From existing antivirals to new antibody therapies – researchers are working tirelessly to find the best drugs to treat Covid-19.
What are the main approaches for Covid-19 treatments?
Oxygen Oxygen is one of the essential medicines for treating patients with Covid-19. As the SARS-CoV-2 virus attacks the lungs, it can cause pneumonia and hypoxaemia (a lack of oxygen in the blood). So for people hospitalised with Covid-19, oxygen therapy is lifesaving. But low- and middle-income countries face hurdles in getting oxygen to patients – it’s expensive, the equipment is not designed for use in low-resource settings, and the countries lack the infrastructure needed, such as electricity and transport networks. Wellcome is co-leading the Covid-19 Oxygen Emergency Taskforce with Unitaid to facilitate access to emergency oxygen in low- and middle-income countries. As well as making oxygen available where it’s needed, more treatment options are essential for treating people with Covid-19 everywhere. Researchers are taking a wide range of approaches to find effective and safe drugs. The three main approaches are: antivirals, anti-inflammatory drugs and antibody treatments. Antivirals Antiviral drugs work by preventing a virus from developing inside the human body. Every virus is different and attacks cells in specific ways, and the antiviral drugs that fight them off are specific too. Very rarely does an antiviral built for one virus also work for another. But it can happen: for example, some HIV drugs have also proved effective in fighting off hepatitis B. While several antivirals specific to Covid-19 are in clinical trials, finding one that works will take time. In the meantime, researchers are hopeful that some existing antivirals, whether already on the market or experimental, could have some useful effect against SARS-CoV-2. So far none of the existing antivirals under research have proved to work. Examples include:
Remdesivir, an antiviral tested as an Ebola treatment. Although it has been authorised for emergency use in some countries, the WHO Solidarity Trial showed that remdesivir does not reduce the risk of dying of Covid-19 or the length of time patients need to stay in hospital.
Hydroxychloroquine, a drug used to treat malaria and rheumatology conditions. After receiving high-profile attention in the media, the large-scale RECOVERY Trial showed that hydroxychloroquine has no benefit for hospitalised patients with Covid-19.
Lopinavir-ritonavir, a combination of antivirals used to treat HIV. The RECOVERY Trial showed it had no clinical benefit for Covid-19 patients.
These results were disappointing, but it's really important to know them, so researchers and clinicians can look at other potential treatments. Another drug that has been gaining visibility for its potential to treat Covid-19 is ivermectin – not an antiviral, but an anti-parasitic drug used to treat diseases caused by parasitic worms. The World Health Organization (WHO) recommends that ivermectin should not be used to treat Covid-19 outside of clinical trials because there isn’t enough evidence about its benefits. One such trial is Oxford's PRINCIPLE trial in the UK, which is looking to see if the drug helps people over-50 with Covid-19 symptoms.
How do we make Covid-19 treatments accessible to all?
Covid-19 has reached every corner of the world, and it will keep spreading unless it is controlled everywhere. To stop the pandemic, to get societies back to normal, and to get economies moving again, any treatments and vaccines must be made accessible to everyone who needs them, everywhere in the world, regardless of their ability to pay. For that to happen:
governments, industry and philanthropy must pool resources to pay for the risk, the research, manufacturing and distribution to ensure everyone has access to treatments
clinical trials need to take place across the world, to make sure treatments work for everyone
national governments must work together to ensure that coronavirus treatments can be manufactured in as many countries as possible and distributed globally to everyone who needs them.
Global collaboration is paramount for ensuring global access to treatments. To promote this, the ACT-Accelerator was launched. Through this collaboration, the World Health Organization, governments and international health bodies have pledged to make sure that any tools developed to fight the current pandemic – vaccines, diagnostics and treatments – will be distributed equitably to everyone who needs them. But more funding is needed to make the work of the ACT-Accelerator possible.
Credited to Welcome