CV-19 therapeutic drug trials and Vaccine

[_Jersey Girl]

Yes, what we're seeing is innovative research in real time. Of course, many or most folks don't think this is coming fast enough but the truth is that it's coming down in warp drive. The Remdesivir was mentioned on the board probably a month ago but thanks to Trump who single focused on Hydrochloriquine (I just typed that without looking up the spelling, hope I got close) it faded into the background.

Since the development of one or more vaccines is going to take longer than therapeutics, I think we all have reason to be hopeful about this research until vaccines are ready for roll out.

I still see convalescent plasma as a more immediate fix but I have no way of knowing how scarce that might be right now.

For myself and JB, we're both on one of the meds that are under trial. I'm hoping that matters in terms of providing some level of protection against the cytokine storm that kills.

ETA: Just looked at Icarus' post. Hydroxychloroquine. ;-)

[_Jersey Girl]

This isn't about drug trials. People read up on diffusion hypoxia and CV-19, and what they're saying about the vents. I don't think I can articulate the problem better than this right now but it's akin to the effects of high altitude. They are seeing that when they put people (don't know what percentage) on the vents, their saturation levels are dropping into the 20's and 30's. That's the direct opposite of what they would expect to see happen. This is based on what ER and ICU doctors are observing in their vent patients. These doctors are suggesting that if patients are put on vents, that the pressure should be set low with the oxygen raised up or that they should be treated using hyperbaric units, and possibly that there's a place for CPAP machines in the treatment.

I've never checked my pulse-ox when returning to altitude but I know something about what they're describing. Instead of people coming in gasping for air, patients are able to speak easily but their saturation levels are low. They drop to even more dangerous levels when placed on the vents. It has something to do with the pressure of the vents destroying the alveoli surfactant tension ( causing the lungs to become stiff when supplemental oxygen is the key without the added pressure) in these patients until they can no longer breathe with or without the vent.

I'm afraid we're going to find out that the vent patients have essentially been killed on account of the standard protocols. I know we're seeing so much contradictory information regarding treatments but this is coming directly from doctors treating patients who were perplexed by what they were seeing, so look for articles and reports online about this.

[_MsJack]

I read the r/Covid19 sub every day. There's usually discussion of the latest studies on drugs and treatments. Unfortunately most of these studies have been observational and not quality, randomized controlled trials. A lot of them have also only been about giving the drug to severely ill patients, but that a drug does not work in the severely ill doesn't mean it won't halt the virus if given after symptom outset.

It's very unfortunate to me that HCQ became the political football it did. It was known to have some efficacy against SARS since 2005, which is part of the reason it was being studied for COVID19. It was being discussed on r/Covid19 long before Trump picked up on it. Now a lot of people seem to want it to fail just because they hate Trump. I'm still waiting for a good trial on patients receiving it early after symptom onset.

Other drugs that have been discussed on r/covid19 include ivermectin, avigan (favipirivir), and famotidine (Pepcid). Remdesivir has to be given in an IV and is hard to make, so it would be great if an existing drug that's more easily administered proved effective against COVID19. Though at this point I'd settle for a rock to throw at this thing.

There was another new drug, a pill, being studied, but the name escapes me. There's also been a lot of discussion on whether having adequate vitamin D levels inhibits or reduces infection severity. (I fixed my vitamin D levels years ago and would recommend it to anyone for non-covid19 reasons. It really improved my mood.)

[_Chap]

I read the r/Covid19 sub every day. There's usually discussion of the latest studies on drugs and treatments. Unfortunately most of these studies have been observational and not quality, randomized controlled trials. A lot of them have also only been about giving the drug to severely ill patients, but that a drug does not work in the severely ill doesn't mean it won't halt the virus if given after symptom outset

May I make a suggestion?

Unless you have unlimited time, intellectual energy and emotional resources, stop "read[ing] the r/Covid19 sub every day". Instead, make use of the professional filtering and quality control that you can get from a source like this:

New England Journal of Medicine free COVID-19 resources

That way you will no longer have to wade through material (much of it worthless) of the kind you get on message boards - using that as a source of information on an urgent topic is a little like feeding your family on a random selection of what you might find in a dumpster behind a supermarket. To say the least, that is likely to result in severe indigestion ...

[_EAllusion]

I read Science and Nature routinely, which obviously now have a lot of COVID material. A few of the people I've followed since the science-blog days have expertise in this area and I follow their conversation and reading suggestions. I don't have any expertise in epidemiology, immunology, or anything like that, but I do have a background in cell biology which helps me process information as it comes out more easily than the average person I suppose.

Some days, it feels like we're still in the "mysterious gay cancer" phase of this epidemic. You just sit back and marvel at how far we've got to go yet. There's so much we don't know.

[_Jersey Girl]

Here's one of many on the diffusion hypoxia and vents.

https://www.livescience.com/silent-hypo ... ients.html

[_Jersey Girl]

I read the r/Covid19 sub every day. There's usually discussion of the latest studies on drugs and treatments. Unfortunately most of these studies have been observational and not quality, randomized controlled trials. A lot of them have also only been about giving the drug to severely ill patients, but that a drug does not work in the severely ill doesn't mean it won't halt the virus if given after symptom outset.

It's very unfortunate to me that HCQ became the political football it did. It was known to have some efficacy against SARS since 2005, which is part of the reason it was being studied for COVID19. It was being discussed on r/Covid19 long before Trump picked up on it. Now a lot of people seem to want it to fail just because they hate Trump. I'm still waiting for a good trial on patients receiving it early after symptom onset.

Other drugs that have been discussed on r/covid19 include ivermectin, avigan (favipirivir), and famotidine (Pepcid). Remdesivir has to be given in an IV and is hard to make, so it would be great if an existing drug that's more easily administered proved effective against COVID19. Though at this point I'd settle for a rock to throw at this thing.

There was another new drug, a pill, being studied, but the name escapes me. There's also been a lot of discussion on whether having adequate vitamin D levels inhibits or reduces infection severity. (I fixed my vitamin D levels years ago and would recommend it to anyone for non-covid19 reasons. It really improved my mood.)

Is that reddit you're talking about? I don't read there unless it's been linked from MDB. There are currently (or was last I checked) 10 meds that are being trialed to mitigate the effects of CV-19. Some you've mentioned there. Also included are ACE1 inhibitors and ARB's. Couple of others I believe that you haven't got listed there. I should have posted the list but I was excited about my being on one of the meds at the time and failed to post it.

If what's being said about Vitamin D is true, I'm essentially bullet proof.

[_Chap]

Also included are ACE1 inhibitors and ARB's.

See this, perhaps:

Renin–Angiotensin–Aldosterone System Blockers and the Risk of Covid-19

CONCLUSIONS
In this large, population-based study, the use of ACE inhibitors and ARBs was more frequent among patients with Covid-19 than among controls because of their higher prevalence of cardiovascular disease. However, there was no evidence that ACE inhibitors or ARBs affected the risk of COVID-19.

[_Jersey Girl]

Also included are ACE1 inhibitors and ARB's.

See this, perhaps:

Renin–Angiotensin–Aldosterone System Blockers and the Risk of Covid-19

CONCLUSIONS
In this large, population-based study, the use of ACE inhibitors and ARBs was more frequent among patients with Covid-19 than among controls because of their higher prevalence of cardiovascular disease. However, there was no evidence that ACE inhibitors or ARBs affected the risk of COVID-19.

Trust me, I've read numerous articles and studies in progress. It's not about affecting the risk, it's about fending off the cytokine storm--tamping that process down.

[_Jersey Girl]

I read Science and Nature routinely, which obviously now have a lot of COVID material. A few of the people I've followed since the science-blog days have expertise in this area and I follow their conversation and reading suggestions. I don't have any expertise in epidemiology, immunology, or anything like that, but I do have a background in cell biology which helps me process information as it comes out more easily than the average person I suppose.

Okay, brain. ;-) Read up on the diffusion hypoxia and get back to us, please.

Some days, it feels like we're still in the "mysterious gay cancer" phase of this epidemic. You just sit back and marvel at how far we've got to go yet. There's so much we don't know.

As I see it, that's exactly where we're at right now. We're throwing stuff against the wall like pasta to see if anything sticks.