China has released the seventh version of the diagnosis and treatment guideline on the novel coronavirus disease (COVID-19). Here are some drugs and therapies that have been recommended by the guideline, and some drugs that have been found to have the potential to defeat the virus and have entered clinical trials.
— CHLOROQUINE PHOSPHATE
Chloroquine Phosphate, a widely used anti-malaria and autoimmune disease drug, has been used for more than 70 years. The drug has been used in treating 285 critically ill COVID-19 patients in a hospital in Wuhan, and no obvious adverse reactions have been found so far.In the latest version of the treatment guideline, Chloroquine Phosphate is recommended for COVID-19 patients from 18 to 65. The amount for patients over 50 kg is 500 mg per dose twice a day for seven days. The guideline also noted that patients should take less than three antiviral drugs.
— TOCILIZUMAB
Tocilizumab, with the common brand name Actemra, is an injectable synthetic protein that blocks the effects of IL-6 in patients with rheumatoid arthritis. IL-6 is a protein that the body produces when there is inflammation.
The latest version of the guideline suggests the use of Tocilizumab in patients with an increasing level of IL-6 and with extensive lesions in both lungs or severe symptoms. Chinese researchers have found that a cause of death for severe and critically ill patients infected with the novel coronavirus is cytokine storm, an overreaction of the immune system. These patients are found with a higher level of IL-6 in their blood. Last month, the increasing level of IL-6 was recommended as a warning sign that the patient’s situation could possibly deteriorate. Currently, the drug is under clinical trials in 14 hospitals in Wuhan and a total of 272 severe patients had been treated with Tocilizumab as of March 5.
— CONVALESCENT PLASMA
Convalescent plasma, processed from the plasma collected from recovered COVID-19 patients, contains a large number of protective antibodies.As of Feb. 28, 245 COVID-19 patients have received the therapy and 91 cases have shown improvement in clinical indicators and symptoms. According to health authorities, plasma therapy has proved safe and effective.
— TCM
Traditional Chinese medicine (TCM) has been proven effective in treating COVID-19 patients. With TCM treatment, patients with mild symptoms have seen their fever or cough alleviated, according to medical experts. For severely ill patients, TCM helped relieve symptoms and restore blood oxygen saturation, preventing the patients’ conditions from developing into critically ill cases.TCM decoction Qingfei Paidu Soup has been recommended to medical institutions nationwide on Feb. 6 after data analysis on 214 cases. As of Feb. 29, the decoction is used in 66 designated hospitals in 10 provincial-level regions in China.
— ANTIVIRAL DRUGS UNDER TRIAL
Favipiravir, an influenza drug available on overseas markets, has been put in a parallel controlled study in Shenzhen, Guangdong Province, with 80 patients enlisted. The initial outcome of the trial shows the drug has relatively obvious efficacy and low adverse reactions. Experts have suggested expanding the trial to further observe and study its effect. Remdesivir, developed against Ebola infections by American pharmaceutical company Gilead Sciences, has shown fairly good antiviral activity against the novel coronavirus at the cellular level. Cao Bin, a respiratory expert who is leading the Remdesivir program, said on Wednesday that two trials for Remdesivir are going on smoothly and China will share the data with the international community after the program is completed.
— STEM CELL TRIAL
Clinical studies on stem cell therapy, which can inhibit the overreaction of the body’s immune system, have also been carried out to treat severe patients.
As of Feb. 21, four patients who have received the therapy have been discharged from hospital, and the trial is expected to be further expanded. Currently, three kinds of stem cells – mesenchymal, lung and embryonic stem cells – are used in treatments. Researchers usually inject stem cell products into the lungs. Meanwhile, the Chinese Academy of Sciences has developed a new stem cell drug, CAStem, which has shown promising results in animal experiments. The research team has applied for urgent assessment by the National Medical Products Administration. Approvals by the ethics committee, and clinical observation and evaluation are in progress. Several research and trials on applying stem cells to treat COVID-19 patients have been carried out in the country.