In DepthInfectious Diseases

Race to find COVID-19 treatments accelerates

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Science  27 Mar 2020:
Vol. 367, Issue 6485, pp. 1412-1413
DOI: 10.1126/science.367.6485.1412

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  • RE: Healthy Children Plasma and Human Thymopoiesis as Potential Therapy Against COVID-19

    During the past 2 decades, there has been a growing strand of viral infections from a corona-shape like viruses such as SARS-CoV, MERS-CoV, and most recently SARS-CoV-2, which is the deadliest among them all. SARS-CoV-2 is a newly recognized viral infection, which has spread rapidly from China to the whole world. The virus has been identified as a novel enveloped RNA betacoronavirus 2 given the title name severe acute respiratory syndrome coronavirus 2 or SARS-CoV-2, which shares phylogenetic similarities to SARS-CoV (1). The term COVID-19 has been designated to patients who have developed clinical symptoms without apparent radiological manifestations (1).
    As of April 23, 2020 the total number of global COVID-19 laboratory-confirmed cases was 2,682,225 with a mortality of 187,330 mostly in the USA (2). The rate of COVID-19 infections has prompted the WHO on March 11, 2020 to declare it a global pandemic.
    Duan and coworkers (3) have evaluated the administration of convalescent plasma (CP) to 10 COVID-19 patients with severe symptoms. It was found that CP therapy was promising and it was well-tolerated by patients, leading to improving symptoms and the disappearance of viremia.
    The present novel approach utilizes plasma obtained from healthy children rather than CP. This stems from the fact that COVID-19 infectivity is uncommon in children and it appears that children are insusceptible to it. Pediatric studies have shown that children are less susceptib...

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    Competing Interests: None declared.
  • RE: Finding Treatment for COVID-19 using fractal mathematics
    • Pratibha , Associate Professor, Dept of Mathematics, Indian Institute of Technology Roorkee, India
    • Other Contributors:
      • Cyril Shaju, PhD Student, Dept of Earth Sciences, Indian Institute of Technology Roorkee, India
      • Kamal , Professor, Dept of Earth Sciences, Indian Institute of Technology Roorkee, India
      • Aman Gupta, Student, Manipal University Jaipur, India

    The world is eagerly looking for a possible treatment for the Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2). The whole genome sequence of this virus along with others are now available but finding a cure for Coronavirus disease 2019 (COVID-19) caused by SARS CoV-2 through biological trials will still be a long process. One of the starting points of the cure may be to try the available solutions for other known viruses or bacteria whose genome sequences match with that of the SARS CoV-2. We have obtained fractal portraits, of 20 different viruses, created by the chaos game representation of their respective genome sequences and compare them for similarities. These portraits are the quickest and the most compact mathematical way of analyzing genome sequences as first described by Jeffrey (1990). The fractal portraits show (i) an excellent match of SARS CoV-2 portrait with those of Hepatitis A, wild Hepatitis A, MERS and Hendra genomes (in decreasing order), (ii) a close match with Nipah, Ebola, HIV and Respiratory Syncytial virus (RSV) genomes, and (iii) no match with the Dengue, Malaria, Influenza, Zika, Rabies, Smallpox, Polio, Measles, Mumps and Rubella genomes. Close matches between Zika and Dengue, and between Hendra and Nipah are also observed.

    For its study, WHO chose an experimental antiviral called remdesivir; the malaria medication chloroquine (or its chemical cousin hydroxychloroquine); a combination of the HIV drugs lopinavir an...

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    Competing Interests: None declared.
  • RE: Corona virus

    Had mycoplasma pneumonia, and was prescribed tetracycline, after many other choices . Cells were similar to covid 19, could a cure be as simple as that or some variant of drugs used for mycoplasma pneumonia ?

    Competing Interests: None declared.
  • COVID-19: why are we not discussing lung edema caused by SARS-CoV-2 infections as therapeutic target ?
    • Wolfgang Liedtke, Professor of Neurology, Anesthesiology and Neurobiology, Duke University School of Medicine, Durham NC, USA
    • Other Contributors:
      • Sven-Eric Jordt, Professor of Anesthesiology and Pharmacology, Duke University, School of Medicine, Durham NC, USA
      • Wolfgang M Kuebler, Professor of Physiology, Charite Universitaetsmedizin, Berlin, Germany

    Given that lethality of COVID-19 during the current pandemic is critically driven by breakdown of the alveolo-capillary barrier of the lung, why is there not a more wide-spread discussion how this particular clinical feature of COVID-19 can be targeted more effectively ? That's what critically-ill COVID-19 patients succumb to. While current strategies focus largely on viral elimination, blocking of viral entry and replication, or modulation of the immune response, alveolo-capillary barrier protection may serve as an important adjunctive therapy to buy time for the immune system to mobilize an effective response. Importantly, COVID-19 is ideally suited for this strategy as it allows for early intervention to protect this barrier at the phase of self-quarantine and supportive therapy prior to overt barrier failure when patients will require intensive care support. Such a strategy may take the burden off ICUs, and could be implemented large-scale even in countries with limited access to high technology medical resources. Various feasible interventions for early barrier protection should be discussed: adrenomedullin, angiotensin-(1-7), sphingosine-1-phosphate, tyrosine kinase inhibitors and TRPV4 antagonists. Which of these could be targeted effectively and feasibly in COVID-19 patients that are not (yet) critically ill ? Our own answer is TRPV4, which can be considered a gatekeeper of alveolo-capillary barrier integrity

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    Competing Interests: None declared.
  • RE: Race to find COVID-19 treatments accelerates
    • Rattan Nath, Scientist, Retired
    • Other Contributors:
      • Sachin Nair, Coach & Medical Student, Change Academy Lake Ozarks
      • Nihaal Nath, Student, University of Missouri
      • Ursula Nath, Student, West Orange High School
      • Jyotsna Nair, Director of Psychiatric Services, Change Academy Lake of the Ozarks

    SOLIDARITY, an unprecedented, coordinated push to collect robust scientific data rapidly during a pandemic, should be used to validate and develop strategies for not just this outbreak but other similar outbreaks of influenza-like illnesses that mostly kill via the development of sepsis and Acute Respiratory Distress Syndrome. There is considerable scattered information that is helpful in this regard beyond just trying out new compounds from observations on various populations affected by ARDS or lung malfunction/recovery from surgery. Integrating this information is helpful in devising a method to protect the frontline workers who then also form a firewall while providing essential services with minimal economic disruption.
    COVID-19 has already exhausted resources in many nations including the USA. Viruses like COVID-19 become lethal primarily depending on the extent to which they lead to Acute Respiratory Distress Syndrome (ARDS). The COVID-19 challenge also brought home the inadequacy of the routine approach of lasting out the annual flu and flu shots as being enough. Better prophylactic measures than just waiting for an almost good enough vaccine are needed. This requires being able to minimize the harm due to ARDS and sepsis even when eventually a vaccine is the cost-effective treatment. Being able to tackle ARDS will also assist in non-infection related ARDS amelioration. These goals may require having stocks or the ability to provide anti-inflammatory biologic...

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    Competing Interests: None declared.

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