By Mr Murka
“According to health experts, the pipeline of drugs will play a crucial role in India’s fight against the novel coronavirus. They argue that Covid-19 vaccines would only provide immunity against severe disease or death. However, one can always catch an infection and could develop complications or long term side-effects from the disease”. Additionally, some people may not be able to generate an immune response despite taking vaccine shots. Others vulnerable groups such as the elderly, immunocompromised patients or those for whom vaccine jabs are not recommended are also at risk. Experts believe that covering 100 percent of the population with vaccines is highly improbable and having a treatment for coronavirus is “very important”.
“These first generation vaccines do not provide sterilising immunity as efficiently. They prevent severe infections. It means that some of those who are vaccinated may still get ill with mild disease, leading to other complications or causing long Covid,” said Dr Raman Gangakhedkar, former scientist at ICMR, adding that we are still learning more about long-term side-effects of Covid.
“Moreover, vaccine non-response is also seen in some people. Additionally, 100 percent vaccine coverage is a utopian goal. Therefore, there will always be some who are vulnerable to infection,” said Dr Gangakhedkar, an epidemiologist, who was the fa e of the Indian Council of Medical Research (ICMR) during government briefings on Covid-19 last year. The top scientist also urged preparedness for a scenario wherein a mutant strain immune to vaccine starts evolving and spreading. “The level of investment and interest in research and development of Covid-19 therapies has been lower than it should have been. One of the biggest risks in clinical trials on COVID-19 therapies is that once cases come down, many companies may not see a big market for further research and trials. That would be a mistake,” he said. Experts believe that the virus SARS CoV2 would stay with humanity and would keep causing Covid-19 at a relatively low rate.
“The results of the clinical study showed that viral load in mild, moderate, or asymptomatic patients after being given two doses of Umifenovir (800mg) twice a day, became zero in an average of five days. Patients did not experience any side effects and their symptoms also did not turn severe,” said the director. Studies conducted by CDRI in collaboration with CSIR-Institute of Microbial Technology (IMT), Chandigarh, showed that Umifenovir exhibits good cell culture inhibition of SARS-Cov2, suggesting that the drug inhibited the entry of SARS-Cov2 virus into human cells, Prof Kundu said.
Of 1180 patients with positive RT-PCRs and positive chest CT scans, 101 patients were finally included in the trial; 50 were assigned to receive IFNβ1a + hydroxychloroquine + lopinavir/ritonavir group and 51 were managed to treat with IFNβ1a + hydroxychloroquine + lopinavir/ritonavir + umifenovir Conclusions: Our findings shed new lights on the facts that additional umifenovir has not been found to be effective in shortening the duration of SARS-CoV-2 in severe patients and improving the prognosis in non-ICU patients and mortality
(Ed – So combination medication not always advised as better)
To date, there are no approved, selective coronavirus antivirals to treat or prevent infections. Even those vaccinated may not all be protected against infection and disease, in particular following infection with variants that are less susceptible to the current vaccines. Antivirals against SARS-CoV-2 will, at least when given early enough after a positive test or after onset of symptoms, reduce the chance to progress to (more) severe disease. In addition, such antiviral drugs will be useful to protect for example healthcare workers and high-risk patients in a prophylactic setting. Such drugs are also needed for the treatment of immunodeficient patients who do not mount a (sufficiently robust) immune response following vaccination. Since the de novo development and approval of (a) specific, highly potent antiviral(s) for SARS-CoV-2 may require years, the main focus for COVID-19 treatment in the current pandemic is to repurpose drugs that have been approved or in clinical trials for other diseases
Treatment with Molnupiravir (150 mg/kg BID) alone resulted in 1.9 (P<0.0001) and 1.3 (P=0.0002) log10/mg reduction in viral RNA and infectious virus loads respectively (Fig. 1B/C).
The combined treatment resulted in a reduction of 2.7 log10 of lung viral RNA titers (Fig. 1B), but interestingly, in a markedly enhanced reduction in infectious virus titers (>4.5 log10 TCID50 per mg lung, P=0.02, P=0.0005 as compared to Molnupiravir and Favipiravir alone, respectively) (Fig. 1C)
(Ed – But certain combinations are highly effective).