Handle with Care

There has been much debate about the pros and cons of the therapy and trials have shown that it improves symptoms like difficulty in breathing and fatigue. But the decision is best left to the physician

- Dr KK Aggarwal

THE severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes Covid-19, is proving to be a mysterious virus even though knowledge about the disease is evolving every day. Accordingly, the guidelines for the management of patients are developed and regularly updated, based on the latest research. This has created several challenges, one being the discrepancy between trial findings and their clinical application.

There were no specific drugs for the treatment of Covid-19 till now and drugs were being repurposed as potential treatment for the disease. However, the multi-country Solidarity Therapeutic Trial, spearheaded by WHO, found that remdesivir had no effect on mortality in hospitalised patients with Covid-19. The other drugs tested alongside were hydroxy chloroquine, lopinavir/ritonavir and interferon, but they also did not reduce mortality. The results were surprising as trials by the National Institute of Allergy and Infectious Diseases, published on October 8, 2020, in the New England Journal of Medicine had shown that recovery was faster with remdesivir in hospitalised patients with Covid-19.

On October 22, remdesivir became the first treatment for Covid-19 to receive FDA approval for use in adults and children aged 12 years or older.

Another line of treatment is convalescent plasma, which is experimental, and has received regulatory approval for its use in Covid-19 patients who do not respond to standard treatment. It was accorded emergency use authorisation by the FDA as a potential promising treatment.