To the Rescue

My four year old grandson has been following a You Tube channel at home that is geared to teaching kids how to draw pictures.  This week the subject was Spider-Man.  I’d say he did a pretty amazing job! After the superhero was completed, the kids were invited to draw something in the background. Jack drew a building and two corona viruses because “Spider-Man kills the Corona virus,” he exclaimed to me.

I think he has it right. We need superheroes if we are going to have any chance against this virus.  Thankfully we have plenty of them.  I have previously talked about our ER and ICU staff and the job they are doing each and every day in the face of personal danger and uncertainty.  We have other superheroes as well that are not as easily seen.  They may not even interact directly with patients but the effects of their work will be crucial to how we move past this pandemic and recover. They are our scientists and researchers.  Many are working long hours in the hopes to develop a vaccine or to find a medication that can treat COVID-19 and lessen the disease burden on all of society.

In a recent post I discussed the trial using convalescent plasma that we are a part of at Missouri Baptist hospital.  Yesterday I received an email from researchers at Washington University that are looking at fluvoxamine.  This medicine has been used for decades in the treatment of bipolar disorder but it also has something called sigma-1 receptor binding which may help to decrease the “cytokine storm” that is so prevalent in those with severe disease.  As such it is hoped that those patients won’t become critically ill and can be managed at home.

You likely have heard of the malaria drug chloroquine and its close cousin hydroxychloroquine (used in rheumatic disease). These two have been around for a long time. They are being looked at in COVID-19 due to possible effects of inhibiting viral entry through a cellular structure called an endosome.  The medicine has a known effect of raising the pH within the endosome which is thought  to inactivate the virus.  Elon Musk tweeted that it would be worth considering and off the shelves it started to fly. We all know that President Trump is all for it.  Scientist insist on doing formal studies both to make sure it works as well as to demonstrate its safety. Just this week I received notice that patients who have been treated are at a higher risk of developing potentially deadly arrhythmias while taking these medicines. As such, when used they should either be on a heart monitor or have an ECG pretreatment and also while on treatment to screen for this tendency.  Careful consideration of the facts is always preferable to brash hyperbole.

Remdesivir has shown promise. It was researched previously for the SARS virus but was not found to be efficacious.  There are several studies that are ongoing for its use in COVID-19.  An oral drug called EIDD-2801 which proportedly introduces genetic mutation into the virus’s RNA making it incapable of infecting cells is showing some promise. There are literally hundreds of other trials going on at present as well.  The knowledge that will be accumulated by our scientists will reap benefit society for years to come. Our understanding of all viral infections will be augmented.  Our scientists are working hard in our behalf.  Thank goodness for superheroes!