Tue, 03/31/2020 - 21:34
A colleague asked me about hyper-immune serum, corticosteroids etc.
It stimulated me to look up the literature on SARS. You can find the review as download; it shows that the hyper-immune serum trials were very few, showed some effect, but were not very convincing in set-up. For COVID, 2 trials are ongoing 17 and 18 in my list).
My take is that we would rather need a combination of very potent and broadly neutralizing antibodies.
In the list, selected from ClinicalTrials.gov, you find two main categories:
- Antivirals: no surprises
- a TMPRSS2 serine protease inhibitor, to block maturation of the spike
- ACE2 receptor inhibitors
- Rendesivir
- Hydroxy-Chloroquine in various setting (also prophylactic and post-exposure)
- Lopinavir.RTV (the first well-controlled trial was published in NEJM and failed)
- Various drug and combinations
- Anti-inflammatory: besides 1 corticosteroid trial, many monoclonals that have shown effects in rheumatoid arthritis, cancer, multiple sclerosis
- Stem cells
- Viagra (you would not believe it…)
I also include the specific guidelines for COVID trials, from Europe and Belgium.
Best wishes,
Guido