Covid-19: where are we with the treatments?

The American-German laboratory Pfizer / BioNTech has announced promising results in young children from its vaccine against Covid-19.

AP - Rogelio V. Solis

Text by: Simon Rozé Follow

4 min

While the Pfizer laboratory announced in the press the safety and effectiveness of its vaccine for 5-11 year olds, vaccination against Covid-19 remains the alpha and omega of most public policies.

Although an effective treatment is still not available, research continues.

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More than a year and a half after the start of the Covid-19 pandemic, there is still no effective, widespread and affordable treatment. The strategy of repositioning already existing drugs has indeed not been conclusive. Developing a new molecule takes time; Faced with the emergency, it is thus products already used to treat other diseases that have been tested against Covid-19.

There, whether it is

antiretrovirals against HIV

(lopniavir-ritonavir), the

remdesivir initially developed against Ebola

, the anti-parasitic

ivermectin 

or the

anti-malarial hydroxychloroquine

, and many others, clinical trials, meta-analyzes follow and resemble each other: nothing works whatever the stage of the disease.

Today, dexamethasone, a common corticosteroid, is barely available.

Useful during the inflammatory phase of the disease, it reduces the mortality of patients admitted to the intensive care unit by 30%.

Develop synthetic antibodies

Faced with the failure of repositioning, it is therefore necessary to develop a new treatment from scratch. It is a long, expensive, complicated process with no guarantee of results, yet necessary. Two main tracks are followed. The first concerns monoclonal antibodies. “

 They are designed to specifically target the S protein of the coronavirus,

 ” explains Anne-Geneviève Marcellin, head of the virology department at the AP-HP hospital in Pitié-Salpêtrière. The S protein is indeed the key that Sars-CoV-2 uses to enter the cells it infects. “ 

It is located on the surface of the virus. These antibodies therefore neutralize the ability of the virus to enter cells 

”. They have two main indications: " 

They can be used in curative, but also in preventive. These antibodies prevent the virus from attaching to the cell and therefore block any onset of infection

. "

There are two main therapies today using this technique.

The one developed by Regeneron had in particular been administered to Donald Trump when he contracted Covid-19.

The second is a dual therapy developed by the American laboratory Lilly.

Unfortunately, if

the first interesting results

had been announced, the emergence of the Delta variant made it ineffective and this solution is now abandoned.

This does not prevent the development of other therapies based on monoclonal antibodies, in particular by the AstraZeneca laboratory.

That said, it's hard to imagine that they could one day act as a mass treatment for Covid-19.

They indeed need to be injected and are expensive.

Towards an anti-Covid pill?

The other area of ​​research avoids this pitfall: it is antivirals. " 

The goal would be to have a treatment that is easy to take, orally, as soon as you have symptoms or when you have been exposed to someone who is sick 

", explains Karine Lacombe, who heads the infectious diseases department. at Saint-Antoine hospital. “ 

If it significantly reduces the risk of being hospitalized and therefore of having a serious form and dying, that would be ideal.

 That said, nothing says that we will succeed as the task is so arduous. Several have nevertheless started in the race and we are expecting clinical trial results soon.

The Merck (molnupiravir) and Roche (AT 527) laboratories must indeed publish theirs by the end of the year.

Their molecules aim to prevent the virus from replicating once in our body.

This is the goal also sought by Pfizer, for whom the results are this time expected during the first quarter of 2022. If these results are conclusive, it will however then be necessary to wait for their validation by the health authorities, which in the best case does not. will not allow these drugs to hit drugstore shelves until the middle of next year.

The benefit of antidepressants

Finally, in the current pharmacopoeia, apart from dexamethasone, another class of drugs is attracting interest.

These are

antidepressants

, which could have an effect against Covid-19.

Several studies go in this direction, but nevertheless require confirmation and in particular a clinical trial in due form.

The inclusion of fluoxetine, better known under the name Prozac, is therefore being studied in the framework of

the Anticov trial, carried out in sub-Saharan Africa

.

It could be tested in the coming weeks.

►Also read: Vaccines: Amnesty International accuses laboratories of neglecting poor countries

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