Current infections
UK
Cases, + 20, 641
Active, 264,034

US

Cases, + 301,438 (last 7 days)

President Trump’s meds

Dr. Sean Conley

Oxygen dropped twice

Did not need oxygen for long at all

Slight cough

Viral load not established yet

Fever

Now

No fever, reducing meds for past 72 hours

No evidence of live virus

Normally 10 days after day 1

Most viral shedding in first 5 days

Not out of the woods yet

https://www.bostonglobe.com/2020/10/0...

Remdesivir

Regeneron treatment, REGEN-CoV-2

Dexamethasone

Zinc

Vitamin D

Famotidine

Melatonin

Daily aspirin

Remdesivir

5 days, intravenous

FDA emergency approval for anyone in hospital with COVID

Probably needs to be given very early

Effect of Remdesivir vs Standard Care on Clinical Status at 11 Days in Patients With Moderate COVID-19, A Randomized Clinical Trial, (JAMA, 21st August)

https://jamanetwork.com/journals/jama...

n = 584

Moderate COVID-19

Remdesivir group and standard care group

7-point ordinal scale on study day 11

5 day course, statistically significant difference in clinical status

Difference was of uncertain clinical importance

10 day course, no statistical difference from standard care


Antibody therapy (Friday 2nd October, morning)

MABs are produced from cell cultures

REGEN-CoV-2

8 grams

2 antibodies which attach to the spike protein

2 monoclonal antibodies

Only available for trial use

Given as compassionate use

Passive immunity

Probably lasts for 4 to 6 weeks

Recovery trial

https://www.recoverytrial.net

RECOVERY COVID-19 phase 3 trial to evaluate Regeneron’s REGN-COV2 investigational antibody cocktail in the UK

https://www.recoverytrial.net/news/re...

14th September

2,000 patients in each group

Dexamethasone

Recovery trial

Early use may reduce immune response

Dexamethasone in Hospitalized Patients with Covid-19 — Preliminary Report, (NEJM, 17th July

https://www.nejm.org/doi/10.1056/NEJM...

Experimental group, n = 2,104

Standard care group, n = 4,321

In patients hospitalized with Covid-19,

Dexamethasone reduced 28-day mortality among those who were receiving either invasive mechanical ventilation or oxygen alone

No benefit in those receiving no respiratory support.

Greatest benefit in those being ventilated

Zinc

The Role of Zinc in Antiviral Immunity, (Advances in Nutrition, July 2019)

https://academic.oup.com/advances/art...

Hundreds of key enzymes

Transcription factor

Second-most abundant trace metal in the body

Zinc deficiency results in a compromised immune system

Required to mount an effective antiviral response

Direct antiviral properties (e.g. influenza)

Critical in generating innate and acquired antiviral responses

The Potential Impact of Zinc Supplementation on COVID-19 Pathogenesis (Frontiers in Immunology, July, 2020)

https://www.ncbi.nlm.nih.gov/pmc/arti...

Preserve natural tissue barriers

Respiratory epithelium, preventing pathogen entry

Probably useful, especially in zinc deficiency

Studies are needed

Testing the effect of zinc as therapeutic option for established disease

Cost-efficient

Globally available

Simple to use

Little to no side effects


Vitamin D

Spanish clinical trial

https://www.ncbi.nlm.nih.gov/pmc/arti...

Calcifediol group, 2% required admission to the ICU

Control group 50% admitted to ICU

Famotidine

H2-receptor antagonists

Cimetidine, ranitidine

Melatonin

Hormone

Pineal gland

Regulates the sleep–wake cycle

Interacts with the immune system

Reduces inflammation

Safety and Efficacy of Melatonin in Outpatients Infected With COVID-19
https://clinicaltrials.gov/ct2/show/N...

Phase 2


Daily aspirin
300 mg
600 mg
900 mg

Low dose

https://www.nhs.uk/medicines/low-dose...

75 mg day

Statins
Talk to Karen about art books like the one she sent me
https://www.youtube.com/redirect?redi...