Methods to Combat the COVID-19 Coronavirus

Discussion in 'Present & Current Events' started by Thomas R. Morrison, Mar 15, 2020.

  1. nivek

    nivek As Above So Below

    Scientists Have Uncovered the Likely Cause of a Serious COVID-19 Symptom: Blood Clotting

    One of the more surprising symptoms of COVID-19 has been the blood clots that many patients, including younger ones, have experienced with the infection. The clots have in some cases led to dangerous blockages in the lungs, caused strokes and even death, even in people without a history of circulatory conditions.

    In a paper published in Science earlier this week, researchers provide a glimpse into what may be driving the clots triggered by COVID-19 infection. The group found that a specific set of antibodies known as autoantibodies—which are rogue versions of cells meant to defend the body from pathogens, but instead attack its own cells (in this case the body’s own blood vessel cells)—may be partly responsible for the clotting risk associated with the disease. Among 172 patients hospitalized with COVID-19, they found that half produced these autoantibodies. In addition, when the scientists injected the autoantibodies into lab mice, the animals developed blood clots.

    In April, the same group of scientists reported that the inflammation associated with COVID-19 can lead to clots in small vessels in the lungs, and that these clots are mostly packed with an immune cell known as a neutrophil. In COVID-19 patients, these neutrophils can explode inside small blood vessels, creating sticky molecular traps that attract other clotting factors circulating in the blood. “Evolutionarily, we think these are meant to trap things like bacteria or viruses,” says Yogen Kanthi, an assistant professor at the University of Michigan, investigator at the National Heart, Lung and Blood Institute and one of the study’s authors. “But if [neutrophils] are over stimulated, they can also grow and cause blockages in blood vessels and drive blood clotting.” In that earlier study, Kanthi and his colleagues found that COVID-19 patients who had more of these “traps” in their blood system were more likely to have severe disease or respiratory failure.

    “Inflammation begets clotting, and the clotting leads to more inflammation,” he says. “It becomes a relentless self-amplifying loop of inflammation and clotting that results in patients getting sicker.”

    In their latest Science paper, the researchers found that the autoantibodies drive this cycle of inflammation and clotting. The autoantibodies found in the COVID-19 patients are the same ones doctors find in patients with an autoimmune disease called antiphospholipid syndrome, in which antibodies seed clots by attracting clotting factors that eventually block blood flow. Understanding how these antibodies contribute to clotting risk among patients with that syndrome led experts like Jason Knight, who study antiphospholipid disease, to anticipate similar clotting among COVID-19 patients. “By May, clotting was all anyone was talking about with COVID-19 patients,” says Knight, an associate professor of rheumatology at the University of Michigan and one of the study authors. “When we started doing autopsies, we saw microvascular clotting in the lungs.”

    Such clotting in small vessels—sometimes too small to even pick up by CT scans—is one of the hallmarks of the blood flow blockages linked to COVID-19. Not only do patients develop so-called macrovascular clots in the bigger vessels including veins and arteries, which can lead to deep vein thrombosis and strokes, but infections also seem to sometimes trigger clots in the tiny vessels in the lungs—which can cause respiratory issues—and the autoantibodies may be the reason for that, since they can bind to blood vessel cells everywhere.

    In fact, says Kanthi, COVID-19 can be seen as “an extreme version of a number of diseases, one of them being antiphospholipid syndrome.” That means that studying these patients could lead to better understanding of COVID-19 and how the coronavirus is contributing to clotting. To start, Knight is already studying one drug, dipyridamole, which is approved to treat strokes and prevent blood clots in people who receive mechanical heart valves, to see if it can reduce the risk of clotting in COVID-19 patients. The drug is relatively inexpensive and directly tamps down neutrophil activation, which may in turn reduce the formation of the hyperactive neutrophil traps in the vessels. The test for the autoantibodies is already available for doctors to order, so ultimately, says Knight, COVID-19 patients might be tested for their antibody levels and then triaged to receive more aggressive blood thinners or other medications such as dipyridamole, if it proves effective, to protect them from clotting.

    The team is currently enrolling COVID-19 patients for the anti-clotting drug study, and could have answers by the end of the year, says Knight. Those findings could open new understanding into how viruses affect the body’s clotting processes; the fact that the body’s autoantibodies can trigger such widespread clotting is new, says Kanthi. “We knew antibodies like this can exist [from our knowledge of antiphospholipid syndrome] but no one ever looked to see if they can cause clotting.”

    It’s not clear yet at what point during the infection these autoantibodies start to form, and what makes people more likely to generate them. Genetics, a person’s history of previous viral and bacterial infections, as well as the revved-up immune response launched by COVID-19 likely all contribute to that risk. But the fact that half of patients may generate these potentially clot-promoting antibodies means that better understanding what these risk factors are, and possibly identifying people who harbor them, may help them from experiencing a more severe and potentially deadly COVID-19 infection.

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  2. 1963

    1963 Noble

    Ferrets Help Scientists Produce Nasal Spray That Prevents COVID-19 Infection.

    “COVID coronavirus replication was completely blocked. …these antivirals (developed from ferret tests) … is easily administered and … protection would be immediate and last for at least 24 hours.”

    — Anne Moscona, M. D. and Matteo Porotto, Ph.D., Professors in the Dept. of Pediatrics and Directors, Center for Host-Pathogen Interaction, Columbia University Vagelos College of Physicians and Surgeons, New York, N. Y.

    “Having something new that works against the coronavirus is exciting.”

    Ferrets Help Scientists Produce Nasal Spray That Prevents COVID-19 Infection.

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  3. nivek

    nivek As Above So Below


    That's some good news, I heard something about this but forgot to follow up, here's a quote from your link...

  4. nivek

    nivek As Above So Below

    Experts caution against getting overexcited about COVID-19 vaccine, treatment news

    Leading public health experts are also painting a rosier picture. Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases and the country’s top infectious disease expert, told CNN that the U.S. could have doses of a COVID-19 vaccine ready to administer to people before the end of the year. He also called the Pfizer results a “big deal.”

    World Health Organization director-general Dr. Tedros Ghebreyesus tweeted about the new vaccine results.

    “We welcome the encouraging vaccine news from Pfizer & BioNTech & salute all scientists & partners around the who are developing new safe, efficacious tools to beat COVID-19,” he wrote. “The [world] is experiencing unprecedented scientific innovation & collaboration to end the pandemic!”

    It all sounds like good news — and experts tell Yahoo Life that it is. But there’s a lot to wade through, and it’s difficult to keep track of everything. Here’s where things stand at the moment.

    The Pfizer vaccine

    Pfizer announced on Monday that its candidate vaccine was more than 90 percent effective in preventing COVID-19 infection in participants in phase III clinical trials. The study has enrolled 43,538 participants and no serious side effects have been reported. The vaccine uses a newer technology called messenger RNA (mRNA) to prompt an immune response in people who receive the vaccine.

    “With today’s news, we are a significant step closer to providing people around the world with a much-needed breakthrough to help bring an end to this global health crisis. We look forward to sharing additional efficacy and safety data generated from thousands of participants in the coming weeks,” Dr. Albert Bourla, Pfizer Chairman and CEO, said in a press release. Based on projections, Pfizer says that it expects to produce up to 50 million vaccine doses in 2020 and up to 1.3 billion doses in 2021.

    Other vaccines

    There are 11 vaccines in phase III clinical trials, or the final phase, according to The New York Times’ coronavirus vaccine tracker. Like Pfizer, Moderna has a vaccine in phase III — and it uses similar technology. Fauci told CNN that the results from Pfizer “shows that the mRNA platform actually does work,” and cited Moderna as using similar technology.

    Eli Lilly’s therapy

    On Monday, the FDA granted an emergency use authorization for Eli Lilly’s monoclonal antibody therapy, bamlanivimab. Monoclonal antibodies are laboratory-made proteins that mimic the immune system’s ability to fight off viruses and other harmful agents, the FDA explains. Bamlanivimab specifically targets the spike protein of SARS-CoV-2 and is designed to block the virus’ attachment and entry into human cells.

    The therapy, which is administered intravenously, is authorized for patients who test positive for SARS-CoV-2, the virus that causes COVID-19, who are at least 12 years old, who weigh at least 40 kilograms (about 88 pounds) and who are at high risk for severe COVID-19 or could be hospitalized with the virus.

    It is now available to be distributed and administered for use.

    Other COVID-19 therapeutics

    Currently, the corticosteroid dexamethasone and anti-viral medication remdesivir are considered the mainstays of treatment for hospitalized patients with COVID-19, Dr. Richard Watkins, an infectious disease physician in Akron, Ohio, and a professor of medicine at the Northeast Ohio Medical University, tells Yahoo Life.

    What do doctors think?

    “There’s light at the end of the tunnel, both for COVID-19 vaccines and therapeutics,” Dr. William Schaffner, an infectious disease specialist and professor at the Vanderbilt University School of Medicine, tells Yahoo Life. “We’re having some successes, and that’s very exciting.”

    Dr. Amesh A. Adalja, senior scholar at the Johns Hopkins Center for Health Security, also tells Yahoo Life that “everything looks promising.”

    “Every day, we continue to learn about how the virus works,” Perry N. Halkitis, dean of the Rutgers School of Public Health, tells Yahoo Life. “As a result, we are more able to develop treatments to attack the virus, symptoms of the virus, and manifestations of the virus.”

    But, despite the advancements, Watkins says it will still be some time before life can return to normal. “It will be several months, at least,” he says. “There are lots of hurdles still.”

    Schaffner agrees. “There are many challenges in the implementation of both these therapies and the vaccines, and we’re going to have to deal with those,” he says. “We shouldn’t get overly excited.”

    “These developments don’t mean that today we don’t need to do what we were doing yesterday,” Adalja says. “Although we have these new things coming, they’re not here yet.”

    For the vaccine, Watkins points out that it’s unclear at this point how long immunity will last. Meaning, no one knows right now how often someone will need to get vaccinated to get the proper protection. The Pfizer vaccine also requires two doses, taken three weeks apart. “That will make compliance with that vaccine a challenge,” Watkins says.

    The Pfizer vaccine is also delicate. “It has very strenuous shipping and handling requirements,” Schaffner says. “It has to be kept very cold and has to be used very quickly because the vaccine degrades very quickly.” That raises a lot of questions about how, exactly, to distribute the vaccine, including whether people would need to go to a specified location to receive it.

    For bamlanivimab, it’s “hard to define” who the most at-risk patients are, Schaffner says. Actually administering the medication is difficult, too, he says. “We do outpatient IV therapy, but those are cancer patients — you don’t want a lot of people with COVID-19 going to those locations,” he says. “And the average doctor’s office is not set up to do IV therapy.”

    Overall, doctors urge people to be patient, continue to practice known methods of preventing the spread of COVID-19, like wearing masks and practicing social distancing, and know that things may get worse before they get better. “We are going to have a bad next few months,” Watkins says.

    “There are no magic wands or bullets here,” Schaffner says. “COVID-19 is not going away.”


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