At the onset of the COVID-19 pandemic, the World Health Organization (WHO) approved four promising therapies for large-scale clinical trials across the globe against COVID-19. These four therapies were, the anti-malarial drugs, Chloroquine/Hydroxychloroquine, Remdesivir, Lopinavir/Ritonavir (HIV drugs) and Interferon-beta (an immune system messenger that can cripple viruses). Over the past few months, several other therapies in the form of drugs, vaccines and herbal remedies have also been proposed and recommended to combat the coronavirus; and some of them are currently undergoing clinical trials. Although there is currently no certified cure or preventative remedy for the coronavirus disease, the Milken Institute reports that there are at least 223 treatments and 141 vaccines being developed to combat the virus and end this pandemic.
REMDESIVIR – drug
REMDESIVIR was produced by Gilead Sciences Inc., a pharmaceutical company based in the US. It was initially developed against the deadly Ebola virus, but was adopted as a potential COVID-19 therapy because it had shown success with other coronaviruses, like the SARS (severe acute respiratory syndrome) and MERS (Middle East respiratory syndrome) viruses.
A clinical trial by the US National Institutes of Health (NIH) has shown that Remdesivir, which acts by preventing the multiplication of the virus in human cells, significantly improves recovery in COVID-19 patients, and lowers the average number of days required for recovery (from 15 to 11). Although, the United States Food and Drug Administration (FDA) has approved the drug for the treatment of people who show severe symptoms of COVID-19, further clinical trials would provide more information about this drug, and determine whether it would be certified as safe and effective for public use.
CHLOROQUINE/HYDROXYCHLOROQUINE – drug
CHLOROQUINE, and its analog, HYDROXYCHLOROQUINE are popular anti-malarial drugs which have been used for long to combat malaria, as well as autoimmune diseases. In Nigeria, the National Agency for Food and Drug Administration and Control (NAFDAC) revealed its plans for large scale clinical trials on these drugs few days after the country recorded her first case in February. Few days after this announcement, several cases of Chloroquine/Hydroxychloroquine poisoning from self-medication were recorded across the country, and more would be recorded in the weeks that followed.
However, results from a recent research reported in the journal, Lancet, suggest that the use of these drugs to combat COVID-19 may be causing more harm than good. Results from this large scale clinical trial show that whether acting alone, or in combination with other drugs, Chloroquine/hydroxychloroquine were responsible for higher mortality (death) as well as irregular heart beats (arrhythmia) in COVID-19 patients . Consequently, WHO has withdrawn its earlier approval on the use of these drugs to combat COVID-19, and halted ongoing clinical trials on the drugs. Meanwhile, these drugs have been in use in Nigeria, especially for COVID-19 patients who show mild symptoms, but it is expected that with new developments, the Federal Ministry of Health would follow WHO’s recommendations.
LOPINAVIR/RITONAVIR – drug
Lopinavir and Ritonavir are therapeutic combinations originally designed against HIV, the virus that causes AIDS. They have shown success against other strains of the coronavirus, but current research reported in the New European Journal of Medicine (NEJM) has shown that they do not offer any significant benefit to COVID-19 patients, especially in comparison with standard healthcare routines.
ASPIRIN/IBUPROFEN – drug
These are anti-inflammatory drugs that may be used to treat coronavirus symptoms. Although, WHO initially advised against their use to treat COVID-19, they are now considered safe and effective in most adults. Children and teenagers should not take aspirin due to its risk of causing a life-threatening condition, characterised by liver and brain damage: Reye’s syndrome.
TOCILIZUMAB – drug
According to the World Economic Forum (WEF), this drug has been used in patients with rheumatoid arthritis; it has also been used to reverse ‘cytokine storm’ in cancer patients. Cytokine storm is a term coined to describe overreactions from the immune system that are often detrimental to an individual, and is also a common cause of severe organ damage and death in COVID-19 patients. Clinical trials on this drug focus on COVID-19/Cancer patients.
SARILUMAB – drug
Just like tocilizumab, sarilumab also targets cytokine storm in COVID-19 patients. It has been used to combat inflammatory arthritis (WEF).
RUXOLITINIB – drug
Ruxolitinib treats inflammatory and autoimmune diseases linked to cytokine storms. Clinical trials on this drug are underway, and test for its effectiveness in COVID-19 patients with severe respiratory symptoms associated with cytokine storms (WEF).
CONVALESCENT PLASMA – non-pharmaceutical intervention
The use of convalescent plasma, that is, blood plasma from individuals who recover from a disease, to combat the disease in sick patients has been in existence for over 100 years. It is readily available, quite safe, and comes with very little risk of harm or side effects. Several clinical trials have shown the effectiveness of convalescent plasma in combating COVID-19 in very sick patients. Although, health practitioners argue that earlier treatment could yield better results, the FDA currently approves the use of this therapy in only severely sick individuals. Convalescent plasma function more or less like vaccines in stimulating the immune system to produce antibodies against a disease. However, whereas vaccines do not contain ready-made antibodies, convalescent plasma does. Its effectiveness is closely linked to how much antibodies the donor produces in his blood.
COVID-ORGANICS – herbal remedy
The herbal remedy from Madagascar which has been under scrutiny by international health organizations, has finally been approved for large scale clinical trials supported by WHO. COVID-Organics is made from the well known sweet wormwood plant, Artemisia annua, used in the manufacture of antimalarial drugs. It has also been adopted by several countries – both within and outside of Africa – as a treatment regimen for COVID-19. Here in Nigeria, pending the arrival of COVID-Organics, the Federal Ministry of Health has declared its plan to begin clinical trials on some locally sourced herbal remedies against COVID-19.
Vaccines help our immune system fight diseases by infecting us with a less severe form of a disease. They are generally effective and safe for use, but may be unsafe in individuals of a particular age group or those suffering from a disease. Vaccines are produced from weakened forms of a disease pathogen, its genetic material or some of its parts, and often take a long time before they are approved for public use. Common COVID-19 vaccines include: BCG (tuberculosis vaccine), ChAdOx1, AD5-nCov and Lentiviral Minigene Vaccines (LV-SMENP) (WEF).