Thousands of researchers around the world are working to
find new treatments for COVID-19, the disease caused by the corona virus. One
of the most promising projects was organized by the University of California
(San Francisco) and led to the identification of 50 existing and developed
drugs for other diseases, which could offer new systems to block the virus and
prevent it from replicating in the cells of the our organism. Compared to
other epidemics that have emerged in the past and on a smaller scale, research
is proceeding faster, between hopes and first failures in experiments.
There is no Cure
Today there is no cure against COVID-19. Most infected people develop mild symptoms, which pass after a few weeks of isolation at home by taking medications to reduce fever and pain. For others, hospitalization may be necessary due to more severe symptoms, especially in the respiratory system. Hospitalized patients are treated in normal wards or in intensive care , depending on their condition, but with treatments that can only reduce symptoms or promote breathing (using oxygen masks or incubation). The goal is to save time by preventing the patient from getting worse while his immune system reacts to the infection to get rid of the virus.
Medicines and Proteins
The search for effective drugs is therefore focusing on the identification of active ingredients that can block the corona virus, preventing it from attacking the cells and exploiting them to replicate and increase the infection. Hundreds of researchers coordinated by the Quantitative Biosciences Institute Corona virus Research Group (QBI) of the University of California, for example, are studying the drugs available on the market today, to identify the most promising candidates against COVID-19. The goal is to find active ingredients that act as a barrier between the corona virus and the proteins of our cells that are used by the virus to produce its copies.
The research at
the QBI were initiated in early January, when they began to circulate the first
information about corona virus (SARS-CoV-2) , following the first
serious cases of atypical pneumonia in Wuhan, in China, where the current
epidemic has started. The most important activity concerned the study of
proteins present in our cells which are exploited by the corona virus to
replicate it. A mapping of this type usually takes a couple of years to be
carried out, but thanks to the collaboration of about twenty laboratories it
was possible to obtain a first map in a matter of weeks.
The result was made possible by the knowledge accumulated in
past years, through the study of other viruses. For example, the
researchers had already done a map of the proteins exploited by HIV and by some
viruses that cause Ebola and dengue.
Laboratory studies carried out in February have made it
possible to discover over 400 proteins that, in one way or another, seem to be
involved in the activity of corona virus on the respiratory system. They
are used in various ways, for example to evade the defenses of the protective
envelope of the cell (cell membrane), insert the genetic code (RNA) of the corona
virus and then exploit the cell structures (organelles) to produce new copies
of the virus, which are released by the cell. These copies then attack
other respiratory cells to further replicate. The immune system reacts
with an inflammation, which serves to kill the virus and destroy the cells that
act as copiers, but the counterattack is not always effective and so there is a
worsening of patients.
The map has highlighted several interactions between corona
virus and cellular proteins that, at least so far, seem to have nothing to do
with producing new copies of the virus. These interactions that have gone
unnoticed so far could hide the key to understanding some characteristics of
viral replication, offering the possibility of intervening to block
it. For each protein on the map, researchers are analyzing the active
ingredients of thousands of drugs that already exist, and are designed for
other diseases, looking for solutions to prevent corona virus from taking
advantage of them.
A first set of ten drugs was recently sent by the QBI to
Mount Sinai Hospital in New York and the Pasteur Institute in
Paris. Laboratory tests include, among other things, the analysis of the
reaction of corona virus to active ingredients in non-human primate cells in
vitro. Depending on the results, the researchers will then be able to test
the drugs on guinea pigs infected with corona virus.
Only after these first tests will it be possible to proceed
with the experimentation on human beings, with great attention for possible
side effects. Active ingredients useful for reducing corona virus
replication by intervening on some proteins, for example, could have unexpected
effects on other activities of the body. New technologies and the
commitment of numerous researchers are making it possible to shorten the time,
but it will still take months before identifying an effective treatment for the
most serious cases of COVID-19.
The work of the QBI concerns numerous drugs developed to treat some forms of cancer and not necessarily viral infections. Other researchers are instead devoting themselves to the anti-virals already available that is, the drugs that are used to slow down or stop the replication of viruses. Their active ingredients are quite specific, but it is hypothesized that with the right combination, results can also be obtained with COVID-19.
Among the anti-virals believed to be the most promising for
now is remdesivir , a recently introduced drug, developed over the years
of the epidemics caused by Ebola in West Africa between 2013 and 2016. His
experimentation led to results that seemed to be encouraging, but a use on a
larger scale revealed poor efficacy compared to other solutions. The drug
had also been tested to treat some cases of MERS and SARS, respiratory
syndromes caused by other corona viruses, with some positive results.
Remdesivir is currently undergoing at least five clinical
trials. The goal is to understand not only if it is effective against the
current corona virus, but also if it involves side effects tolerable by
patients. In some cases, in fact, very powerful drugs could have the
contraindication to do more harm than good, and finding the right balance is
From China, meanwhile, the first evaluations have arrived on
another experiment with anti-virals that had been deemed promising, and the
news is not good. In the scientific journal The New England Journal
of Medicine, a group of researchers reported that
they had found no benefit in seriously ill patients with COVID-19 after the
administration of lopinavir and ritonavir, two anti-virals normally used
against HIV and which appeared to be indicated. in the treatment of corona
In the study, however, the researchers explain that their
experience was partial and that their conclusions should not be considered
definitive. The research was conducted on 199 adults aged between 49 and
68 years, all hospitalized in serious condition due to corona virus in a Wuhan
hospital. For 14 days half was treated with normal therapies and half with
the two anti-virals: at the end of the experiment, no differences were found
between the two groups neither in terms of shortening the disease nor in
In an editorial accompanying
the study, doctors and researchers were praised for the accuracy of their work,
carried out in very difficult conditions with hospitals full of patients to
attend. The hope is that clinical trials such as this one will be repeated
in other hospitals, to have more data and information on the possible efficacy
of drugs and treatments.