Covid -19 Update

Updated: Jul 27, 2020

The Covid-19 pandemic has severely disrupted all of our lives but progressively some improvements are being made in terms of therapeutics and vaccine. Masks, self-distancing and washing hands are necessary to prevent transmission of infection.

The core problems with Covid-19 are viral replication and transmission (even during asymptomatic phase), chemokine and cytokine storm and clotting issues that result in pneumonia, organ failure and death. The virus attacks not just the lung but other systems including the brain, heart, kidney and liver. A large number of drugs and vaccine trials are underway, exceeding about 400 or so. Some drugs have shown early promise including Tocilizumab, Leronlimab, Lenzilumab, Remestemcel, CAP-1002, but are pending randomized control trials. Remdesevir and dexamethasone have shown benefit and the former was approved for usage but it showed no mortality benefit. Baricitinib, Selinexor, favipiravir and many other drugs are also in trials. One of these drugs, Leronlimab, appears to attack all of the Covid-19 core problems and may be useful. However, it's efficacy must be proven in randomized control trials.

Itulozumab showed good results in India today and will undergo randomized trials elsewhere to assess it’s efficacy in preventing deaths in Covid-19. Hopefully, one or more of the other drugs will be approved soon. Two vaccines will likely go into phase III trial, one by Moderna Therapeutics and one by BioNtech/Pfizer, are the earliest in starting phase III by the end of July. Others will follow including ones from Astra Zeneca and Johnson and Johnson, Novavax and Inovio pharmaceuticals. Chinese vaccines are in trails as well with one showing promise and being tested in Chinese military personnel.

Amongst the first symptoms of Covid-19 are rhinorrhea, shortness of breath, cough, sore throat and smell/ taste issues for which a referral to an Otolaryngologist such as Dr. Khetarpal should be considered.

Be well and stay safe.

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