Rezilir Health is Open
GENERAL INFORMATION
There was a fair amount of internet-related controversy on the overview of COVID-19 information we linked to on Saturday morning and by Sunday morning, Medium had taken the feed down. We will find a good general overview in a subsequent update.
PHARMACOLOGIC TREATMENT OPTIONS
Hydroxychloroquine
- There are a number of US clinical trials that are emerging to study hydroxychloroquine. The first clinical trial is for medical professionals/workers (University of Minnesota sponsored) – send an email to covi19@umn.edu. The second study will be run by NY state for patients, further details are to come.
- The University of Washington added hydroxychloroquine to its internal treatment guidelines
- The Chinese studies have looked mainly at chloroquine. There is an in vitro study (Yao – see footnote) comparing the two showing that hydroxychloroquine can get better inhibitory studies. Clinically we consider both of these medications to be relatively equivalent.
- The French government is setting up a new trial to expand work on the abstract from France discussed earlier this week that showed a successful reduction in COVID 19 load with azithromycin and hydroxychloroquine.
Kaletra
- The NEJM study looked at Keletra (ritonavir/lopinavir) and concluded that the medication had no effect on survival. The quality of the study was good. More research needs to be done and will be done.
NSAIDS
There are reports from Europe that NSAIDs may exacerbate virus progression. We are looking into this but in the meantime recommend Tylenol (Acetaminophen).
Angiotensin 2 Blockers
- Initial data is conflicting on whether ARBs could help or hurt patients; at this point, patients should remain on ARBs
Favipiravir
The Japanese made flu drug was reported in the Guardian to be effective in reducing the duration of COVID-19 virus in patients and improve long conditions of those who received treatment. (Awaiting link to study) Tocilizumab an anti-inflammatory was reported by the Chinese to have improved results in an observational, non-randomized study.
One clear risk that is emerging across all age groups are co-morbidities – particularly insulin resistance, chronic inflammation, and immune issues. These are all issues we have tried to address. We remain optimistic that new therapeutic options will rapidly emerge to help patients and medical workers with treatment options for COVID-19.
Clinical Footnotes. 1. Yao et al 2020. In Vitro Antiviral Activity Hydroxychloroquine https://doi.org/10.1093/cid/ciaa237
2. Cao et al 2020 Lopinar-Ritonavir https://www.nejm.org/doi/full/10.1056/NEJMoa2001282?query=recirc_curatedRelated_article
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