NEW DELHI: There is no cure yet for Covid-19. Doctors and scientists are scrambling to find treatments and drugs that can save the lives of infected people and perhaps prevent infection. Even the most promising treatments to date only help certain groups of patients, and await validation from further trials. Here are 16 major treatments assessed by The New York Times, and what the latest research says about them.

BLOCKING THE VIRUS Antiviral drugs can stop viruses such as HIV and hepatitis C from hijacking our cells. Scientists are searching for antivirals that work against the new coronavirus. Remdesivir (Promising evidence) It stops viruses from replicating by inserting itself into new viral genes. While it didnt fulfill its original purpose of fighting Ebola and hepatitis C, preliminary data suggests it can reduce hospital stay in severe cases from 15 to 11 days. The latest data also hints that it might reduce death rates among those who are very ill.

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Favipiravir (Tentative or mixed evidence) Favipiravir is a flu drug that blocks a viruss ability to copy its genetic material. A small study in March indicated that it might clear out the coronavirus from the airway, but results from larger, well-designed clinical trials are still pending.

EIDD-2801 (Tentative or mixed evidence) Another antiviral originally designed to fight the flu, EIDD-2801 has had promising results against the new coronavirus in studies in cells and on animals. It is still being tested in humans. Recombinant ACE-2 (Tentative or mixed evidence) The coronavirus enters a cell by latching on to a human protein called ACE-2. Recombinant (artificial) ACE-2 proteins might be able to lure it away from vulnerable cells. They have shown promising results in experiments on cells, but not yet in animals or people. Lopinavir-Ritonavir (Not promising) At first, this combination of HIV drugs seemed to stop the new coronavirus from replicating, but clinical trials in patients proved disappointing and the WHO suspended them this month. However, the drugs might still play a role as a preventive and in treating patients with mild symptoms. Hydroxychloroquine and Chloroquine (Not promising) At the start of the pandemic, researchers found that these old anti- malaria drugs could stop the coronavirus from replicating in cells. A few small studies on patients also offered hope that hydroxychloroquine could treat Covid. However, data from randomised clinical trials shows hydroxychloroquine didnt help people with Covid-19 get better or prevent healthy people from contracting the coronavirus. Also, giving hydroxychloroquine to people right after being diagnosed didnt reduce the severity of their disease. The US Food and Drug Administration (FDA) now warns that the drug can cause serious side effects to the heart and other organs when used to treat Covid-19. MIMICKING THE IMMUNE SYSTEM Most patients fight off the virus with a strong immune response. Drugs might help people who cant mount an adequate defense

Convalescant Plasma (Tentative or mixed evidence) A century ago, doctors used plasma from the blood of recovered flu patients to treat people sick with flu. The same strategy has been tried on severely ill Covid patients and the early results are promising. The FDA has authorised plasma therapy for very sick Covid patients.

Monoclonal antibodies (Tentative or mixed evidence) Convalescent plasma contains a mix of antibodies, only some of which can fight the coronavirus. Researchers have identified the most potent Covid antibodies and their synthetic copies known as monoclonal antibodies can be manufactured in bulk and injected into patients. Safety trials for this treatment have only just begun.

Interferons (Tentative or mixed evidence) Interferons are molecules that our cells produce to make the immune system attack viruses. Injecting synthetic interferons is now a standard treatment for immune disorders. Experiments in mice and cells suggest that interferon injections could be used both as a preventive and a treatment for Covid-19.

PUTTING OUT FRIENDLY FIRE The most severe symptoms of Covid-19 are the result of the immune systems overreaction to the virus. Scientists are testing drugs that can rein in its attack

Dexamethasone (Promising evidence) This cheap and widely available steroid blunts many types of im- mune responses. Doctors have long used it to treat allergies, asthma and inflammation. A study of more than 6,000 people found that dexametha- sone reduced deaths by one-third in patients on ventilators, and by one- fifth in patients on oxygen.

Cytokine inhibitors(Tentative or mixed evidence) The body produces molecules called cytokines to fight off diseases. But in excess, they can trigger a cy- tokine storm, which causes the immune system to overreact to in- fections. Researchers have created several drugs to halt cytokine storms, including tocilizumab, sari- lumab and anakinra. While a few have offered modest help in some trials, others have faltered. The drug company Regeneron recently announced that a branded version of sarilumab, Kevzara, failed Phase 3 clinical trials.

Cytosorb (Tentative or mixed evidence) Cytosorb is a cartridge that filters cytokines from the blood in an at tempt to cool cytokine storms. The machine can purify a patients entire blood supply about 70 times in a 24-hour period.

Stem cells (Tentative or mixed evidence) Certain kinds of stem cells can secrete anti-inflammatory molecules. Researchers have tried to use them to treat cytokine storms, and now dozens of clinical trials are under way to see if they can help Covid-19 patients. But stem cell treatments havent worked well in the past, and its not clear yet if theyll work against the coronavirus.

OTHER TREATMENTS Doctors and nurses often administer other supportive treatments to help patients with Covid-19.

Prone positioning (Widely used) The simple act of flipping Covid-19 patients onto their bellies opens up the lungs. The manoeuvre might help some individuals avoid the need for ventilators entirely.

Ventilators (Widely used) Devices that help people breathe are an essential tool. Some patients do well if they get an extra supply of oxygen through the nose or via a mask connected to an oxygen ma- chine. Patients in severe respira- tory distress may need to have a ventilator breathe for them until their lungs heal.

Anticoagulants (Tentative or mixed evidence) The coronavirus can invade cells in the lining of blood vessels, leading to tiny clots that can cause strokes. Anticoagulants are commonly used to slow the formation of clots, and doctors sometimes use them on Covid-19 patients with clots.

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What the research says about Covid-19 treatments - ETHealthworld.com