Hope against COVID-19: Drug cuts deaths by a third and other findings

June 2020 MedicalNewsToday; Some have suggested that the U.S. is currently struggling with two pandemics at once. Although a simple vaccine cannot fix the racism pandemic, many scientists are actively working to tackle the ongoing COVID-19 crisis in their labs.

In this feature, we continue our series on hopeful scientific findings by rounding up the evidence available. Since we last wrote about scientific progress in the fight against COVID-19, many developments have taken place.

A mathematical model showed that the widespread use of face masks — even homemade ones — could slow the pandemic and prevent a second wave. Meanwhile, a new antibody test promises more accuracy, and a study has shown that the lockdown measures that authorities put in place prevented an additional 500 million infections — a staggering number.

Importantly, an analysis of more than 15,000 new coronavirus genomes from 75 different countries revealed that SARS-CoV-2 mutations do not strengthen the virus but are either neutral or detrimental to it.

The most heartening findings, though, are probably in the realm of potential treatments. From a duo of antiviral drugs that inhibits the virus to a common steroid drug that slashed deaths in a clinical trial and a cancer drug that may prevent severe inflammation, we explore potential new therapies for COVID-19 below.

First, we begin with the surprising benefits that an antibiotic may offer in the treatment of COVID-19.

Azithromycin: Why an antibiotic holds promise in the antiviral fight

Medical News Today has recently conducted an exclusive interview with Dr. Catherine Oldenburg, co-principal investigator in the ACTION trial.

The ACTION trial is “a nationwide trial in the U.S. that is designed to evaluate the efficacy of a single dose of azithromycin compared to placebo for [the] prevention of hospitalization in COVID-19 patients” who have either no symptoms at all or mild-to-moderate ones.

In the interview, Dr. Oldenburg explains why she and her team chose azithromycin, an antibiotic, to treat an infection with SARS-CoV-2.

The researcher notes that the choice of an antibiotic to treat a viral infection may seem counterintuitive, as antibiotics do not treat viruses. However, azithromycin is special in that it affects the immune system.

“[O]ne of the interesting things about azithromycin is that it has really strong immunomodulatory effects, so it has these […] nondirect effects on the immune system. That means it’s an interesting candidate.”

Previous studies have shown the drug to be effective against SARS-CoV-2 when in combination with hydroxychloroquine. However, because the latter raised great concerns about safety, and the FDA have retracted their emergency use authorization for it, the scientists decided to investigate the antibiotic on its own.

Furthermore, due to its excellent safety profile and extremely wide use, Dr. Oldenburg explains, azithromycin was perfect for including in an outpatient trial. The interview contains details about how to enroll in the trial.

Breakthrough: Drug slashes deaths by a third

A team of researchers from the United Kingdom recently announced that the common steroid drug dexamethasone drastically reduced deaths in a clinical trial of people with severe COVID-19.

Scientists at the University of Oxford led the trial, called RECOVERY, which involved testing six potential treatments for COVID-19, dexamethasone being one of them. Doctors commonly use dexamethasone to treat inflammation, allergic reactions, and immune-mediated conditions.

In the trial, the researchers compared dexamethasone treatment with standard of care in a group of severely ill COVID-19 patients who required ventilators or supplemental oxygen to breathe.

The 28-day mortality rate was one-third lower in the dexamethasone group.

Furthermore, the overall mortality rate was 17% lower in the dexamethasone group than in the control group.

Commenting on the findings, Duncan Young, a professor of intensive care medicine at the University of Oxford, said:

“The results are very robust due to the large number of patients recruited to the trial. The drug prevented one death in eight in ventilated patients, and one death in 25 in patients on oxygen.”

“Although this appears [to be] a relatively modest effect on outcome, for ventilated patients, the NNT (number needed to treat) of eight is better than almost any other intervention studied in patients on ventilators for any disease.”

Dr. Nick Cammack, COVID-19 Therapeutics Accelerator Lead at the Wellcome Trust in London, said:

“This is a major breakthrough: Dexamethasone is the first and only drug that has made a significant difference to patient mortality for COVID-19. Potentially preventing one death in every eight ventilated patients would be remarkable. Finding effective treatments like this will transform the impact of the COVID-19 pandemic on lives and economies across the world.”

“While this study suggests dexamethasone only benefits severe cases, countless lives will be saved globally,” added Dr. Cammack.

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