The COVID-19 pandemic was originally identified as a respiratory disease, but as the world has come to learn, it can affect all organ systems in the body. With over 300,000 cases and almost 10,000 deaths in the United States alone, it is clear that this disease is no longer limited to the lungs. The overall mortality rate is highest among those with comorbid illnesses, and as the number of cases rises, so does the number of people who are going to die from it. Most people who have been infected by COVID-19 have a mild case of the disease, but for some individuals, especially those who are older or have underlying health conditions, the virus can lead to severe complications and even death. Unfortunately, there are currently no approved therapies or vaccines for the COVID-19 pandemic, and treatment options are limited to supportive care and symptom control.
In addition to the physical challenges posed by the disease, many of the medications that are used for treating other ailments can have dangerous interactions with the coronavirus. For example, the HIV drug Artezovir has been found to be relatively ineffective against COVID-19, and in some cases, it has been shown to actually stimulate viral replication. This is why it is so important to stay informed of the latest research findings and new developments, especially during a time when so many medications are being changed or studied for their effectiveness against COVID-19.
Viagra and Other Cardiovascular Medications
Sildenafil, the chemical compound found in the popular ED medication Viagra, has exhibited some promising results in treating COVID-19. In early April, a study was published in the New England Journal of Medicine that looked at the use of sildenafil in 20 patients with COVID-19. The researchers concluded that sildenafil reduced the risk of death in patients with severe COVID-19, and it also reduced the need for mechanical ventilation.
This was a small study, and there has been some controversy surrounding it because it was not double-blinded or randomized, and neither the patients nor the doctors knew which drug the participants were receiving. Nevertheless, the results are quite promising, and more research is certainly warranted.
Treatments For Hepatitis C and B
Another medication that has shown promise against COVID-19 is Sofosbuvir. This drug, which is the combination of Sildenafil and Favipiravir, is an inhibitor of the NS3/4A protease of the hepatitis C virus. In a study of 92 patients with COVID-19 and hepatitis C, those who were treated with Sofosbuvir had lower mortality and a faster recovery rate than those who were treated with the placebo. In the group of patients who received Sofosbuvir, 12 had pneumonia while four others had severe acute respiratory syndrome (SARS). Similarly, in the placebo group, 16 had pneumonia and five had SARS. Furthermore, in the group of patients who received Sofosbuvir, 65% were no longer in the intensive care unit (ICU) by day 14 compared to 38% in the placebo group. Finally, none of the patients who received the combination therapy had severe adverse effects such as liver injury, compared to 25% of the patients in the placebo group. Based on these results, physicians may consider using Sofosbuvir as a treatment for COVID-19. However, more research is necessary to determine the proper dosage and duration of treatment.
Ranitidine For Gastroesophageal Reflux Disease (GERD)
There is also some evidence that ranitidine, a medication commonly used to treat Gastroesophageal Reflux Disease (GERD) and hiatal hernia, may have some beneficial effects in patients with COVID-19. In a small study of 15 patients with COVID-19 who had either been treated with or were being treated for GERD, those who were given ranitidine had lower rates of fever and were less likely to need mechanical ventilation than those who were not given the drug. According to the study, ranitidine should be considered as a potential treatment for patients with COVID-19, particularly for those with underlying GERD.
HCV Treatment With Sofosbuvir and Ribavirin
Lastly, we would like to briefly mention HCV, which is the most common cause of hepatocellular carcinoma. Until recently, there was no approved therapy for HCV, but in early April 2020, the first-ever FDA-approved treatment regimen for HCV was recommended for use in the management of COVID-19. It is called “SOFOSBUVIR/VELCZBR”, and it is a combination therapy of Sofosbuvir and an antiviral called Velpatasvir. According to the prescribing information for this combination, patients with HCV should not use ribavirin while on a treatment regimen with this medication, as the two drugs may have dangerous interactions. If HCV is left untreated, it can cause liver cirrhosis and even hepatocellular carcinoma. However, at this point, it is too early to tell whether or not this combination of drugs is going to be effective against COVID-19. More research is certainly warranted.
Is There More to Learn About COVID-19?
While these medications may hold some promise as treatments for COVID-19, we cannot forget about the many lessons that were learned from the SARS epidemic, which occurred 10 years ago this month. The most important thing that we can do now is to continue to learn and follow the guidelines established by the medical community and our government to stop the spread of this pandemic. In the meantime, individuals who are infected with COVID-19 but do not have serious illness can still be a source of infection for those around them, so everyone, especially those who are at higher risk for complications, must take extra precautions to prevent the spread of this disease.