COVID-19 medication update

A recent trial by the World Health Organization (WHO) has evaluated the use of four drugs to treat people who become ill with COVID-19.

The trial looked at four potential treatments:

• Remdesivir, an ebola drug
• Hydroxychloroquine, a malaria drug
• Interferon, an auto-immune drug
• Lopinavir and Ritonavir, a HIV drug combination

The study was a large-scale clinical trial looking at over 11,000 adult patients, from 500 hospitals in more than 30 different countries. The results from this trial suggest that none of the treatments had a large effect on the risk of somebody dying or on the time they spent in hospital.

In medical research, whenever a paper is published it must be peer-reviewed. This means that it is checked by other specialists who were not involved in the research or writing the paper. They make sure that the research was done well and that the researchers are not saying things that they do not have proof of. This paper has not yet been peer-reviewed, so we must be careful with the results. However, this paper is one of the largest to have looked at the effect of these treatments, so it could be a very important paper.

The findings are also different to the results from a trial by Remdesivir manufacturer, Gilead. Their final report from a trial on 1,000 people, published in October, concluded that Remdesivir could shorten the recovery time of people with COVID-19.

What other medication is currently being used?

Another drug that is now being widely used on COVID-19 patients is dexamethasone. This is a low-cost steroid that is used to treat a range of other conditions. The WHO advises to use this in severe and critical cases. Results from a trial in the UK found that the medication was effective for people receiving mechanical ventilation or oxygen, but not for people who were not receiving any breathing support.

What is next for research into COVID-19 treatments?

The WHO say that the next steps will be to look at a range of treatments including:

• monoclonal antibodies, which mimic our immune response,
• immunomodulators, which calm our immune system, and
• new anti-viral drugs that have been developed in the last few months.

Results from the WHO trial: https://www.who.int/news/item/15-10-2020-solidarity-therapeutics-trial-produces-conclusive-evidence-on-the-effectiveness-of-repurposed-drugs-for-covid-19-in-record-time

Results from the Gilead trial on Remdesivir: https://www.nejm.org/doi/full/10.1056/NEJMoa2007764?query=featured_coronavirus

Results from the trial on dexamethasone: https://www.nejm.org/doi/full/10.1056/NEJMoa2021436