 milligrams twice daily for 10 days for patients diagnosed as mild, moderate and severe cases of novel coronavirus pneumonia and without contraindications to chloroquine.” 

More than 20 clinical studies were launched across several Chinese hospitals. Doctors found superior positive responses in over 100 patients who received chloroquine, including reduction in pneumonia.  South Korea is also conducting studies on chloroquine, hydroxychloroquine and zinc. 

Lopinavir and Ritonavir

The combination of lopinavir and ritonavir has been used to treat HIV patients for years. Scientists have found that COVID-19 and HIV have a similar enzyme although the enzymes work differently as COVID-19 does not have the pocket that the HIV drugs fit into to block the enzyme. 

When the COVID-19 outbreak started in December 2019 in China, some patients were flown to Thailand where doctors administered a combination of flu and HIV medicines with severe cases of COVID-19. 

They found that large doses of the flu drug oseltamivir combined with HIV drugs lopinavir and ritonavir improved the conditions of the patients at the Rajavithi Hospital in Bangkok. Their conditions reversed within 48 hours. 

China’s National Health Commission recently began recommending lopinavir and ritonavir, which is sold by Illinois-based AbbVie, which also donated about $1.5 million worth of Kaletra to China after its outbreak. 

China News reported that when Wang Guangfa, the leader of Peking University First Hospital’s pulmonary and critical care medicine department, contracted COVID-19, he was cured after he was administered Kaletra.