A Korean medical task force unveiled guidelines for treatment of patients with Covid-19, according to a Korean Biomedical Review article updated today.
http://www.koreabiomed.com/news/articleView.html?idxno=7428
If patients are young, healthy, and have mild symptoms without underlying conditions, doctors can observe them without administering antiviral treatment, according to the guidelines. Also, if more than 10 days have passed since the onset of the illness and the symptoms are mild, physicians do not have to start an antiviral medication, the task force said.
But, if patients are old or have underlying conditions with serious symptoms, physicians should consider an antiviral treatment. If they decide to use the antiviral therapy, they should start the administration as soon as possible, the task force noted.
For the antiviral treatment, the doctors recommended lopinavir 400 milligrams/ritonavir 100 milligrams (Kaletra two tablets, twice a day) or chloroquine 500 milligrams orally per day, the news service reported.
As chloroquine is not available in Korea, doctors could consider hydroxychloroquine 400 milligrams orally per day, they said. There is no evidence that using lopinavir/ritonavir in combination with chloroquine improves outcomes, they added.
Combining lopinavir/ritonavir with chloroquine or hydroxychloroquine could cause serious arrhythmias and drug interactions due to the increased QT interval, the task force said. Thus, the combination should be administered cautiously, in a very limited case, it emphasized.
The antiviral treatment is best at seven to 10 days. Still, the period could be shortened or extended depending on clinical progress, the doctors said.
The doctors did not recommend use of ribavirin and interferon as the first-line treatment because of many side effects. Physicians only should consider using ribavirin and interferon the other drugs don't work or cannot be administered.
Korea's Covid-19 death rate is below 1 percent, it has been reported. Though the "crude" rate is not altogether accurate, it compares very favorably with the "crude" rates elsewhere, which run between 2 and 8 percent.
In a related matter, on grounds that the therapy "might" work, a group of Chinese physicians issued a consensus recommendation that virtually every patient with Covid-19 pneumonia receive a 500-milligram chloroquine phosphate tablet twice per day for 10 days. The recommendation covers patients diagnosed with mild, moderate and severe Covid-19 pneumonia and without contraindications to chloroquine.
https://www.ncbi.nlm.nih.gov/pubmed/32164085
Expert consensus on chloroquine phosphate
for the treatment of novel coronavirus pneumonia
Leads for this post came from a MedMastery YouTube video.
Dr. Mehmet Cengiz Öz, a television personality who directs the Cardiovascular Institute and Complementary Medicine Program at New York-Presbyterian Hospital, told an interviewer that he was surprised that the press paid little heed to a French study that showed very effective results in fighting Covid-19 with a chloroquine regimen. See
Study: Chloroquine deals Covid-19 knockout blow
https://invisiblepaul.blogspot.com/2020/03/french-researchers-preliminary-results.html
Considering that the French test shows that the chloroquine treatment knocked out the virus in 75 percent of the small number of patients within six days -- shortening typical viral infection from 20 days -- an urgent question for the FDA is whether it is now running testing to see whether the French results are confirmed. As several days have passed since the French announcement, one would expect that U.S. health authorities would have preliminary answers within the next two or three days.
http://www.koreabiomed.com/news/articleView.html?idxno=7428
Fauci noncommittal on antivirals
Antiviral drugs should be administered only to patients at higher risk, and the drug regimen should begin as quickly as possible, task force members said in a video conference.
But, Dr. Anthony Fauci, the White House's point man in the Covid-19 fight, is hesitant about "anecdotal" reports about the efficacy of chloroquine and other anti-virals. Fauci has said he planned to consult with other medical experts on whether clinical studies should go forward. Fauci, a career government immunologist who is director of the National Institute of Allergy and Infectious Diseases and is a member of the White House Coronavirus Task Force, is noncommittal about President Trump's intense interest in these treatments. Fauci's comments were elicited by Fox commentator Laura Ingraham.
If patients are young, healthy, and have mild symptoms without underlying conditions, doctors can observe them without administering antiviral treatment, according to the guidelines. Also, if more than 10 days have passed since the onset of the illness and the symptoms are mild, physicians do not have to start an antiviral medication, the task force said.
But, if patients are old or have underlying conditions with serious symptoms, physicians should consider an antiviral treatment. If they decide to use the antiviral therapy, they should start the administration as soon as possible, the task force noted.
For the antiviral treatment, the doctors recommended lopinavir 400 milligrams/ritonavir 100 milligrams (Kaletra two tablets, twice a day) or chloroquine 500 milligrams orally per day, the news service reported.
As chloroquine is not available in Korea, doctors could consider hydroxychloroquine 400 milligrams orally per day, they said. There is no evidence that using lopinavir/ritonavir in combination with chloroquine improves outcomes, they added.
Combining lopinavir/ritonavir with chloroquine or hydroxychloroquine could cause serious arrhythmias and drug interactions due to the increased QT interval, the task force said. Thus, the combination should be administered cautiously, in a very limited case, it emphasized.
The antiviral treatment is best at seven to 10 days. Still, the period could be shortened or extended depending on clinical progress, the doctors said.
The doctors did not recommend use of ribavirin and interferon as the first-line treatment because of many side effects. Physicians only should consider using ribavirin and interferon the other drugs don't work or cannot be administered.
Korea's Covid-19 death rate is below 1 percent, it has been reported. Though the "crude" rate is not altogether accurate, it compares very favorably with the "crude" rates elsewhere, which run between 2 and 8 percent.
In a related matter, on grounds that the therapy "might" work, a group of Chinese physicians issued a consensus recommendation that virtually every patient with Covid-19 pneumonia receive a 500-milligram chloroquine phosphate tablet twice per day for 10 days. The recommendation covers patients diagnosed with mild, moderate and severe Covid-19 pneumonia and without contraindications to chloroquine.
https://www.ncbi.nlm.nih.gov/pubmed/32164085
Expert consensus on chloroquine phosphate
for the treatment of novel coronavirus pneumonia
Article in Chinese; Abstract available in Chinese from the publisherIn previous research, it was found that use of zinc with chloroquine enhances results in diseases related to Covid-19. A 2010 paper with the title "Zn2+ Inhibits Coronavirus and Arterivirus RNA Polymerase Activity In Vitro and Zinc Ionophores Block the Replication of These Viruses in Cell Culture" was published by PLOS One, an open source biology journal.
Multicenter collaboration group of Department of Science and Technology of Guangdong Province and Health Commission of Guangdong Province for chloroquine in the treatment of novel coronavirus pneumonia.
At the end of December 2019, a novel coronavirus (COVID-19) caused an outbreak in Wuhan, and has quickly spread to all provinces in China and 26 other countries around the world, leading to a serious situation for epidemic prevention. So far, there is still no specific medicine. Previous studies have shown that chloroquine phosphate (chloroquine) had a wide range of antiviral effects, including anti-coronavirus. Here we found that treating the patients diagnosed as novel coronavirus pneumonia with chloroquine might improve the success rate of treatment, shorten hospital stay and improve patient outcome. In order to guide and regulate the use of chloroquine in patients with novel coronavirus pneumonia, the multicenter collaboration group of Department of Science and Technology of Guangdong Province and Health Commission of Guangdong Province for chloroquine in the treatment of novel coronavirus pneumonia developed this expert consensus after extensive discussion. It recommended chloroquine phosphate tablet, 500mg twice per day for 10 days for patients diagnosed as mild, moderate and severe cases of novel coronavirus pneumonia and without contraindications to chloroquine.
Leads for this post came from a MedMastery YouTube video.
Dr. Mehmet Cengiz Öz, a television personality who directs the Cardiovascular Institute and Complementary Medicine Program at New York-Presbyterian Hospital, told an interviewer that he was surprised that the press paid little heed to a French study that showed very effective results in fighting Covid-19 with a chloroquine regimen. See
Study: Chloroquine deals Covid-19 knockout blow
https://invisiblepaul.blogspot.com/2020/03/french-researchers-preliminary-results.html
Considering that the French test shows that the chloroquine treatment knocked out the virus in 75 percent of the small number of patients within six days -- shortening typical viral infection from 20 days -- an urgent question for the FDA is whether it is now running testing to see whether the French results are confirmed. As several days have passed since the French announcement, one would expect that U.S. health authorities would have preliminary answers within the next two or three days.
Fauci's stance makes you wonder whether what critics take to have been Trump's overcautious behavior was a result of the advice from a career government bureaucrat.
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