Covid-19: Is there any cure/treatment?

	Covid-19
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Covid-19: Is there any cure/treatment?
(as of May 2020)
First of all, these is a simply way to stop the pandemic. According to be a study by the Utrecht University in the Netherlands if we washed our hands regularly, wore masks, and kept our social distance from each other, the pandemic would go away even without a vaccine or treatments (paper).
That said, several tentative cures have been proposed.
France was the first country to authorize the use the anti-malarian drug hydroxychloroquine, a drug also widely publicized by Trump and Fox News in the USA, based on a study published on March 27 by Didier Raoult, but the study is controversial (see this article). But there are more and more signs that common medications like this one might worsen the disease's severity. On April 13 Brazil suspended a study because too many patients who were administered the drug developed serious heart problems that could have killed them, and in any case 13.5% of the patients died of covid-19. On April 16 a Chinese study found no benefits (quote: "no difference in the rate of viral load reduction or symptom alleviation between the group treated with hydroxychloroquine and the one that had not been"). On May 26 France banned the use of hydroxychloroquine to treat covid-19 after reports that it increases the chances of dying. On June 5 The University of Oxford ended a large trial of the antimalarial drug hydroxychloroquine after their study showed no benefit from the drug for covid-19 patients (announcement). On June 15 the FDA revoked emergency authorization of the antimalarian drugs hydroxychloroquine and chloroquine, deeming them useless and possibly harmful to treat covid-19. (The study by Mandeep Mehra at Harvard has been retracted so i don't mention it here).
On the other hand, on April 10 Gilead published the results of a test of remdesivir showing that this drug improved the conditions of 68% of critically-ill covid-19 patients in multiple locations of the world, but the drug is not approved for treating any disease. One week later Kathleen Mullane at the University of Chicago reported that 68% of patients cured with remdesivir improved.
A study in Hong Kong (carried out between February 10 and March 20 but published only on May 11) reported that a combination of three drugs (interferon beta-1b, lopinavir-ritonavir, and ribavirin) was successful in treating moderate cases of covid-19. At the end of April, the Norwegian biotech company BerGenBio began Phase II clinical trials of its oral drug bemcentinib at six British hospitals.
British biotech startup Synairgen is testing an inhaled treatment called SNG001 which is based on interferon beta, a substance which the body produces when it gets a viral infection.
Upi Singh at Stanford is testing interferon-lambda as a drug that could boost the immune system during the early stages of covid-19 infection.
On June 16 Oxford University announced a treatment for covid-19, the low-dose steroid treatment dexamethasone.
And there are many more drugs being tested for covid-19. Then there are different strategies to find a cure, notably the stem-cell strategy. At the end of February two Chinese teams reported success in using mesenchymal stem cells to treat covid-19 pneumonia ( a February 27 study in Yunnan province and a February 28 study at Beijing YouAn Hospital), and since then several startups around the world have been offering stem-cell treatments either to cure or to prevent covid-19 pneumonia On April 24, the biotech company Mesoblast reported an 83% survival rate in severe covid-19 cases treated with these stem cells at Mount Sinai Hospital since the end of March.
Meanwhile, a study by Gonzalo Otazu at the New York Institute of Technology, published on April 9, showed that people vaccinated against tuberculosis with the bacillus Calmette-Guerin (BCG) vaccine are less likely to die of covid-19, the first rational explanation of why the death rate is lower in South Korea and Japan (where that vaccination is mandatory). This followed a paper on April 6 by Mayda Gursel and Ihsan Gursel of the Middle East Technical University in Turkey that also points at low infection rates in the Philippines, Sri Lanka, Cambodia, Thailand, Vietnam and Nepal compared with Europe and the USA.
One possible treatment is via synthetic antibodies: identify the antibodies that fight the infection, manufacture them in a lab, and inject people with them. Antibody drugs are under development by Junshi Biosciences of Shanghai (the first ones to show benefits on infected monkeys), Eli Lilly (using antibodies made by Vancouver-based AbCellera), Regeneron, GlaxoSmithKline (using antibodies made by Vir Biotechnology, or, better, by its Swiss subsidiary Humabs BioMed), and Amgen (via Seattle-based Adaptive Biotechnologies). On May 15 Sorrento Therapeutics of San Diego announced that they have successfully tested in vitro an antibody called STI-1499 that protects from getting infected.
One key step towards developing drugs that neutralize the virus is to solve a scientific puzzle: the coronavirus is made of proteins, some of which are essential for the virus to replicate (the so-called "proteases"). Scientists in three continents are trying to discover the structure of these proteins and how to disable their action. See this article in Nature.
The easiest and fastest way to develop a treatment is to reuse something that we already know are safe and ready for human use. At the end of January, Haitao Yang's team at Shanghai Tech University in China published on the open-access Protein Data Bank the 3D structure of Mpro, the virus's main protease (without Mpro, there is no viral replication) and then they screened a library of more than 10,000 approved drugs and compounds that are already in clinical trials to check whether any would disable Mpro. Britain's synchrotron facility Diamond Light Source did the same thing in collaboration with the A.I. startup Exscientia, an Oxford spin-off.
We now have millions of infected people worldwide. Can we use their antibodies to make a treatment for everybody else? Arturo Casadevall at the Johns Hopkins Hospital published his paper advocating convalescent serum therapy in mid-March and the Chinese published the first study on convalescent plasma transfusion at the end of March.
We have a limited number of infected humans, but we have an unlimited number of animals that we could infect. Can we infect animals and then harvest the antibodies that they produce? Are these animal-made antibodies identical to the human-made antibodies? Are they safe to transfer to humans? Would this be an alternative to having a vaccine? Can antibodies be transferred from animals to humans? In early April the Chinese were able to infect ferrets, Emergent BioSolutions is trying with horses, in mid-May the University of Texas used a llama.
One trick to make sure that animal antibodies work also for humans is to genetically engineer them to produce the same antibodies for covid-19 that the human body produces. That's what SAB did: they genetically engineered cows to give them an immune system that's part human and the cows produced human antibodies for covid-19. These could then be turned into a drug for covid-19 patients.

See also:
Back to FAQ/ Q&A about Covid-19,
Data on Covid-19 and selected sources,
Covid-19: How it may change the World,
The Clown & the Virus,
The Clown & the Virus - Part 2,
Trump's Virus,
Sinophobia & Covid-19,
Sinophobia & Covid-19 in US Media,
Was covid-19 made in the USA? in China? TM, ®, Copyright © 2020 Piero Scaruffi All rights reserved.
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