The Health November 2020 | Page 19

Another approach to tackle Covid-19 will be the discovery of drugs to cure the severe acute respiratory symptoms that come with it

| Hot Topic |

November , 2020 | The Health

19

At the time of writing , Covid-19 cases were on the rise again with Kota Kinabalu , Semporna , Tawau and Lahad Datu in Sabah ; and now Selangor , as the main epicentres of the outbreak for this current wave .

A snap Sabah election was the cause of this outbreak . Interstate travel and political campaigns exacerbated the transmission of the virus , slowly turning green zones even in Peninsular Malaysia into red ones again .
One hopes to ride through this pandemic . Besides observing social distancing , hygiene and movement restrictions , there ’ s an urgent need to develop a safe and productive vaccine . Nevertheless , vaccine development entails a multi-stage process and could take up to 10 years .
Currently , the COVAX initiative by Gavi ( Vaccine Alliance ) and the World Health Organization ( WHO ) serves as a platform to support development , manufacturing and fair distribution of Covid-19 vaccines by the end of 2021 .
Another approach to tackle the disease will be the discovery of drugs to cure the severe acute respiratory symptoms that come with Covid-19 . Hydroxychloroquine , an anti-malaria drug , was hyped to be a potential drug for Covid-19 .
Effectiveness of drugs to treat Covid-19
Nevertheless , three extensive studies did not find the drug to benefit severely ill patients or those who have been exposed to the virus . Indeed , other trials on the drug for Covid-19 are either now halted or paused .
Remdesivir , an antiviral drug developed by Gilead Sciences , has been authorised for emergency use for severe Covid-19 patients in some countries . It was initially created for hepatitis C , Ebola and Marburg viral infections , but was later found to be not useful for these indications .
Despite the enthusiasm on the effectiveness of the drug in earlier studies , at the time of writing , a multinational study by WHO reports that it did not help in preventing Covid-19 mortality .
Critically ill Covid-19 patients experience inflammation due to immune system overdrive or paralysis , in response to fighting the SARS-CoV-2 virus . In an interesting and hopeful development , steroids , such as dexamethasone , hydrocortisone , and methylprednisolone , were found to improve outcomes of severely ill Covid-19 patients who require oxygen or mechanical ventilation via harmonisation of inflammation in the lung .
Corticosteroids are usually safe , inexpensive and widely available . Nevertheless , this category of drugs is not recommended for Covid-19 patients who experience mild symptoms as dampening of the immune system will not be helpful in their recovery from the disease .
Can antibiotics cure Covid-19 ?
More recently , a group of researchers from the University of Hong Kong discovered that Ranitidine Bismuth Citrate ( RBC ), a drug commonly used to treat stomach ulcers , can stop SARS-CoV-2 replication in hamsters .
Compared to corticosteroids , which harmonised the immune system to alleviate lung inflammation and provide symptomatic relief , RBC directly interferes with viral replication enzymes and reduces viral loads .
RBC is clinically safe and priced at less

Covid-19 : Vaccines , treatment options and antibiotics

Another approach to tackle Covid-19 will be the discovery of drugs to cure the severe acute respiratory symptoms that come with it

than a quarter of Remdesivir . Plans are being developed to test the efficacy of RBC in clinical trials .
Last but not least , can antibiotics work to cure Covid-19 ? The SARS-CoV-2 virus causes the disease . As antibiotics work on bacteria only , this group of drugs cannot be used to eliminate the Covid-19 virus . That said , some patients develop secondary bacterial infections during hospitalisation , which will require the usage of antibiotics for treatment . Worryingly , the use of antibiotics rose during the pandemic . It is due to the misuse of these drugs for viral respiratory infections by the general public ( out of fear of Covid-19 ).
In conjunction with World Antimicrobial Awareness Week on Nov 18-24 , we would again like to caution everyone against antibiotic misuse , to prevent episodes of antibiotic resistance . — The Health
Assoc Prof Dr Tan Toh Leong is Consultant Emergency Physician , Faculty of Medicine , Universiti Kebangsaan Malaysia ( UKM ), Founder and President of Malaysian Sepsis Alliance ( MySepsis ) while Assoc Prof Dr Neoh Hui-min is Senior Research Fellow , UKM Medical Molecular Biology Institute ( UMBI ), UKM and Secretary of Malaysian Sepsis Alliance .
sepsis Alert
By Assoc Prof Dr Tan Toh Leong
and ASSOC PROF DR NEOH HUI-MIN
Critically ill Covid-19 patients experience inflammation due to immune system overdrive or paralysis , in response to fighting the SARS-CoV-2 virus . In an interesting and hopeful development , steroids , such as dexamethasone , hydrocortisone , and methylprednisolone , were found to improve outcomes of severely ill Covid-19 patients who require oxygen or mechanical ventilation via harmonisation of inflammation in the lung .”