A vaccination against a Sars-CoV-2 infection is far from foreseeable, and the planned tracking app is still missing. However, as long as the number of infections in large parts of the world such as the USA, Brazil or Russia increases sharply, there are many sick people who need medical help – often also in intensive care units. This sometimes overwhelms the health systems.
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It is all the more urgent that researchers worldwide are looking for drugs that can be used to treat the disease and, at best, to defeat it. The Ebola drug Remdesivir, for example, made headlines last week because those affected recovered faster after taking it. Shortly thereafter, the United States allowed the drug to be used in Covid 19 patients in hospital. The malaria drug hydroxychloroquine, however, is probably not effective against Sars-CoV-2.
Scientists in Hong Kong are now reporting that they have successfully treated Covid-19 patients with a cocktail of three other drugs. It has been shown that the combination of the different active ingredients in patients with a mild to moderate course of the disease quickly reduces the number of viruses in the body, writes the microbiologist Kwok-Yung Yuen in the study published by the specialist magazine “The Lancet” on Friday . However, it still has to be investigated whether this is also the case with seriously ill corona patients.
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Combination of drugs against HIV, MS and hepatitis
The study involved 127 corona infected people in six different hospitals in Hong Kong. 86 of them received the antiviral drug cocktail consisting of interferon beta-1b, which is used, among other things, to treat multiple sclerosis, the active ingredient combination lopinavir / ritonavir used for HIV, and the hepatitis drug ribavirin. The remaining 41 study participants only received the HIV drug lopinavir / ritonavir.
There was no placebo group as a control in the current study. However, a study published in the “New England Journal of Medicine” on Thursday showed that HIV medication did not offer any further advantage compared to standard treatment, which included oxygenation and other intensive care measures.
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In Hong Kong, therapy started on average five days after the patient first showed symptoms of Covid 19 disease. Doctors did not use triple therapy later than seven days after the onset of symptoms because interferon beta is known to have a so-called pro-inflammatory effect, which can even increase inflammation in the body. Who received which therapy was chosen at random, the authors state that they have no conflicts of interest.
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No virus detection five days earlier
In the study participants treated with the drug combination, the nasopharyngeal smears on the coronavirus were negative on average after seven days. According to the study, this took an average of twelve days in the control group. However, this does not prove that the viruses have also disappeared from the body. However, with the help of the drug cocktail, the symptoms of the disease also disappeared after an average of four days, twice as fast as with the other patients.
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According to the authors, there were only minor side effects in both groups. These included nausea and dizziness. According to the report, the symptoms resolved on their own. However, there was one exception: In the control group that only received the HIV drug, one subject had liver inflammation. Because hepatitis is a known, common side effect of the drug, the patient had to stop the therapy.
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The study provides “early but important” knowledge, the authors write. However, the problem was that a placebo group was missing as a control. In addition, further clinical tests with more participants are important to confirm the success of the therapy.
The study also provides no information as to whether the combination of medications also helps patients with a severe course. For them, effective treatment would be particularly important both for individual recovery and for relieving the burden on the health system.
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Whether it is advisable to use triple therapy for mild courses, which – even if there were only a few side effects in the current study – also has undesirable consequences must be considered. An effective therapy has therefore not been found with this examination either, but one of many important steps on the way there has already been done.
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