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With COVID-19 cases on a sharp rise the world over, researchers and scientists are in a race against time to develop drugs that can stop the disease. The new coronavirus infection, caused by severe acute respiratory syndrome coronavirus 2 or SARS-CoV-2, was first seen in late 2019.

According to the World Health Organization (WHO), over a dozen clinical trials have commenced in a global effort called the Solidarity Project to find a treatment that can control the spread of the disease that has overwhelmed several countries.

"There is no specific medicine recommended to prevent or treat the new coronavirus," the WHO had said, according to the Washington Post. "Some specific treatments are under investigation, and will be tested through clinical trials."

Four of the drugs being tested have been used to fight other life-threatening conditions such as HIV/AIDS, malaria, ebola as well as previous outbreaks caused by strains of coronaviruses, like severe acute respiratory syndrome (SARS) and Middle-East respiratory syndrome (MERS).

  1. WHO's Solidarity initiative against COVID-19
  2. Multiple drugs on trial to fight COVID-19
  3. Urgency to develop vaccines and treatment

The WHO announced the Solidarity trials on 18 March 2020 to encourage countries the world over to begin testing and come up with novel ideas and treatment methods to counter the spread of COVID-19. According to WHO Director-General Tedros Adhanom Ghebreyesus, instead of multiple smaller trials to find a coronavirus treatment, a combined effort towards a comprehensive study in an effort to test and come up with treatment methods was the need of the hour.

Along with countries like Thailand, Argentina, Bahrain, Canada, France, Iran, Norway, South Africa, Spain and Switzerland, India has also joined in the effort. "In order to look at the newer drugs that might come, we are also likely to start our participation in the solidarity trial that WHO is starting," R.R. Gangakhedkar, chief epidemiologist of the Indian Council of Medical Research (ICMR), had said.

Remdesivir (first developed to fight ebola), malaria medicines chloroquine and hydroxychloroquine, anti-HIV drugs Ritonavir and Lopinavir and Ritonavir/Lopinavir with interferon beta have been put forward for testing, as various cases of their use were found to be successful at different stages of treatment. 

In fact, the export of hydroxychloroquine, sold under the brand name Plaquenil among others in India and used in the treatment of malaria, was earlier stopped to cater to the shortages appearing in India. Cipla, the Indian pharmaceutical giant, is among the manufacturers developing drugs for clinical trials, along with major pharmaceutical companies from Europe and other parts of the world.

European pharma giant Discovery has begun trials in countries including France, Spain, Germany and the UK, many of which have been ravaged by the spread of the disease in recent weeks. Another company, Roche, has put forward its arthritis drug Actemra as it has been successful in treating COVID-19 induced pneumonia in initial testing.

The need to create a treatment rapidly has been due to the alarming rise in the number of cases around the world. But for drugs to be approved, they have to undergo several weeks of trials, first on animals and then on humans, the latter of which is getting underway. It is estimated that at least 15% of those who get COVID-19 become very ill - it is these people, along with the medical staff of hospitals who are exposed to infection, who need these drugs the most.

Instead of having to develop compounds that curb the spread of the virus from scratch, which would have been time-consuming, researchers chose to repurpose drugs used to treat other diseases. One or all four of these drugs could be used for treating the patients in different stages of illness in a coordinated global effort for randomized trials.

The development comes following several studies that have suggested the type of drugs that have already been approved for use in the United States. Testing also includes using antibody-rich plasma from patients who have already recovered from COVID-19.

Chinese researchers had managed to share the genetic code of the virus, SARS-CoV-2, with the global scientific community as early as January 2020. This allowed scientists to rapidly develop vaccines for human trials to begin in earnest. Biotechnology company Moderna has already begun testing its experimental vaccine on healthy volunteers, while a China-based biotechnology firm has also put its vaccine forward for human trials.

The development of these vaccines and drugs has come in record time, thanks to the early genetic code-sharing among the scientific community, as compared to previous outbreaks of SARS and MERS. During the ebola outbreak in 2014, precious time was lost in holding clinical trials.

Although the number of cases has plateaued in China, positive cases have seen a rapid rise in countries like the United States, Italy, Spain and Iran, with Italy reporting the most number of deaths caused by COVID-19. The coming together of the scientific community from the world over to battle this crisis has been unprecedented, as have the curbs and restrictions on the movement of people all around the world.

Medicine NamePack SizePrice (Rs.)
AlzumabAlzumab Injection6995.16
AnovateANOVATE OINTMENT 20GM90.0
Pilo GoPilo GO Cream67.5
Proctosedyl BdPROCTOSEDYL BD CREAM 15GM66.3
ProctosedylPROCTOSEDYL 10GM OINTMENT 10GM63.9
RemdesivirRemdesivir Injection15000.0
Fabi FluFabi Flu Tablet3500.0
CoviforCovifor Injection5400.0
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References

  1. Learning from SARS: Preparing for the Next Disease Outbreak: Workshop Summary. Knobler S et al. Coronavirus Research: Keys To Diagnosis, Treatment, And Prevention Of SARS National Academies Press (US); 2004. NBK92477.
  2. Cortegiani A et al. A systematic review on the efficacy and safety of chloroquine for the treatment of COVID-19. Journal of Critical Care. 2020 Mar 10. (Epub) PMID: 32173110.
  3. Lescure F et al. Clinical and virological data of the first cases of COVID-19 in Europe: a case series. Lancet. 2020 Mar. (Epub)
  4. World Health Organization [Internet]. Geneva (SUI): World Health Organization; Clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspected: Interim guidance.
  5. Sheahan TP et al. Comparative therapeutic efficacy of remdesivir and combination lopinavir, ritonavir, and interferon beta against MERS-CoV. Nat Commun. 2020 Jan 10;11(1):222. PMID: 31924756.
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