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Emergency Medicine Global Health Outbreaks and Updates

COVID19 Emerging Treatment

COVID19 Emerging Treatments

  • Chloroquine[1]
    • Antimalarial and autoimmune medicine
    • Commonly found as an oral tablet
    • Antiviral properties and immunomodulating effects
    • Currently in FDA phase 3 study [2]
      • 400mg by mouth, daily for 5 days
    • One study appears to advocate a 1gm loading dose followed by 500mg BiD[3]
      • There are questions on duration of treatment with this regime
    • Remdesivir study[4]
      • Developed by Gilead Sciences
      • Investigational broad-spectrum antiviral treatment previously trialed against Ebola
      • Shows good efficacy against MERS and SARS in animal studies[5]
      • 200mg IV on day one then 100mg daily for a total of 10 days [6]
        • University of Nebraska Medical Center study
      • Oseltamivir
        • Influenza A and B treatment
        • Currently under investigation
        • 75mg by mouth, twice per day for 5 days
      • Ribavirin
        • Hepatitis C antiviral treatment
        • 1200mg twice per day
      • Lopinavir/Ritonavir
        • HIV antiviral treatment
        • 400mg/100mg by mouth twice per day
        • Brand name Kaletra

 

Vaccine Development

  • Multiple laboratories are working on vaccines
  • Promising trials from Hong Kong [7]
  • Moderna Theraputics from Massachusetts[8]

Novavax announced on 2/26/20 it has started testing COVID-19 vaccine candidates in animal models in the hopes of identifying a candidate to be used in human testing as early as this spring[9]

[1] https://www.nature.com/articles/s41422-020-0282-0

[2] https://clinicaltrials.gov/ct2/show/NCT04261517

[3] https://www.sciencedirect.com/science/article/pii/S0924857920300820

[4] https://www.nih.gov/news-events/news-releases/nih-clinical-trial-remdesivir-treat-covid-19-begins

[5] https://www.niaid.nih.gov/news-events/remdesivir-prevents-mers-coronavirus-disease-monkeys

[6] https://www.pulmonologyadvisor.com/home/topics/lung-infection/clinical-trials-underway-to-test-remdesivir-for-covid-19/

[7] https://www.sciencedaily.com/releases/2020/02/200226091227.htm

[8] https://time.com/5790545/first-covid-19-vaccine/

[9] http://ir.novavax.com/news-releases/news-release-details/novavax-advances-development-novel-covid-19-vaccine

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