Currently, no drugs capable of removing the new coronavirus from the body are known and, therefore, in most cases, treatment is performed with few measures and medications capable of relieving the symptoms of COVID-19.
Milder cases, with symptoms similar to those of common influenza, can be treated at home with rest, hydration, and the use of fever medications and pain relievers. More severe cases, where more severe symptoms and complications such as pneumonia occur, should be treated during hospitalization, often in intensive care units (ICU), to ensure, mainly, adequate oxygen administration and sign monitoring. Vital.
- Drugs approved for the treatment of coronavirus.
- By Anvisa and the Ministry of Health.
- Are those capable of relieving symptoms of infection.
- Such as:.
These remedies should only be used under the direction of a doctor and, although approved for the treatment of the new coronavirus, they are not able to remove the virus from the body, but are only used to relieve symptoms and improve the comfort of the infected. Person.
In addition to medications that help relieve symptoms, several countries are developing studies of infected patients to try to identify a drug that can remove the virus from the body.
The medications under study should not be used without the advice of a doctor or as a means to prevent infections, as they can cause a variety of side effects and life-threatening effects.
Here is a list of the main drugs under study for the new coronavirus
It is a broad-spectrum antiviral drug that has been developed to treat the Ebola virus epidemic, but has not shown any positive results like other substances. However, due to its extensive action against viruses, it is being studied to understand whether it may have better results in the removal of the new coronavirus.
Early laboratory studies with this drug, both in the United States [1] [2] and in China [3], have shown promising effects, as the substance may have prevented replication and multiplication of the new coronavirus, as well as other viruses in the coronavirus family.
However, before it can be recommended as a form of treatment, this drug must be the subject of several human studies, to understand its true efficacy and safety. Thus, there are currently about 6 studies underway with a high number of patients infected with COVID-19, both in the United States, Europe and Japan, but the results are not expected to be published until April, at this time, there is no evidence that Remdesivir can, in fact, be used safely to eliminate the new coronavirus in humans.
Updated April 29, 2020
According to a survey conducted by Gilead Sciences [8], in the United States, the use of Remdesivir in patients with COVID-19 appears to have the same results over a 5- to 10-day treatment period, and in both cases patients are published. 14 days and the incidence of side effects is also low. This study does not indicate the effectiveness of the drug in eliminating the new coronavirus and, as a result, further studies are still underway.
A study in China of 237 patients with severe effects of COVID-19 [15] reported that patients treated with this drug showed slightly faster recovery compared to control patients, with an average of 10 days compared to control patients. 14 days submitted by the placebo-treated group.
Updated May 22, 2020
The preliminary report of another U.S. survey With Remdesivir [16] he also noted that the use of this medicine appears to reduce recovery time in hospitalized adults, as well as the risk of lower respiratory tract infection.
Updated July 26, 2020:
According to a study from Boston University’s School of Public Health [26], remdesivir reduces the duration of treatment in patients admitted to the ICU.
Dexamethasone is a type of corticosteroid widely used in patients with chronic breathing problems, such as asthma, but can also be used in other inflammatory problems, such as arthritis or inflammation of the skin. This drug has been proven as a way to reduce symptoms of COVID-19 as it can help reduce inflammation in the body.
According to a study in the United Kingdom [18], dexamethasone appears to be the first drug tested to significantly reduce the mortality rate of critically ill patients with COVID-19. According to the results of the study, dexamethasone was able to reduce the mortality rate up to 28 days after infection with the new coronavirus, especially in people who need to be assisted by a fan or administer oxygen.
It is important to remember that dexamethasone does not remove coronavirus from the body, it only helps relieve symptoms and prevent more serious complications.
Updated June 19, 2020
The Brazilian Society of Infectious Diseases has recommended the use of dexamethasone for 10 days for the treatment of all COVID-19 patients admitted to the ICU with mechanical ventilation or who need to receive oxygen. However, corticosteroids should not be used in mild cases or as a means of infection prevention [19].
Updated July 17, 2020:
According to scientific research in the United Kingdom [24], treatment with dexamethasone for 10 consecutive days appears to decrease the mortality rate of patients with very severe infection with the new coronavirus, which require a fan. In these cases, the mortality rate appears to be increasing from 41.4% to 29.3%. In other patients, the effect of treatment with dexamethasone did not show such strong results.
Hydroxychloroquine, such as chloroquine, are two substances used in the treatment of patients with malaria, lupus and other specific health problems, but are not yet considered safe in all cases of COVID-19.
Studies in France [4] and China [5] have shown promising effects of chloroquine and hydroxychloroquine to reduce viral load and decrease the transport of the virus in cells, reducing the virus’s ability to multiply, thus providing faster recovery. However, these studies were conducted with small samples and not all tests tested positive. Learn more about using hydroxychloroquine to treat coronavirus.
For now, according to brazil’s Ministry of Health, chloroquine can only be used in people admitted to the hospital for 5 days, under constant observation, to assess the occurrence of possible serious side effects, such as heart problems or vision disturbances.
Updated April 4, 2020
One of the ongoing studies, with the combined use of hydroxychloroquine and the antibiotic azithromycin [9], in France, showed promising results in a group of 80 patients with moderate symptoms of COVID-19. This group identified a marked decrease in the viral load of the new coronavirus in the body after about 8 days of treatment, which is below the average of 3 weeks from people who did not undergo any specific treatment.
In this survey, of the 80 patients studied, only one person ended up dying because they would have entered the hospital in a very advanced stage of infection, which may have made treatment difficult.
These results continue to support the theory that hydroxychloroquine use may be a safe way to treat COVID-19 infection, particularly in cases of mild to moderate symptoms, as well as reducing the risk of disease transmission. However, it is necessary to wait for the results of other studies that are carried out with the drug, to obtain results with a sample of the larger population.
Updated April 23, 2020
The Federal Medical Council of Brazil has approved the use of hydroxychloroquine in combination with azithromycin at the discretion of the physician, in patients with mild or moderate symptoms, but who do not require hospitalization in intensive care units, where other viral infections, such as influenza or H1N1, are confirmed and the diagnosis of COVID-19 [12] is confirmed.
Thus, in the absence of solid scientific results, this combination of drugs should be used only with the consent of the patient and on the recommendation of the doctor, after assessing the possible risks.
Updated May 22, 2020
According to an AMERICAN study of 811 patients [13], the use of chloroquine and hydroxychloroquine, associated with or not azithromycin, does not appear to have any beneficial effect on the treatment of COVID-19, even appears to double the mortality rate of patients, as these drugs increase the risk of heart problems, in particular arrhythmia and atrial fibrillation.
To date, this is the largest study conducted with hydroxychloroquine and chloroquine. The results presented go against what has been said about these drugs, more studies are still needed.
Updated May 25, 2020
The World Health Organization (WHO) has temporarily suspended research on hydroxychloroquine, which it has coordinated in several countries. The suspension should be maintained until the safety of the medicine is reassessed.
Updated May 30, 2020:
The State of Esperito Santo, Brazil, has withdrawn the indication of the use of chloroquine in patients with COVID-19 in severe condition.
In addition, prosecutors of the Federal Prosecutor’s Office in Sao Paulo, Rio de Janeiro, Sergipe and Pernambuco demand the suspension of regulations indicating the use of hydroxychloroquine and chloroquine in the treatment of patients with COVID-19.
Updated June 4, 2020
The journal Lancet withdrew the study publication of 811 patients who demonstrated that the use of hydroxychloroquine and chloroquine had no beneficial effects for the treatment of COVID-19, due to the difficulty of accessing the primary data presented in the study.
Updated June 15, 2020:
The FDA, which is the leading pharmaceutical regulatory agency in the United States, has withdrawn emergency approval for the use of chloroquine and hydroxychloroquine in the treatment of COVID-19 [17], justifying the high level of risk of the drug and the apparent low potential for the treatment of the new coronavirus.
Updated July 17, 2020
The Brazilian Society of Infectious Diseases [25] recommends that the use of hydroxychloroquine in the treatment of COVID-19 be discontinued at all stages of infection.
Updated July 23, 2020:
According to a Brazilian study [27], conducted jointly by the hospitals Albert Einstein, HCor, Sorio-Libans, Moinhos de Vento, Oswaldo Cruz and Beneficiary Portuguesa, the use of hydroxychloroquine, associated with azithromycin, does not appear to have an effect in the treatment of mild to moderate patients infected with the new coronavirus.
Mefloquine is a drug indicated for the prevention and treatment of malaria in people who intend to travel to endemic areas. Based on studies in China and Italy [6], a treatment regimen in which mefloquine is associated with other drugs is being studied in Russia in order to verify its effectiveness in COVID-19 disease control, but there are still no conclusive results.
Therefore, the use of mefloquine to treat infection with the new coronavirus is not yet recommended, as more studies are needed to demonstrate its efficacy and safety.
ivermectin is a deworming indicated for the treatment of parasitic infestations, which cause problems such as onchocerchostics, elefantiasis, pediculosis (lice), ascaridiosis (intestinal worms), scabies or strongiloidosis and which has recently shown very positive results in the elimination of the new coronavirus, in vitro.
A study in Australia tested ivermectin in the laboratory in in vitro cell cultures, and it was found that iVERmectin was able to eliminate the SARS-CoV-2 virus in 48 hours [7]. However, human clinical trials are needed to verify its efficacy in vivo, as well as therapeutic dose and drug safety, which should occur over a period of between 6 and 9 months.
Updated July 2, 2020
The Regional Pharmacy Council of Sao Paulo (CRF-SP) has published a technical note [20] stating that the drug ivermectin has antiviral action in some in vitro studies, but that more research is needed to consider that ivermectin can be used safely in humans against COVID-19.
Thus, it warns that the sale of ivermectin is done only upon medical prescription presentation and within the time and dosage recommended by the doctor.
Updated July 10, 2020
According to a explanatory note published by ANVISA [22], there are no conclusive studies demonstrating the use of ivermectin for the treatment of COVID-19, and the use of the drug to treat infection with the new coronavirus should be the responsibility of the treating physician.
In addition, the first results published by a study by the USP Institute of Biomedical Sciences (ICB) [23], show that ivermectin, although it is able to remove the virus from infected cells in the laboratory, also causes the death of these cells, which may indicate that this remedy may not be the best treatment solution.
Tocilizumab is a drug that decreases the action of the immune system and is therefore normally used to treat patients with rheumatoid arthritis, to decrease the exacerbated immune response, reduce inflammation and relieve symptoms.
This drug is under study to help treat COVID-19, especially in the more advanced stages of infection, when there are a lot of inflammatory substances produced by the immune system, which can worsen the clinical condition.
According to a study in China [10] in 15 patients infected with COVID-19, the use of tocilizumab has been shown to be more effective and has fewer side effects, compared to corticosteroids, which are the drugs commonly used to control the inflammation generated. by the immune response. .
However, more studies are needed to understand the best dosage, determine the treatment regimen and discover possible side effects.
Updated April 29, 2020
According to a new study in China of 21 patients infected with COVID-19 [14], treatment with tocilizumab appears to be able to reduce symptoms of infection shortly after administration of the drug, reducing fever, alleviating the feeling of tightness in the chest and improving oxygen levels.
This study was conducted in patients with severe symptoms of infection and suggests that treatment with tocilizumab should be initiated as soon as possible when the patient moves from a moderate to severe infection with the new coronavirus.
Updated July 11, 2020
New research by the University of Michigan in the United States [28] has concluded that the use of tocilizumab in patients with COVID-19 appears to reduce the mortality rate in ventilated patients, although the risk of new infections has increased.
Convalescence plasma is a type of biological treatment in which people who have already been infected with coronavirus and recover are taken, a blood sample that is then subjected to centrifugation processes to separate plasma from red blood cells. Finally, this plasma is injected into the sick person to help the immune system fight the virus.
The theory behind this type of treatment is that antibodies that were produced by the body of the infected person and remained in the plasma can be transferred to the blood of another person still suffering from the disease, which helps strengthen immunity and facilitate the elimination of the virus.
According to technical note No. 21 published by Anvisa, Brazil, convalescence plasma can be used as an experimental treatment in patients infected with the new coronavirus, provided that all health control rules are followed. In addition, all cases using convalescent plasma for the treatment of COVID-19 should be notified to the General Blood and Blood Coordination of the Ministry of Health.
Avifavir is a drug produced in Russia whose active substance is the substance favipiravir, which, according to the Russian Direct Investment Fund (RDIF) [21], is able to treat coronavirus infection, having been included in COVID-19 treatment and prevention protocols in Russia.
According to ongoing studies, in 10 days, Avifavir showed no new side effects and in 4 days, 65% of treated patients tested negative for COVID-19.
To date, there are no proven natural remedies to eliminate coronavirus and help cure COVID-19, however, WHO recognizes that the Artemisia annua plant can help with treatment [11], especially in places where access to medicines is more difficult and the plant is used in traditional medicine, as is the case in many parts of Africa.
Artemisia annua plant leaves are traditionally used in Africa to help treat malaria, and therefore WHO recognizes that studies are needed to understand whether the plant can also be used in the treatment of COVID-19, as some synthetic malaria medicines have also done so. showed promising results.
However, it is important to remember that the use of the plant has not been confirmed against COVID-19 and that more research is needed.