The Covid-19 pandemic has created significant chaos in society. Two years from when the pandemic first started and we are still struggling to deal with this virus, which has clogged our hospitals and stressed our healthcare workers to the limit. While several vaccines have been developed to prevent Covid 19, there remains a significant number of Americans who still remain unvaccinated. It is the unvaccinated individuals who remain at the highest risk for hospital admission and death. Unfortunately, even after the administration of the vaccines, the immunity appears somewhat short-lived, and recurrent breakthrough infections are still happening, but the symptoms are milder. Over the past several months, it has been observed that new variants of Covid-19 continue to appear. In any case, despite the vaccines, there is still an urgent need for drugs to help provide Covid-19 treatment.  The typical symptoms include respiratory distress, shortness of breath, confusion, heart dysfunction, muscle pain, and altered mental status. 

What Covid-19 Treatments are Available?

How are doctors treating Covid-19? To date, there are several types of drugs available to treat the symptoms of Covid-19. They each can be helpful at varying stages of the illness. There are anti-inflammatory drugs, antiviral drugs, and antibody therapy.

Anti-inflammatory Drugs

One of the oldest and very potent anti-inflammatory classes of drugs is corticosteroids. These agents have been used for over a century and can suppress chronic inflammation. Corticosteroids, including Dexamethasone, were one of the first drugs to be used to suppress lung inflammation in Covid-19 patients. They are often given to patients who have respiratory distress or are on a mechanical ventilator. Other anti-inflammatory drugs include hydrocortisone, tocilizumab, and sarilumab.  Corticosteroids can reduce the symptoms of Covid-19 and ease breathing. These agents are relatively inexpensive and readily available. The downside is that for the short term, the corticosteroids are safe, but they can have long-term adverse effects if the use is prolonged, which limits their usefulness.

How are doctors treating Covid-19?  Other than corticosteroids, there are several anti-inflammatory agents on the market as Covid-19 treatments, which include sarilumab and tocilizumab. These agents have been widely used in India, China, and Australia with some success in managing Covid-19 symptoms. The only downside is that they are many times more expensive than corticosteroids and not readily available. Plus, these agents can only be given by injection. At the moment, there is a severe shortage of these agents around the world. The anti-inflammatory drugs work best during the later phase of the Covid-19 treatment and are usually administered when the corticosteroids fail to work.

Anti-inflammatory drugs are used to suppress the body’s immune system from hyper-reacting. If the hyper-reaction is not countered, it can lead to damage to many other organs of the body with serious consequences. Anytime there is an infection, it initiates a cascade of inflammatory reactions that results in the release of potent chemicals from the body’s immune cells. These chemicals generally kill the foreign agent or infection. Usually, these chemicals have a very short half-life and are rapidly broken down by the body to prevent damage to the body tissues. But if there is a continuous release of these chemicals, it can also harm the body’s cells and tissues.

Antiviral Drugs

Antiviral drugs are used to stop or slow down the multiplication of the coronavirus within the body. These agents can help keep virus levels low, but do not affect the immune system. By keeping the levels of the coronavirus low, there is less work for the immune system to do. The two antiviral drugs to fight coronavirus include Paxlovid and Molnupiravir. 

Paxlovid is used orally twice a day for 5 days. Preliminary evidence indicates that it can reduce the rate of hospitalization and death by 89%. Molnupiravir acts similarly and stops the virus from multiplying in the body. It can also reduce the rate of hospitalization and death by about 50%. Note about Molnupiravir: The Indian Council of Medical Research (ICMR) has issued a statement about the use of this drug.  Clinical trials have yet to begin, and it is possible that the negatives associated with this drug could outweigh any positive benefits.  For these antiviral drugs to work as a Covid-19 treatment, they have to be taken as soon as the symptoms appear, preferably within the first 12 hours. Currently, there is a shortage of both these two agents, but, once available, they will be first distributed to low-income nations who can’t afford the vaccines. 

The antiviral drug Remdesivir is not as potent as the above two and it has only been shown to reduce the severity of symptoms in a few patients.  Remdesivir is a Covid-19 treatment given through a drip method and it is said that it can speed up the recovery time from Covid-19 symptoms.

Monoclonal Antibody Therapy

How are doctors treating Covid-19? Another approach to managing the symptoms of Covid-19 infection is through the use of antibody therapy, which is given through an infusion of antibodies. These antibodies are very similar to the naturally occurring antibodies in the body’s system. They bind to the surface of the coronavirus, which is then targeted by the immune system for destruction. The antibody therapy has proven to be the most effective remedy against coronavirus and can markedly reduce the symptoms and risk of death. The United States Federal Drug Administration (FDA) has already approved several monoclonal antibodies for emergency use, including Sotrovimab, Casirivimab, Ronapreve, and Imdevimab. Several small clinical trials have shown that these monoclonal antibodies are effective and safe. Once again, however, because of the large number of symptomatic patients, there is a global shortage of these drugs for antibody therapy for Covid-19 treatment.  Currently, these drugs are reserved for those most critically ill with the virus.

It must be emphasized that, unlike the vaccines, these drugs are used to manage the acute symptoms of the disease and are not widely used for prevention.

The big question that remains is whether these novel drugs will also work against the variants of the coronavirus. Because the monoclonal antibodies are made specifically for one virus, there is concern that new monoclonal antibodies will be needed if new variants continue to appear. However, early results show that these drugs have been holding up against the new variants of the coronavirus. The monoclonal antibodies need to be administered via injection, which may require a short stay in the hospital, which also increases the cost of care.

All the above therapies require a prescription from a healthcare provider, but there is no cost to the patients. 

Miscellaneous Drugs

There are other treatments available to manage the symptoms of Covid-19 and they include the following:

1. Ivermectin, which has been used to treat parasites and widely promoted globally, has not been fully proven to work.
2. Convalescent plasma involves taking plasma from survivors of Covid-19 and using it to treat other people with the infection. It does reduce symptoms but not death.
3. Several antimalarial drugs have been used to treat Covid-19 but solid data demonstrating their benefits are still lacking.

Who is Eligible?

Because of the serious shortage of these medications, high priority patients are usually given first preference and they include the following:

• Those over the age of 65
• Those living in long-term care facilities
• Those who are immunocompromised, have cancer, received an organ transplant, or are receiving cancer treatment
• Have HIV
• Have recently been treated with high dose corticosteroids or other immunosuppressive drugs
• Individuals with comorbidity, like COPD, emphysema, obesity, diabetes, cancer, stroke, kidney failure, liver disease, etc.

CONCLUSION

How are doctors treating Covid-19? For the most part, these Covid-19 treatments have been used to treat unvaccinated patients. Individuals who have been vaccinated tend to develop mild symptoms and rarely need these treatments. The recommendation is that all adults should be vaccinated as soon as possible because this reduces the risk of hospitalization and thus the need for these drugs is minimized.

At Cano Health, we stay up-to-date on all the latest treatments, developments, and therapies to help minimize Covid-19 symptoms and impacts from the virus.  Your good health is our priority.  Our mission is to offer healthcare solutions that will benefit you. Call 855.975.5119 today to learn more.