In 2009, Karen Starco (1), a researcher at the University of Arizona Medical School, noted that the symptoms that occurred in patients during the spread of what was known as "Spanish flu" in 1918 were sometimes remarkable, as many cases suffered - very seriously. - From hyperventilation and fluid accumulation in the lung, and with further research, Starco discovered that this was due to excessive use of aspirin as a treatment for the disease, which contributed to the high mortality rates alongside the epidemic.
In cases of epidemics, a simple statement from one of them about the benefit of a drug or its ability to treat is enough to push people to start storing and using it in large doses for the sake of prevention, but those doses may be more dangerous than the epidemic itself. In the case of the new Corona, it seems that the spread of talk about the promising results of chloroquine, the drug that is mainly used in the treatment of malaria, prompted people to buy as much of it as possible (2), and some have already started using it in harmful doses for prevention purposes, so I ask You have to calm down a little, and to track together the expected course of treatment for the new Corona, because scientific facts in such circumstances are the most valuable currencies.
Chloroquine and his companion
To understand how chloroquine works in the body, we can start from what we know about coronaviruses, as they carry in their outer shells appendages that can attach to specific receptors outside human cells (especially the lung), after which the virus remains for a period suspended on the cell, then swallowed by the latter When the virus’s DNA enters the cell, specifically we mean RNA and is short for RNA, it treats it like its natural nucleic acid and uses it to produce an enzyme, called (3) “RNA-based RNA polymerase,” which replicates the virus again.
Chloroquine was used in SARS injuries 17 years ago and had a role in saving some patients from serious conditions. Researchers believe that it is not related to chloroquine specifically but to zinc, because entering the cell prevents this enzyme from performing its function normally, but human cells do not allow easily With the introduction of zinc into it, here comes the role of chloroquine, which improves this mechanism, and it also appeared - in this context - that the presence of zinc in large quantities outside the cells improves its quantities within it.
In Covid-19 cases, the first uses of chloroquine appeared in South Korea, where researchers (4) indicated a significant role this drug could play in relieving symptoms in the advanced stages of the disease, due to the low amounts of the virus in the body, and because chloroquine is not present in South Korea Experts recommended either using hydroxychloroquine (commercially: placonyl) or another drug called "caletra", and it contains two viruses, ritonavir and lopinavir, which is produced by the American company Abbot, and had also shown positive results in some cases in South Korea, especially if combined With other medications.
Meanwhile, there was (5) Chinese consensus that, by the twelfth of March, we had grown up about the necessity of using the same drug, or its hydroxy-chloroquine companion, in advanced cases of Covid-19, and researchers from Peking University had published (6) , On March 9th, a paper in the journal Clinical Infection Disease indicates that hydroxychloroquine was effective in a very dangerous and deadly development in critical cases of the new corona called a "cytokine storm", and that hydroxychloroquine - in relation to patients' tolerance to the drug - was Better than chloroquine itself.
But the problem that chloroquine has encountered so far is that it is not fully guaranteed, it has only been used with small numbers of patients in initial trials. For example, the French experience of chloroquine is the most popular to date (7), the results were promising as by the end of the treatment protocol only 25% of patients had positive results in examining the presence of the new corona versus 90% of people in the group that did not use chloroquine, but These experiments were performed on only 25 people.
In fact, and because this use was not legally documented, the first tests for chloroquine were performed on patients in late cases so that the last line of defense was before death, and some scholars in this range (8) believe that the enormity of the matter and the vast numbers of patients that need treatment call for some Slow down before deciding to include chloroquine or hydroxychloroquine in treatment protocols extensively. Otherwise, the case of cyclosporine may be repeated with AIDS (9), and after successful initial trials, it appeared that it was not effective as a treatment.
Giants race
Not only were chloroquine and hydroxychloroquine the first symptom that doctors made in intensive care rooms for the treatment of Covid-19, the war against my new comrades Corona, meaning "SARS 2002" and "MERS 2012", was somewhat successful, and because there is a similarity in the composition Genetics of this group of viruses, this opened the door to reflect on the medicines that were used to treat them, along with another set of drugs.
For example, another drug called (10) "Remdesivir", an American antivirus that was used - but did not work - was used in the case of the Ebola virus several years ago, and works - almost with many biological complications - in a way similar to that of chloroquine. , As it prevents new copies of the virus from forming in the cell. At the beginning of the crisis, American patients were examined on remedies and had good results. On February 4, China had already started its clinical trials on it, but the final results needed some time to be confirmed.
As for Favipiravir, which is produced by a Japanese company called "Avigan", it went a long way towards treating Covid-19, as the Chinese medical authorities had announced (11) only a few days ago that it was effective in a way that was described as "clear" in Treatment of patients in the cities of Wuhan and Shenzhen, and therefore approved by a law of use, and the way it works similar to the two former companions, it prevents the work of the enzyme "RNA-dependent polymerase RNA", and thus prevents the virus from repeating itself within the cells, thus limiting its spread inside the body.
In experiments, on about 350 patients, those who received a therapeutic protocol containing faviravir only showed an improvement (12) in four days and their virus screening results were negative compared to eleven days in the case of those who did not receive faviravir, but - as we mentioned before - The matter, due to its magnitude, requires careful use of such results as a sure picture of what can be relied upon, especially since the numbers - globally - are increasing rapidly today (about 15-20 thousand new cases per day).
On the other hand, APN01 recently entered "ABN Zero One" as one of the candidates for the treatment of Covid-19, which is produced by a European company based in Austria and Vienna, this drug appeared in 2010 to treat an advanced case of lung infections, called acute respiratory syndrome (ARDS). , Which is the main cause of death. We now know (13) that "ABN Zero One" works at the position the virus attaches to on the surface of the cell, which prevents its entry, and thus reduces the numbers of viruses entering cells, and reduces infection.
As for Tocilizumab, a Swiss product produced by a Russian company under the name "Aktimra", it is originally a drug that is used - mainly - to treat adults suffering from active rheumatoid arthritis, in moderate to severe cases, Chinese doctors used (14) Tocilizumab in cases of response Severe immune action - in advanced cases - which mainly leads to organ failure and death in coronavirus patients. China conducted some preliminary trials on 20 acute cases of Covid-19 and succeeded in removing 19 patients from the hospital, within two weeks.
Endless solutions
Despite all these possibilities, chloroquine and its companion are still the most accepted possibility, other drugs are expensive and not available in its quantity, and humans have been using it for more than 70 years to treat and prevent malaria and in some immune diseases, which suggests it becomes the first choice for doctors in Advanced cases of Covid-19, and this may contribute in the near future in a way that can be described as "good", in the development of the proportions of critical cases or deaths, which may become the first human line of defense against the new corona, until the vaccine arrives.
But in the end, please note that these measures being taken now are - in any case - a completely exceptional form of the protocol followed, most of these drugs have not yet passed the first stage of clinical trials (15), and are used only in very sophisticated cases of the disease that represent To date - only about 5% of people who do not have a solution other than experimentation, but because the circumstance itself is exceptional, it required intervention in this way.
For this reason it would be very wrong in fact, that people spread out on the streets in search of covid-19 drugs. These drugs are experimental for this disease, as they have severe damage that starts from severe nerve inflammation and reach serious problems of vision with respect to chloroquine, for example, in addition to that they are used only for advanced cases of the disease and are placed within a regular treatment protocol and need careful medical follow-up, the demand for these drugs Using it as a preventive or without medical supervision may put us in a situation similar to what happened in the Spanish flu. As we always repeat, the virus does not come alone but is accompanied by a state of panic that may cause some to adopt behaviors that completely stand in contrast to their interests.