As the world battles the COVID-19 pandemic and races to engineer a vaccine, a plethora of pharmaceuticals have been touted by politicians and plastered across newspapers. But do any of them actually work?
Remdesivir
What is it?
Remdesivir is a broad-spectrum antiviral drug that is delivered intravenously. Once it enters the body, it interferes with the RNA-dependant RNA polymerase enzyme (RdRP). RdRP is an enzyme present in viruses that copies RNA strands from RNA templates. Remdesivir also instigates chain termination, an action that completely stops RNA synthesis. Without functioning RdRP, a virus is unable to copy its RNA—it cannot make more genetic code of itself.
Does it work?
Sometimes, sort of. Remdesivir has previously been used with varying effectiveness against Hepatitis C and Ebola. However, the data on its use in COVID-19 patients doesn’t look awesome. Some reports, such as one from the World Health Organization, showed virtually zero benefit to giving patients the drug. Other reports showed a reduction in recovery time, but not any reduction in mortality. That means that the drug speeds up recovery for patients that are recovering, but it doesn’t actually make a patient any more likely to survive in the first place.
Human Recombinant Soluble ACE2 (hrsACE2)
What is it?
hrsACE2 is basically a decoy ACE2 protein. ACE2 is a protein found in type II alveolar cells—the protein that the SARS-CoV-2 virus connects to in order to facilitate infection. hrsACE2 tricks the virus into binding to it instead of the actual alveolar cells (cells of the alveoli—in the lungs).
Does it work?
We don’t know yet. It has been shown to work in experiments on cells in a lab environment, but it has not actually been tested on people yet.
Hydroxychloroquine
What is it?
Hydroxychloroquine is a malaria drug. It tells certain cells to release interferons, a type of signaling protein. Interferons inhibit the activation of dendritic cells, which in turn helps to reduce the inflammation caused by the body’s immune response to a COVID-19 infection.
Does it work?
No. At first, it actually looked like it was effective though. At the same time that President Trump was touting the drug as a “miracle cure” for COVID-19, several small studies were released that indicated that the drug may actually be beneficial; the FDA issued an Emergency Use Authorization (EUA) in March, 2020. However, upon further review and larger studies, the drug has been found to be ineffective for the treatment of COVID-19; additionally, it can cause cardiac issues. The EUA was revoked in June, 2020. Both the FDA and NIH advise against the use of hydroxychloroquine for COVID-19.
Convalescent Plasma
What is it?
Convalescent plasma is the plasma (the liquid component of blood) from patients who have survived COVID-19. When a patient survives COVID-19, the antibodies that their body generates remain in the blood for a time after the infection has passed. When the plasma is transfused into a patient fighting COVID-19, the antibodies will be transferred and can help the new patient to fight the virus.
Does it work?
Probably. Anecdotal data supports its use in COVID-19 patients. Even though it has been granted an EUA by the FDA, the NIH COVID-19 Guidelines Panel claimed that “there are insufficient data to recommend either for or against the use of convalescent plasma for the treatment of COVID-19.” At this point, there have not been any studies large enough to offer legitimate support for the use of the plasma.
Dexamethasone
What is it?
Dexamethasone is a steroidal anti-inflammatory drug. It is commonly used in high-altitude mountaineering to treat high-altitude pulmonary edema (HAPE).
Does it work?
Only on some patients. It was found to reduce mortality by ⅓ in patients on ventilators in a study from New England Journal of Medicine; however, it was found to not help—and sometimes harm—patients with non-severe symptoms. The NIH now recommends dexamethasone only for patients on ventilators.
Blood Filtration Systems
What are they?
Blood filtration systems are machines that continuously filter patients’ blood. Cytokines, the molecules that are released by immune cells and cause inflammation, are filtered out. This can reduce the impact of cytokine storms.
Do they work?
We don’t know yet. At this point, there is not enough data to make an informed decision. However, these machines may also filter important things out of the blood, such as medications. For that reason, the risks may outweigh any potential benefits.
As you may have noticed, the answer to “does it work” is not “yes” for any treatments available at this time. That is because we don’t have anything that definitely works, is safe, and can be used widely. COVID-19 is dangerous, deadly, and difficult to manage. Stay distanced, stay safe, and stay healthy.