Early Intervention with Repurposed Drugs to Treat COVID-19

Abstract

Background: Severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) is a single-stranded RNA virus responsible for the Coronavirus disease 19 (COVID-19) pandemic. A hallmark of the virus is its spike protein, which interacts with the angiotensin-converting enzyme 2 (ACE-2) receptor to invade the cell. After entry, SARS-Cov-2 hijacks existing cellular machinery to self-replicate. The virus binds to the ACE-2 receptors and activates bradykinin production. Early symptoms of COVID-19 include dry cough, sore throat, fever, chills, muscle aches, diarrhea, abdominal pain, shortness of breath, and loss of taste and smell. Repurposed drugs were used to treat COVID-19 early, preventing complications of a deadly cytokine storm that starts around day 10. This study evaluates the effectiveness of these repurposed drugs. Methods: A retrospective observational study to review the efficacy of treatment by measuring symptom resolution. Quantitative symptomatic data was observed for 26 patients (9 patients were 55+) with a lab-confirmed, positive SARS-CoV-2 test. Patients' symptoms improved rapidly in the first ten days. Symptom plot analysis over time with correlation coefficient for each medicine was examined. The medicines were lopinavir/ritonavir (Kaletra), bamlanvimab (monoclonal antibody), glycopyrrolate-formoterol (Bevespi), ciclesonide (Alvesco), famotidine (Pepcid), and diphenhydramine(Benadryl). How each medication works on Covid pathways is shown. Results: Out of 26 patients, eight (30.8%) were treated with lopinavir/ritonavir, bamlanvimab, glycopyrrolate-formoterol, ciclesonide, and diphenhydramine. Patients experienced a rapid improvement in COVID-19 symptoms within 3 - 5 days. The correlation coefficients for each medicine and the number of symptoms were determined. The more negative the faster the resolution of symptoms: Correlation coefficient for Kaletra -0.1407, Bevespi -0.227, Alvesco -0.2191, famotidine -0.1554 Conclusion: Early treatment, with a combination of the repurposed drugs Kaletra, Bevespi (glycopyrrolate-formoterol), Alvesco (ciclesonide), Benadryl (diphenhydramine), Monoclonal Antibodies (bamlanvimab), and Pepcid (famotidine)] interrupts the viral life cycle and prevents the progression into a cytokine storm.