Why is COVID-19 so hard to treat? Growing evidence points to unique infectious profile

Press release:

A comprehensive review into what we know about COVID-19 and the way it functions suggests the virus has a unique infectious profile, which explains why it can be so hard to treat and why some people experience so-called “long-COVID”, struggling with significant health issues months after infection.

There is growing evidence that the virus infects both the upper and lower respiratory tracts – unlike “low pathogenic” human coronavirus sub-species, which typically settle in the upper respiratory tract and cause cold-like symptoms, or “high pathogenic” viruses such as those that cause SARS and ARDS, which typically settle in the lower respiratory tract.

Additionally, more frequent multi-organ impacts, and blood clots, and an unusual immune-inflammatory response not commonly associated with other, similar viruses, mean that COVID-19 has evolved a uniquely challenging set of characteristics.

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Aspirin use may decrease ventilation, ICU admission and death in COVID-19 patients

George Washington University researchers found low dose aspirin may reduce the need for mechanical ventilation, ICU admission and in-hospital mortality in hospitalized COVID-19 patients. Final results indicating the lung protective effects of aspirin were published today in Anesthesia & Analgesia.

“As we learned about the connection between blood clots and COVID-19, we knew that aspirin – used to prevent stroke and heart attack – could be important for COVID-19 patients,” Jonathan Chow, MD, assistant professor of anesthesiology and critical care medicine and director of the Critical Care Anesthesiology Fellowship at the GW School of Medicine and Health Sciences, said. “Our research found an association between low dose aspirin and decreased severity of COVID-19 and death.”

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New trial finds arthritis drug no better than standard care for severe covid-19

Adding the arthritis drug tocilizumab to standard care for patients in hospital with severe or critical covid-19 is no better than standard care alone in improving clinical outcomes at 15 days, finds a new trial published by The BMJ today.

There was an increased number of deaths at 15 days in patients receiving tocilizumab, resulting in the trial being stopped early.

Today’s results contradict earlier observational studies suggesting a benefit of tocilizumab. However, observational effects are limited by a high risk that they may be due to other unknown (confounding) factors – and some studies have not yet been peer reviewed or published in a medical journal.

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Smoking associated with increased risk of COVID-19 symptoms

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Smoking is associated with an increased risk of COVID-19 symptoms and smokers are more likely to attend hospital than non-smokers, a study has found.

The study published today in Thorax, by researchers from King’s College London, investigates the association between smoking and the severity of the COVID-19.

Researchers analysed data from the ZOE COVID Symptom Study App. Of the participants of the app, 11% were smokers. This is a lower proportion than the overall UK population of 14.7%, however, it reflects the demographics of the self-selected sample of the ZOE COVID Symptom Study.

While more than a third of users reported not feeling physically well during the period of study (24th March and April 2020), current smokers were 14% more likely to develop the classic triad of symptoms suggesting diagnosis of COVID-19: fever, persistent cough and shortness of breath – compared to non-smokers.

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New virtual screening strategy identifies existing drug that inhibits Covid-19 virus

Colorized scanning electron micrograph of an apoptotic cell (pink) heavily infected with SARS-COV-2 virus particles (green), isolated from a patient sample. Image captured at the NIAID Integrated Research Facility (IRF) in Fort Detrick, Maryland.

Press Release:

A novel computational drug screening strategy combined with lab experiments suggest that pralatrexate, a chemotherapy medication originally developed to treat lymphoma, could potentially be repurposed to treat Covid-19. Haiping Zhang of the Shenzhen Institutes of Advanced Technology in Shenzhen, China, and colleagues present these findings in the open-access journal PLOS Computational Biology.

With the Covid-19 pandemic causing illness and death worldwide, better treatments are urgently needed. One shortcut could be to repurpose existing drugs that were originally developed to treat other conditions. Computational methods can help identify such drugs by simulating how different drugs would interact with SARS-CoV-2, the virus that causes Covid-19.

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New clinical trial to test whether structured exercise benefits ‘long Covid’ patients

Researchers at the University of Warwick and University Hospitals Coventry and Warwickshire (UHCW) NHS Trust in the UK to investigate whether a tailored online exercise and support programme would benefit those experiencing long-term symptoms of Covid-19

Press Release:

  • One of the first clinical trials to investigate treatment for the long-term symptoms of Covid-19 to be led by University of Warwick and University Hospitals Coventry and Warwickshire NHS Trust
  • Researchers are to pioneer a tailored and supervised online exercise and support programme for those experiencing what has been dubbed ‘long Covid’
  • Previous research on similar diseases such as SARS has shown some benefit of exercise rehabilitation for patients

Researchers at the University of Warwick and University Hospitals Coventry and Warwickshire (UHCW) NHS Trust in the UK are to investigate whether a tailored online exercise and support programme would benefit those experiencing long-term symptoms of Covid-19 – what has been dubbed ‘long Covid’.

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Baricitinib plus Remdesivir shows promise for treating COVID-19

This colorized transmission electron micrograph shows a SARS-CoV-2 virus particle, isolated from a patient.

Press release:

The combination of baricitinib, an anti-inflammatory drug, and remdesivir, an antiviral, reduced time to recovery for people hospitalized with COVID-19, according to clinical trial results published in the New England Journal of Medicine. The study was supported by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.

The clinical trial is the second iteration of the NIH Adaptive COVID-19 Treatment Trial (ACTT-2), a study protocol to evaluate therapeutics for people hospitalized with COVID-19. Remdesivir is a broad-spectrum antiviral treatment developed by Gilead Sciences, Inc. Baricitinib was discovered by Incyte and licensed to Eli Lilly and Company, and marketed under the brand name Olumiant. It is approved in more than 70 countries as a treatment for adults with moderately-to-severely active rheumatoid arthritis. Researchers hypothesized that because many severe symptoms of COVID-19 are caused by a poorly regulated inflammatory response, a therapeutic designed to target inflammation could be helpful for patients. The primary results of this study were first announced in September.

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Genes could be key to new COVID-19 treatments, study finds

Press release:

Potential treatments for Covid-19 have been identified after the discovery of five genes associated with the most severe form of the disease.

Genetic evidence is second only to clinical trials as a way to tell which treatments will be effective in a disease. Existing drugs that target the actions of the genes reveal which drugs should be repurposed to treat Covid-19 in clinical trials, experts say.

Genes involved in two molecular processes – antiviral immunity and lung inflammation – were pinpointed. The breakthrough will help doctors understand how Covid-19 damages lungs at a molecular level.

Researchers from the University of Edinburgh made the discovery by studying the DNA of 2,700 patients in 208 intensive care units (ICUs) in the UK.

Researchers from the GenOMICC consortium – a global collaboration to study genetics in critical illness – compared the genetic information of Covid-19 patients in ICU with samples provided by healthy volunteers from other studies, such as UK Biobank, Generation Scotland and 100,000 Genomes.

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