Patients Critically Ill With COVID-19 At Hospitals In New York City

Can COVID-19 Recover Plasma Disease Patients: Clinical trials will test whether antibodies to the coronavirus prevent infection and aid survival. As of March 28, 11 seriously ill COVID-19 patients in New York City hospitals had fallen ill and Houston became the first in the United States to receive a promising experimental treatment.

But the medicine, which is licensed for emergency use by the US Food and Drug Administration, is not made in a pharmaceutical laboratory. It comes from the blood of other patients who have recovered from the coronavirus infection.

Treatment consists of COLID-19, a liquid component of blood taken from an infection survivor. Now that the United States leads the world in confirmed cases of the disease, and there is no proven treatment yet, researchers are racing to establish clinical trials to find out if SARS-CoV-2, how effective it is against viruses that cause COVID-19.

If the treatment is beneficial, it can get FDA approval for widespread use. A vaccine against SARS-CoV-2 is the most distant compared to the year (SN: 2/21/20). In an effort to control COVID-19 over the next several months, the question is, “What types of treatments can we administer to reduce this epidemic?”

Pathologist John Roback of the Emory University School of Medicine in Atlanta, who conducts research on transfusion medicine. He said the main candidates are already approved drugs for the treatment of diseases such as malaria, which can be remodeled for COVID-19 (SN: 3/10/20) and summon plasma.

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To fight a virus, the immune system develops antibodies, proteins that bind to parts of the virus and prevent infection. When a person produces antibodies in response to an infection or after being vaccinated, it is called active immunity.

The initial ramp to antibody production can take about a week or two, but once this happens, the immune system will be able to respond quickly to the next exposure to the virus. For some viruses and vaccines, active immunity can last for decades or even a lifetime.

Convulsive plasma, also known as passive antibody therapy, is a type of passive immunity. It can provide antibodies right away, but the protein will only last a few months, possibly a few months.

“We’re using antibody-enriched plasma from a patient with spasm,” says Jeffrey Henderson, a physician and infectious disease scientist at Washington University School of Medicine in St. Louis.

Henderson, United States He is part of a group of researchers working to conduct clinical trials for convalescent plasma, called the National COVID-19 Convalescent Plasma Project. There are plans to analyze plasma in three different groups.

A randomized clinical trial is designed to test whether plasma can prevent infection in people exposed to Cov-19, such as a family member, an infectious disease physician at Johns Hopkins University School of Medicine. Says project member Samuel Shoham.

They say that COVID-19 patients recovered during the trial trial will undergo a plasma test, which will be from plasma taken from patients prior to the December 2019 pandemic. Another test is planned to see if plasma can sustain people with moderate illness who are hospitalized in need of intensive care, Shoham says.

And a third trial aims to study whether the therapy helps critically ill patients. The project is awaiting the green light from the FDA to begin enrolling patients in all trials. Controlled clinical trials are needed to get definitive answers on whether rheumatism can prevent plasma disease or improve COVID-19 symptoms, and which ones can help the most.

But a look at the history of infectious diseases, described in an April 1 comment in the Journal of Clinical Investigation, provides several examples where passive antibody therapy appeared to prevent or ameliorate infection. Concurrent plasma was used to help prevent measles and mumps outbreaks before vaccines were available.

There is some evidence that people who received plasma during the 1918 influenza epidemic were less likely to die. Convulsive plasma has also been used against SARS and MERS, two other coronavirus epidemics. But the studies that showed any benefit did not compare how the treatment worked with the placebo.

This is also true for previous studies on the use of plasma for the treatment of COVID-19. In one, five critically ventilated COVID-19 patients received convulsive plasma 10 to 22 days after hospitalization in Shenzhen, China.

As of March 25, after just over 50 days in the hospital, and in stable condition after 37 days of transfusion, three patients were discharged, the researchers reported March 27 in JAMA. Although the patients improved, they also received antiviral drugs, so it’s unclear what therapy, if any, had an effect.

In the United States, some blood banks and hospitals are preparing to collect plasma from people recovering from COVID-19. The Red Cross has established a donor application form for those who wish to contribute plasma. There is also information to register for plasma donation to the National COVID-19 Convulsive Plasma Project.

For clinical trials in the United States, researchers will examine donated plasma to determine whether to neutralize the antibodies it contains, Henderson says. This type of antibody prevents the virus from entering the host cell, preventing infection. The data so far suggest that the spike protein.

A specific protein in SARS-CoV-2 that the virus uses to bind to a protein in human cells (SN: 2/3/20), is used to neutralize antibodies. points towards. Researchers suspect that this type of antibody is what makes convulsive plasma effective. And it also indicates which one can be more beneficial when using plasma.

At the onset of the disease, the virus is infecting cells and hijacking the cellular machinery to make multiple copies of itself. “But as the disease progresses, the tissue damage caused by the virus is more difficult to reverse and is not necessarily directed at the virus alone,” Henderson says.

The body’s inflammatory response can contribute to the damage. This, she says, does not mean that passive antibody therapy doesn’t help anyone with COVID-19 get seriously ill, she says. “Of course, we have a lot to learn, but we are thinking that antibodies can prevent the virus from increasing their numbers.”

Seizure plasma clinical trials are starting in other countries as well. While physicians await a response to full testing, other patients may be treated under the emergency authority of the FDA. It’s great that critically ill patients and their doctors have this option, Shoham says. Meanwhile, “We are trying to find out what really works.

The plasma of patients recovered with COVID-19 contains antibodies that can help reduce the effects of the virus in critically ill patients. Chengdu, China – As Corontica spreads to all continents except Antarctica, and more than 3,000 people have died.

China is recovering to develop effective COVID-19 treatments. Doctors focused on halting disease progression at the critical stage as work continues to develop effective drugs, the vaccine. Dr. Kong Yufeng, a recovered patient from COVID-19 who went through his 14-day quarantine, donates plasma to a clinic in Wuhan, Hubei province, China.

Scientists and doctors from around the world are rushing to cure the disease, COVID-19, before Infecting More and more people and an even greater challenge to global health. The progress made by Chinese health workers in curing the disease offers hope: More than half of patients in China.

Where it first emerged late last year, have reportedly been discharged, and the remaining number of confirmed cases has been reduced to less than 35,000. China is exaggerating the recovery rate and providing medical assistance to other countries when necessary.

Foreign Minister Wang Yi called his counterparts in the worst-affected countries of Italy and Iran over the weekend to offer assistance. Most of those who have recovered have experienced mild symptoms of the disease, but there is an increase in mortality among the elderly and those whose infection is in a critical state.

According to a doctor who works at one of Wuhan’s main hospitals, this remains a major challenge for medical personnel treating COVID-19 patients who requested anonymity while hospital management spoke to the media. He was detained.

The overall death rate among those infected is approximately 2.3 percent in China. However, according to a study on initial samples, published last week in The Lancet, a UK medical journal, the disease killed 61.5 percent of seriously ill people.

The doctor told Al Jazeera: “Common procedures for treating pneumonia, such as using a ventilator, applying patients to antiviral and antibacterial treatments, and using steroids proved to be relatively ineffective in treating patients who are found in the later stages of the disease.

Coronavirus swabs – A photo provided by the National Institutes of Health (NIH) shows a transmission electron microscope image of SARS-CoV-2, also known as 2019-nCoV, which causes the COVID-19 Es virus, which is different from a patient. America. Doctors in China say the virus does not respond to traditional pneumonia treatments.

The unsatisfactory supply of ECMO machines and effective medications contributed to the high mortality rate, and the doctor referred to the machine that provides cardiac and respiratory support to patients whose heart and lungs are failing.

Authorities have emphasized the importance of reducing mortality among those who are most severely affected, generally those who are older or who have existing health problems, such as heart disease, diabetes and hypertension.

“One of the main things we’re trying to do right now is reduce the number of patients whose condition is progressing to the critical phase and improve the survival rate of those who are already in that state.” Levels ”, said the doctor.

To do this, we need to understand what medications will be useful. According to the latest data from the Chinese Clinical Trials Registry, 293 clinical trials of various drugs that have existed so far have the potential to combat new coronaviruses.

Despite the general logic of “more testing, better chance of success, some experts have expressed concern about the large amount of testing that has been done and how this can really disrupt the research process. A doctor at a major research institute in Beijing said:

Frankly, it is a bit ridiculous that there are so many clinical trials underway, especially given the fact that some of the drugs used in the tests are not likely to be effective in treating the disease. Gumnami Baba said to Al Jazeera.

As a result, this leaves less room for trials that are actually an opportunity to effectively treat patients and indirectly slows down the process of finding a real cure. While there is currently no single medication that has allowed scientists to determine its efficacy against the disease.

All 293 medications or a combination of medications have been tried, one stands out: Remedisvir, an antiviral medication that is made by the American pharmaceutical company. Gilead. Science and purpose to fight the Ebola virus.

“The only medicine we have at the moment is that we can have real efficacy and that is Remedisvir,” Bruce Aylward, deputy director general of the World Health Organization or WHO, said at the press conference after visiting the epicenter of the outbreak in Wuhan.

The drug made its debut in the fight against COVID-19 early last month, when a paper report on treating a case discharged in the United States was published in The New England Journal of Medicine. Two days later, the Sino-Japanese Friendship Hospital in Wuhan also began its clinical trial, and results are expected in April.

Which may give doctors a more definitive answer to the drug’s effectiveness. Plasma donation: Gilead also announced the start of a two-phase 3 clinical trial to assess the drug’s safety and efficacy on February 26, which would include 1,000 infected adults. Doctors in China are putting other contenders into clinical trials.

In addition to remdesivir, doctors in China are putting other contenders into clinical trials, including chlorine phosphate, an antimalarial drug, after finding “apparent efficacy” in treating COVID-19. Previously, HIV drugs, such as lopinavir or arbidor, were also included in China’s diagnostic and treatment plan, which has been updated six times since the outbreak began.

None of these medications has been universally applied to all patients struggling with new coronaviruses. This problem extends to plasma drawn from donated blood from those who have recovered. Earlier this month, doctors confirmed that using plasma had some benefit in fighting the disease, but experts remain cautious.

Any complementary medication or option is only part of the entire treatment plan, so the idea of injecting plasma to give patients immediate results can only be seen in the movies,” said Dr. Zhang Wenheng, leader of a medical team sent from Shanghai. he said. To help Wuhan cope with the outbreak.

The results are limited, and the use of plasma will likely reduce the time it takes to treat the disease from five to 10 days to three to five days. Others are also alerted to the treatment, preferring to wait until the test results are revealed. Outstanding professor at Columbia University, Dr. David Ho said:

It is unclear how effective these drugs will be and we need some new drugs to effectively slow the progression of the disease. In addition to using existing drugs, the development of a vaccine has also been in the news since a group of scientists in Shanghai first released the viral genome of the virus in early January.

Finding a Vaccine: Despite a concerted effort from around the world, experts believe it will take at least a year for any vaccine to be available to the general public. Modern, a US-based biotech company, is leading the world race and on February 24 launched the first batch of a vaccine against the new coronavirus for human use.

In a statement, the company said that the vials of mRNA-1273, the name of the official vaccine, had been sent to the National Institute of Allergy and Infectious Diseases (NIAID) to be used in the Phase 1 study in the United States.

The clinical trial will be the first at a research center in Seattle among 45 volunteers and is expected to take 13 months to determine the primary goal, whether the vaccine will trigger an immune system response and whether it is safe.

After Phase 1, there will be a clinical trial to assess the vaccine’s ability to counter the truly new coronavirus. “The earliest efficacy test will take an additional six to eight months, making it the fastest we can get a virus sequence from a test.”

It will not apply unless it applies to the epidemic, unless it lasts another year or year and a half, “NIAID Director Anthony Fauci said last week at a press conference hosted by the President of the United States, Donald Trump said.

In addition to the lengthy process of developing a vaccine from scratch, the researchers also expressed concern about its fate: many doubts could halt its development if the outbreak begins to stop, as happened with SARS, originating in China, the last major outbreak to occur.

A leading pulmonologist in China, Dr. “We never had a chance to test SARS vaccines because there was no need to continue development at that time,” said Zhong Nanshan. “However, I think the nature of the rapid spread of the virus in this case, and how unexpectedly the epidemic will last until later, is important to continue this effort.”

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