Categories: Health InformationMSK articles

Treating COVID-19

Note: This blog was written in 2020, and so much has changed since then, including the availability of medications and vaccinations for COVID. For the most up-to-date info about treatments for COVID-19, visit the Australia Government, Department of Health website.

At the moment there’s no treatment for COVID-19.

Wow, that was blunt. I probably should have eased you into it, but unfortunately that’s the truth. Regardless of what you may see on social media, or what a certain President might say at a press conference, we just don’t have a treatment for COVID-19 yet.

Doctors can treat many of the symptoms people are experiencing, but there’s no specific treatment for SARS CoV-2 (severe acute respiratory syndrome coronavirus-2), the virus that causes the disease we know as COVID-19. There’s also no specific treatment for the severe complications that some people experience which has led to thousands of deaths worldwide

The reason for this is that it’s a new virus, one we’ve never encountered before. That’s why it’s referred to as novel coronavirus – it’s brand new so we have no immunity to it.

We have nothing in our medicine cabinet specifically designed to deal with this virus. Antibiotics don’t work – because it’s a virus and antibiotics only work against bacterial infections.

What we do have in our favour are the efforts of the world’s scientific and medical community working tirelessly to find ways to safely treat this disease. We also have the work that was done at the time of the previous coronavirus outbreaks.

In 2003 we saw an outbreak of SARS (severe acute respiratory syndrome) and in 2012 we saw MERS (Middle East respiratory syndrome). These coronaviruses are closely related to SARS CoV-2.

While a treatment for SARS or MERS didn’t make it to large, human trials, there were promising results in labs tests, animal studies and small clinical trials. These drugs were some of the first to be studied for use in COVID-19.

Medications currently used to treat other conditions, for example hydroxychloroquine which suppresses an overactive immune system in people with lupus and rheumatoid arthritis (RA), are also being investigated. If we can repurpose an existing drug it’s hoped that we may have a treatment sooner rather than later.

So let’s have a quick look at some of the treatments being investigated

Anti-virals

Viruses, like the one that causes COVID-19, have only one job – to make more of themselves. They get into the cells of bacteria, animals and people, hijack them, and turn the cells into virus making factories.

Anti-virals stop them from making more copies of themselves.

Researchers are currently investigating several anti-virals including those used to treat viruses such as Ebola and HIV (human immunodeficiency virus).

There have been some early trials, using small numbers of people with COVID-19, that have had mixed results.

For example, remdesivir wasn’t effective against Ebola, but it had been effective against SARS and MERS in the lab and in animal studies. However we don’t yet have enough information to know if it will work in humans with COVID-19 or not.

Repurposing other drugs

As well as looking at ways to disable the virus and prevent people getting sick, researchers are also looking at medications we currently use for other conditions, to see if they’ll help people manage complications of the infection, especially those that affect the lungs and other internal organs.

The most widely talked about drug, hydroxychloroquine, works well to suppress the immune system in people with RA and lupus. However there’s limited evidence that it works for people with COVID-19. Trials are ongoing, including COVID SHIELD, a new trial being conducted at the Walter and Eliza Hall Institute in Melbourne.

Other drugs that suppress the immune system are also being investigated including the RA drug baricitinib.

The focus on immune suppression is to help manage the “cytokine storm” that some people with severe COVID-19 experience. This is when the immune system releases too much of an immune protein (cytokine) into the blood. This causes a high fever and inflammation, and in severe cases it can lead to multiple organ failure.

However there’s concern that treating people with an immune suppressing drug when their body is fighting an infection may be dangerous. We need more information from large, randomised controlled trials before we know if these drugs will help or harm people.

Other therapies

As well as going through our medicine cabinet and looking at old drugs to treat a new virus, researchers all over the world are looking at other ways to treat COVID-19.

They include plasma therapy, a process that involves taking the blood plasma from someone who’s recovered from COVID-19 and transferring it to someone who has the disease; stem cell therapy to treat people experiencing acute respiratory distress and the gene-editing technology CRISPR to find antibody targets for the disease.

These are just some of the innovative therapies that are being investigated to treat COVID-19.

Lots of work to be done

While a lot has been achieved in a short amount of time, we need to remember that with all of these trials we’re still very much in the early stages. We just don’t have enough data to know if the drugs or therapies work and if they’re safe.

We can feel confident though that the world’s scientific and medical communities are making great progress in their efforts to find safe and effective ways to treat COVID-19. But it will take time, both to come up with a vaccine and to find a treatment that we can produce in sufficient quantities to deliver on a global scale.

So we need to continue with our physical distancing, maintain good hygiene, stay active, eat well manage our mental health and follow the restrictions that are in place where we live. This will eventually pass, but it will take some time.