With a Covid-19 illness, the chances treatment of recovery in autumn 2020 are greater than when the pandemic broke out in the spring. Because doctors have more experience in the treatment of corona patients.
The coronavirus not only attacks the lungs, but can also cause severe damage to blood vessels and kidneys. Physicians can take targeted action against this by inhibiting blood clotting and inflammation with medication. Remdesivir can inhibit the proliferation of coronaviruses
In the early stages of corona disease, the drug remdesivir can help when administered through the vein. The antiviral agent was originally developed for the treatment of Ebola. Remdesivir can inhibit the multiplication of coronaviruses in the cells and prevent them from spreading uninhibited in the body.
Currently, remdesivir is the only drug that has gone through clinical trials and is approved for the treatment of Covid-19. However, the results of two recent studies are disappointing with regard to the impact of the drug on patient survival. If remdesivir is administered later in the disease, it has no effect on mortality, according to interim results of a WHO study.Dexamethasone can prevent inflammation
In people seriously ill with Covid-19 who need artificial ventilation, the administration of the cortisone preparation dexamethasone has proven to be effective. The drug slows down an often occurring excessive immune reaction (“cytokine storm”). In the fight against the virus, the immune system also attacks its own body and thus triggers life-threatening inflammatory reactions in various organs. Dexamethasone has an anti-inflammatory effect and dampens the immune system.
In studies, dexamethasone was able to reduce mortality by a third in ventilated Covid-19 patients, and by about a fifth in those who only needed oxygen.Anticoagulants can prevent blood clots
Another therapeutic approach is the administration of anticoagulants. They are designed to keep the blood fluid and prevent damage to organs.
Autopsies of deceased corona patients showed that many small blood clots formed in various organs. However, it is not yet completely clear
- what part of this the virus itself has
- how many of those affected suffered from pre-existing conditions of the heart and lungs
- what damage the cytokine storm causes in the vessels.
Antibody therapy can support the immune system
Artificially produced antibodies against Sars-CoV-2 or obtained from the blood of recovered Covid-19 patients are intended to support the body of seriously ill people in the fight against the acute infection. So far, however, the study situation is still inconsistent.
For example, further testing of an initially promising antibody cocktail was stopped by the manufacturer due to new safety concerns. In addition, antibody therapies may have the disadvantage that they could hinder the development of the body’s own immunity against Sars-CoV-2. It is therefore unclear whether Covid-19 patients treated with antibodies could become infected again immediately after the antibodies have been degraded. Experts on the topic
Prof. Dr. Tobias Welte
Vice President and Medical Director Hannover Medical School
Prof. Dr. Marius M. Hoeper
Comm. Director of the Clinic for Pneumology
Hannover Medical School
Carl-Neuberg-Straße 1
30625 Hanover, Germany
www.mhh.de
Prof. Dr. Stefan Kluge, Director of the Clinic for Intensive Care Medicine
Deputy Head of the Centre for Anesthesiology and Intensive Care Medicine
University Medical Center Hamburg Eppendorf
Martinistrasse 52
20251 Hamburg, Germany
www.uke.de
Prof. Dr. Klaus F. Rabe, Medical Director
LungenClinic Grosshansdorf GmbH
Wöhrendamm 80
22927 Großhansdorf, Germany
www.lungenclinic.de
Dr. Stefan Schmiedel, Senior Physician
I. Medical Clinic and Polyclinic (Gastroenterology with Sections Infectiology and Tropical Medicine)
Center for Internal Medicine
University Medical Center Hamburg Eppendorf
Martinistrasse 52
20246 Hamburg, Germany
www.uke.de
Further information
Permanent Working Group of Competence and Treatment Centres for Diseases caused by Highly Pathogenic Pathogens
at the Robert Koch Institute (STAKOB)
Information on detection, diagnosis and therapy of patients with Covid-19 (as of 9.10.2020)
www.rki.de (PDF-Download)