What medications are being used to treat COVID-19?

September 17, 2020 | by Edward-Elmhurst Health
Categories: Healthy Driven Life

With the number of people infected by the novel coronavirus (COVID-19) rising every day, scientists are working around the clock to find ways to effectively treat the virus.

Since antibiotics don’t work against viruses, the body’s immune system must typically fight them off until they run their course. This is challenging when symptoms become severe, as in some cases of the novel coronavirus.

This is a complex disease process; it is a new virus that we have only known about for less than a year. While new medicines are being developed to fight COVID-19, doctors are currently relying on a range of existing medicines to treat infected patients.

In October 2020, the Food and Drug Administration (FDA) approved the use of antiviral drug remdesivir as a treatment for people age 12 and older who are hospitalized for COVID-19.

Doctors had been using remdesivir since May, when the FDA granted an emergency use authorization (EUA) for the drug. This is a mechanism the FDA uses to allow medications to be used in emergency situations because they have shown some benefit and good safety data.

“The Food and Drug Administration’s approval of remdesivir for the treatment of COVID-19 is a great accomplishment. We are encouraged with having this medication in our tool kit to help treat patients with COVID-19 infections. The other medications are being used based on our clinical experience with treating this disease as well as experience with treating other diseases. Immune modulators, corticosteroids and anticoagulants, along with remdesivir, are assisting patients with their recovery,” says Phillip Williams, Pharm.D., MBA, Associate Vice President of Pharmacy Services for Edward-Elmhurst Health.

The FDA rescinded the EUA for hydroxychloroquine in June 2020 due to lack of efficacy against the virus and safety concerns, especially cardiovascular safety.

An EUA for COVID-19 convalescent plasma was granted in August 2020. Because the FDA has not approved convalescent plasma as a treatment for COVID-19, it is regulated as an investigational product. Patients previously infected by COVID-19 and recovered may have antibodies that could be transferred to sick patients via plasma transfusion.

If you have had COVID-19 and recovered, you may want to consider donating your plasma so that others may use it and potentially have a more positive outcome from the disease. You can contact your local blood collection center for instruction on how to give.

The current methodology to treat COVID-19 involves using antiviral medications, anti-inflammatory medications and immune system modulators, including remdesivir, glucocorticoids and tocilizumab.

There are also investigational drugs for COVID-19 being studied in clinical trials underway across the globe.

“New information is being disseminated daily. This new information is constantly being reviewed and evaluated to determine if and when we should incorporate new medications into our treatment decisions and when we should alter what is currently being done,” says Williams.

Current treatment for mild to moderate COVID-19 symptoms may include supportive care such as hydration (IV fluids), pain and fever control, and breathing treatments. Sometimes antibiotics are used to treat concurrent bacterial infections.

There is some information cautioning patients about taking non-steroidal anti-inflammatory medications, such as ibuprofen (Motrin) and naproxen (Aleve). This information has not been studied or confirmed and therefore, it is difficult to make a recommendation. Acetaminophen (Tylenol) is an effective medication for mild pain and fever control.

Patients with more severe symptoms are typically admitted to the hospital and treated with various medications to slow the progression of the disease and relieve symptoms. Some patients need supplementary oxygen and mechanical ventilatory support.

Techniques such as proning (having patients lay on their stomach), as well as the addition of glucocorticoids, such as dexamethasone and blood thinners (heparin), have helped our patients recover quicker. Patients who develop clotting complications as a result of the virus may receive blood thinners.

“There are some potential new medications on the horizon that we are keeping a close eye on with the hope that they prove to be safe and effective against this disease,” says Williams. “We have learned a great deal about how to optimally treat patients with severe disease and incorporated new techniques and medications that have had a very positive effect on recovery and reduced mortality.”

Many are wondering when a vaccine to prevent COVID-19 will become available.

“While it typically takes years to safely develop, produce, market and distribute a new vaccine, we are encouraged with the number of vaccine and pharmaceutical companies that have produced a vaccine and are currently testing it in large numbers of people all over the world. We are encouraged that all of the usual and customary safety data is being collected and tabulated for submission to the FDA for review and potential approval for use. The FDA has stated publicly that they will require all of the necessary data before they review any potential vaccine to ensure that vaccine is effective and safe,” says Williams.

What is unique about this vaccine discovery process is that the United States government, through Operation Warp Speed, is providing financial support to vaccine manufacturers to begin producing vaccine before it is approved. Therefore, when a vaccine is approved, some quantity of vaccine will be immediately available.

“We’re hopeful that there will be a limited amount of approved vaccine available by the end of the calendar year,” says Williams.

The U.S. government and Operation Warp Speed, via the Centers of Disease Control and Prevention, will work with individual state health departments, who in turn will work with local county health departments, on the distribution and administration of the vaccine.

“It is reasonable to think that when vaccine first becomes available that it will be reserved for frontline healthcare personnel, first responders and those individuals deemed to be high-risk. Other groups of individuals may also be included in this first phase depending on how much vaccine is available. As time goes on, more vaccines will potentially be approved for use and additional manufacturing will occur, which will result in larger groups of people receiving the vaccine,” says Williams.

It is all dependent on when a vaccine(s) is/are approved, how many are available, and how quickly more vaccines can be produced. No one has a crystal ball and all of this is dependent on the clinical trials of the various vaccines and the timing of FDA approval.

In the meantime, doctors continue to emphasize the importance of infection prevention and control measures to slow the spread of the virus.

“We have been predicting a surge of coronavirus infections as we move from summer to fall and winter.  We are seeing the beginning of this surge now in our communities and it is impacting our healthcare systems and hospitals. We are seeing more patients hospitalized now compared to the previous couple of months,” says Williams. “To keep yourself, your family and your friends healthy, please continue to social distance, wash your hands, and wear a face mask to prevent the spread.”

It is important to note that treatment information is changing daily, and medications are being added and removed based on evolving experience and information about COVID-19.

Fortunately, most people who become ill with COVID-19 will be able to recover at home. However, if you begin to experience more severe symptoms, such as an elevated fever, shortness of breath and/or trouble breathing, seek immediate medical attention.

At Edward-Elmhurst Health, our top priority is the safety and protection of patients, staff, physicians and the community. For updates on our planning and response efforts as we work to stop the spread of COVID-19, please check EEHealth.org/coronavirus.

The information in this article may change at any time due to the changing landscape of this pandemic. Read the latest on COVID-19.

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