The global pursuit for the treatment that will end the COVID-19 pandemic is at utmost importance for everyone to recover back to normal. Developing a safe and effective vaccine would take 18 months to years. Now, world leaders aim to fast-track the development of any treatment by funding laboratories. In this series, we will follow the discoveries on possible treatments and actions taken to support scientists.
- Recovered patients’ plasma to aid severe COVID cases
While there is still no specific treatment for COVID-19, plasma of recovered patients are being utilized for mean-time treatment of severe or critical cases. Experts believe that the plasma of survivors may aid the recovery of the patients. This method has been utilized for over a century and has been used to treat H1N1, ebola, SARS, and other respiratory illnesses.
Convalescent plasma therapy depends on the fact that the body heals itself. Plasma is a liquid portion of the blood which contains mostly water and proteins.
The recovered patient’s plasma holds antibodies which can fight the SARS-CoV-2 virus which causes COVID-19. They must have the Immunoglobulin G or IgG antibody present in their plasma before donating.
Dr. Jonas del Rosario, spokesperson of the Philippine General Hospital (PGH), said in an interview with CNN that PGH has been practicing this kind of treatment regimen. They had used it in several patients, some became stable yet there was still no significant evidence that the treatment is proven effective.
Plasmapheresis and blood donation are two ways to extract plasma from donors. The former requires a machine to filter and separate plasma from the cells. For this, the cells will be retained in the blood of the donor afterwards. Meanwhile, plasma will be simply extracted from the blood in regular blood donation.
Further clinical trials in China, in the USA, and in India will test the efficacy of convalescent plasma therapy in treating COVID patients.
https://www.health.harvard.edu/diseases-and-conditions/treatments-for-covid-19
https://www.hss.edu/condition-list_prp-injections.asp
- Remdesivir antiviral clinical trials will end for worldwide access
Remdesivir, an antiviral drug, made headlines for being the pioneer drug to be approved by Japan and the United States for COVID-19 treatment. Early results show significant effects on the recovery and fatality rate of patients. However, the problem now is the distribution to the patients.
The antiviral will be globally available after clinical trials close at the end of May. Even before being publicly available, the demand for the treatment has been high since the US Food and Drug Administration (FDA) and Japan’s Ministry of Health, Labour and Welfare (MHLW) granted emergency authorisation earlier in May.
Gilead Sciences Inc. started the experimental trials for Remdesivir in April which included two studies: monitoring of both severe cases and moderate manifestations of COVID-19 to test the safety and efficacy of the drug. Approvals were met from the aforementioned departments after the success of the Phase III trial conducted by the U.S. National Institute of Allergy and Infectious Diseases.
Several studies show that Remdesivir has a significant effect in the treatment of COVID-19. From the preliminary results released last April 29, the studies by the US National Institutes of Health (NIH) concluded that it reduces 31% of hospital stays compared to placebo or a medical treatment with no therapeutic effect. Early analysis of data also showed that patients recover at an average of 11 days with Remdesivir and those with placebo recovered in 15 days. Furthermore, the death rate was lower with the drug, a notable 8%, compared to placebo, 11.6%.
Remdesivir is part of the nucleoside analogue class of antiviral agents which cease the reproduction of viruses. It ceases the reproduction of the virus by mimicking it’s ribonucleic acid (RNA) which carries genetic information of a cell. Viruses replicate using the host’s cells by assembling chains of RNA with RNA-dependent RNA polymerase or the enzyme catalyst for replication. The process will be stopped when the RNA polymerase detects the drug instead.
It had been tested for other illnesses and was proved successful. According to the World Health Organization (WHO), clinical testing with coronavirus-caused diseases such as Middle East Respiratory Syndrome (MERS-CoV) and severe acute respiratory syndrome (SARS) generated positive results. Additionally, it is commonly used to treat human immunodeficiency virus (HIV) infection, hepatitis B virus (HBV), and many more.
Now, the European Union aims to fast-track the distribution by possibly introducing the drug to the market despite the doubt in sufficient resources for worldwide need.
Sources:
https://www.ncbi.nlm.nih.gov/books/NBK548938/
https://www.gilead.com/purpose/advancing-global-health/covid-19/remdesivir-clinical-trials
- PH participates in global vaccine and treatment trials
World leaders cannot emphasize the importance of an effective treatment enough — it will bring us back to normal. Moving forward, the Philippines pledged to participate in the vaccine clinical trials in January 2021 and the Solidarity Trial of the World Health Organization (WHO).
The PH government guarantees participation in Phase 3 vaccine trials next year, according Health Undersecretary Maria Rosario Vergeire. President Rodrigo Duterte even specified the vaccine trial of United States biotech firm Moderna in his report last May 19, 2020.
Moderna reported promising data in their first clinical tests of an experimental vaccine against SARS-CoV-2 conducted on a small group of volunteers on May 18. Eight of the participants developed neutralizing antibodies similar to or exceeding the levels of naturally recovered patients from COVID-19.
The vaccine candidate named mRNA-1273 was “generally safe and well-tolerated” according to the makers’ website. These results were from their Phase 1 study in partnership with the US National Institute of Allergy and Infectious Diseases in March.
Meanwhile, the Department of Health (DOH) announced the engagement of the country in WHO’s Solidarity Trial last April 17 which had been approved by the Single Joint Research Ethics Board (SJREB).
The trials will be conducted in 20 hospitals nationwide. It includes four possible therapies for COVID-19 which includes antiviral Remdesivir, antimalarial drug Chloroquine or Hydroxychloroquine, antiretroviral drugs Lopinavir with Ritonavir, and Lopinavir with Ritonavir plus Interferon beta-1a.
Currently, WHO confirms that there are only six candidate vaccines for COVID-19 which may take 12 to 18 months to be made public.
Sources:
https://www.cnn.ph/world/2020/5/18/Moderna-covid-vaccine-trial-early-results.html
- Adapting infect-recover herd immunity still risky in any country
The hope in stopping the disease through herd immunity has been considered in countries such as Sweden and Britain. Governments and scientists said that herd immunity can contain the spreading of the SARS-CoV- 2 virus. Although no country is close to achieving herd immunity or mass immunity against the coronavirus considering that there has been no guarantee of immunity against reinfection and that Health Care Systems could handle the surge of cases.
Achieving immunity through mass infection and recovery, or vaccination is the simple concept of the herd immunity theory. Majority of the population, between 60% and 80%, should build immunity against the virus to cut the possibility of reinfection.
Sweden has been implementing relaxed measures against COVID-19, which means schools, restaurants, and parks are open. In Stockholm, Sweden’s capital, only 7.3% of the population developed antibodies to fight the virus by late April. Mr. Anders Tegnell, Sweden’s state epidemiologist, claims that the curve of Stockholm converted into a plateau within weeks of relaxed measures. Nevertheless, the low number of immunity against the virus disagrees with Mr. Tegnell’s statement.
In theory, herd immunity will slow down the infection rate by creating a resistance from an illness in the population. It also assumes that past infection will protect a person from being infected the second time. However, there is no accurate method for tracking the infected people and the contagiousness of the virus itself.
Adapting this may cause outbreaks and possible reinfection. Michael Mina, an epidemiologist at the Harvard T.H. Chan School of Public Health, said that there is no safe way to build up herd immunity since it may cause large outbreaks. In addition, the Philippines’ Department of Health (DOH) recorded a case of reinfection in Bicol. Bicol#34 had tested negative and was discharged on April 26. After 16 days, Bicol#34 was tested for the follow-up check-up which yielded a positive result.
Previous contagious diseases such as measles and polio required immunity in more than 80% of the population to attain herd immunity through mass vaccination. No recorded data confirms successful herd immunity by infection and recovery alone.
According to the World Health Organization (WHO), treatments and vaccines are estimated to be available in a year or longer.
Sources:
https://news.mb.com.ph/2020/05/15/bicol-records-covid-19-reinfection/
- Novavax develops 10th coronavirus vaccine in clinical trials
Maryland-based biotech company Novavax Inc. started Phase 1 of clinical trials for novel coronavirus vaccine candidate, NVX‑CoV2373, last May 26. They became the 10th company in human clinical trials and is expecting preliminary results in July.
The vaccine candidate produced high levels of neutralizing antibodies in the pre-clinical tests. Novavax’ statement suggests that it can be a protection against COVID-19 since it will be significantly immunogenic on humans.
Around 130 participants, ages 18-59, are enrolled for Phase 1 to evaluate the safety and effectiveness of the vaccine. Different doses of the vaccine will be administered – with and without adjuvant or a compound that can boost the immune response reaction of the participant.
The World Health Organization (WHO) listed 115 candidate vaccines in preclinical evaluation while 10 are in clinical trials as of May 27.
Moderna and BioNTech, companies also in clinical trials, use a new type of vaccine taking advantage of mRNA. These vaccines stimulate the body’s immune response through producing copies of coronavirus’ spike protein using mRNA.
In contrast with mRNA vaccines, NVX‑CoV2373 was generated from an established technology called a subunit vaccine. It directly emits copies of the spike protein into the body to stimulate an immune response. The virus’ spike protein is the key to attacking the virus for it is the primary binder to a receptor or an access to the human cell.
Novavax proposed to fast-track the manufacturing of the vaccine with the $388 million fund from the Coalition for Epidemic Preparedness Innovations (CEPI) in the intention to have supplies available if confirmed as an effective treatment for COVID-19.
If proven successful in the Phase 1 trials, a larger number of participants internationally will be tested for the safety, effectiveness and Covid-19 disease reduction capacity of the vaccine.
Sources:
https://www.cnn.ph/world/2020/5/26/another-covid-vaccine-enters-human-trials.html
Author
Stephanie de Jesus
Managing editor for Print Media
Probe editor
HiLites ASHS 