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Antiviral compounds?

Old 03-31-20, 10:44 PM
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Antiviral compounds?

I haven't heard much about the use of antiviral compounds in the fight against SARS-CoV-2. Looking at how China managed to control this far better than one might have expected, based on the experiences of Spain, Italy and now the US, it makes me wonder if they were doing something fundamentally different. (I fully understand social isolation can be more easily enforced in a police-state, but is that enough to account for the differences?) One thing I did hear is that the Chinese have been deploying various antiviral compounds. Why don't we?

There are some interesting pre-prints if you are interested:

https://www.biorxiv.org/content/10.1...03.19.997890v1

https://www.biorxiv.org/content/10.1...03.22.002386v3
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Old 03-31-20, 11:15 PM
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The most effective treatment is to promote the body's own immunity. In addition, there are a few natural substances that are beneficial, such as eucalyptus oil.

Traditional Chinese medicine is still widely used in China. Many people would have used it.
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Old 03-31-20, 11:32 PM
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I completely agree that an effective vaccine would be ideal, but it might be a way's off.

I'll skip the Pangolin extract.
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Old 04-01-20, 07:59 AM
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Originally Posted by wgscott View Post
I haven't heard much about the use of antiviral compounds in the fight against SARS-CoV-2. Looking at how China managed to control this far better than one might have expected, based on the experiences of Spain, Italy and now the US, it makes me wonder if they were doing something fundamentally different. (I fully understand social isolation can be more easily enforced in a police-state, but is that enough to account for the differences?) One thing I did hear is that the Chinese have been deploying various antiviral compounds. Why don't we?

There are some interesting pre-prints if you are interested:

https://www.biorxiv.org/content/10.1...03.19.997890v1

https://www.biorxiv.org/content/10.1...03.22.002386v3

That is obviously the first line of new treatments that will be used, but figuring out which ones are safe AND effective is going to take trials. Those pre-prints are about compounds that haven't been tested on humans yet.

My understanding is that Europeans generally move to human trials faster than the US, so I suspect that might be where we get the first proper clinical trials. Otherwise, I suspect we'll see some non-systematic "they're going to die anyway without it" off-label use in the US that won't be able to tell us whether they're actually helping.
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Old 04-01-20, 08:21 AM
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In the absence of any advice other than to self isolate and when one must go out in public, maintain 2 meters from each other it's left to ourselves what other we may do in hope it might help. And to those ends, myself and my partner have taken to attending to our immune systems by way of daily raw garlic ( 2 cloves) , echinacea, zinc, vitamin C and the constant vapourisation of a four thieves oil blend. It might work, it might not, but there is no harm trying and besides doing something for oneself promotes proactive positive thought of which may also be a factor in immunity.
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Old 04-01-20, 09:35 AM
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Definitely look into alternatives while developing a vaccine. What frosts me is public figures with zero scientific or medical background speculating about drugs by name resulting in folks running out and hoarding them depriving those who need them for their known treatment.
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Old 04-01-20, 02:00 PM
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Originally Posted by Dekaye View Post
daily raw garlic ( 2 cloves).
Although there is very little evidence that this in any way enhances one's immune system, it could really help with enforcing the 2 meter social distancing thing.
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Old 04-01-20, 02:04 PM
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This is one I have my eye on:

https://www.theguardian.com/world/20...rus-says-china




https://en.wikipedia.org/wiki/Favipiravir

$9/mg from Sigma. My guess is it could be made a lot cheaper in bulk.
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Old 04-01-20, 02:14 PM
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Originally Posted by wgscott View Post
Although there is very little evidence that this in any way enhances one's immune system, it could really help with enforcing the 2 meter social distancing thing.
I'm gonna hire a witch doctor. What has science every done for us?

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Old 04-01-20, 02:21 PM
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Originally Posted by Seattle Forrest View Post
What has science every done for us?

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Old 04-02-20, 12:26 AM
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I'm seeing all kinds of claims for boosting our immune system, including larger doses of zinc, vitamin C, even kratom. Only one doctor has made that claim about kratom, an Asian MD and researcher who wrote and talked about it months before the current coronavirus. So while his claim wasn't timed to coincide with marketing voodoo potions to fight COVID-19, for all I know he's a shill for the burgeoning kratom market in Malaysia and elsewhere. I haven't seen any evidence to back up his claim. There's little or no evidence for any of the claims about vitamins, minerals, essential oils, etc.

I just take a regular multivitamin that already has complete vitamins and minerals, other than iron which I add. And I've already been using small amounts of kratom for more than a year, mostly for chronic pain. Works fine, helps me exercise and sleep, both of which definitely strengthen my immune system. I already have a compromised immune system so I'm pretty cautious.

But I'm skeptical that there's anything magical in kratom that boosts our immune system, other than making it easier for me to exercise and sleep with less pain. I just recommended it to a friend who said she has hardly slept in two weeks. She's young, fit and generally optimistic, but lack of rest can wear down anyone. And she has the same allergies and asthma I have, which can sometimes make us vulnerable to worse respiratory problems. If it helps her sleep, that's good enough even if it's not an immune system booster.
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Old 04-03-20, 11:22 AM
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elderberry gummies with zinc
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Old 04-03-20, 01:19 PM
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Originally Posted by wgscott View Post
I haven't heard much about the use of antiviral compounds in the fight against SARS-CoV-2. Looking at how China managed to control this far better than one might have expected, based on the experiences of Spain, Italy and now the US, it makes me wonder if they were doing something fundamentally different. (I fully understand social isolation can be more easily enforced in a police-state, but is that enough to account for the differences?) One thing I did hear is that the Chinese have been deploying various antiviral compounds. Why don't we?

There are some interesting pre-prints if you are interested:

https://www.biorxiv.org/content/10.1...03.19.997890v1

https://www.biorxiv.org/content/10.1...03.22.002386v3
I read one of the early trials of one of the drugs in China. It seemed to show moderate improvement among the patients, but didn't reach statistical significance.

However, the trial was conducted in the critically ill patients.

One of the issues with pneumonia is that once the lungs fill with fluid and puss, it is a major problem to get them cleaned. A drug that can stop further infection might be critical in treatment, however, with or without treatment, the patients are in bad shape. In the trial I read, at least a couple patients died before the first dose of drug/placebo.

I believe that the treatment guidelines for Flu antivirals is that they get best results if administered as soon as symptoms show up.

So, rather recruiting those already in fulmanent pneumonia, recruit those who are at high risk, but either picked up with asymptomatic contact testing, or early in presenting the disease. Or, perhaps younger, otherwise healthy individuals who have a severe case of the disease, but should be able to recover.
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Old 04-03-20, 01:50 PM
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Yeah, I totally agree. A lot of these (like the one pictured above) and the one being used by Gilaid are inhibitors of the RNA-dependent RNA polymerase (which is a great target, not only because it is required for viral replication, but also because non-transformed human cells don't have that enzyme). For the reasons @CliffordK states, these would be most effective earlier in the infection.

Chloroquine and its derivatives are anti-inflamatories and might help to suppress the cytokine storm that is responsible for the pneumonia and organ failure.
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Old 04-03-20, 01:58 PM
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canklecat

My wife, an immunologist/virlogist, agrees. She says the whole idea of "boosting the immune system" is science-fiction, and in the case of this virus, a huge part of the problem is immune system over-response.

Last edited by wgscott; 04-03-20 at 02:10 PM.
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Old 04-03-20, 02:25 PM
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Originally Posted by wgscott View Post
@canklecat;

My wife, an immunologist/virlogist, agrees. She says the whole idea of "boosting the immune system" is science-fiction, and in the case of this virus, a huge part of the problem is immune system over-response.
Thus, one of the standard treatments of pneumonia is steroids. Although, I have no doubt it is a tight rope, one needs a certain amount of immune response, just not too much.

Perhaps one should look at the treatment in phases. Even use something like body temperature to judge the appropriate treatment.

So, say body temperature > 100°, use antiviral treatment.
body temperature < 100°, or > 105° supplement antiviral treatment with anti-inflamitories.

It gets tough if the O2 sats start dropping, or one needs supplemental O2, or a ventilator. Which is worse, the immune response or the infection?
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Old 04-03-20, 02:32 PM
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Beats me. I've also heard some anti-inflamatories like Ibuprofen can make things worse (reported by the French) vs. acetominophen/paracetamol.
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Old 04-03-20, 02:36 PM
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I'm seeing a lot of woo about NSAIDs lately, pro and con.

This seemed to start even before one French doctor recommended against taking ibuprofen. The WHO took some flack for that but that one doctor wasn't speaking on behalf of the WHO, and there was little evidence that ibuprofen was particularly bad for COVID-19. There have also been sketchy cautions about ACE inhibitors too.

Best I can figure, the anti-NSAID hysteria stemmed from an older article about massive doses of aspirin causing complications and deaths during the 1918 flu pandemic. That article started recirculating earlier this year, when the coronavirus was still being conflated with "the flu." But in 1918 they were taking up to 30 grams a day, far more than any reasonable amount by contemporary standards. I take two 325mg tablets twice a day for chronic sinus inflammation. Taking 30 grams a day sounds like a recipe for burning up the GI lining.
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Old 04-03-20, 02:37 PM
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Apropos to this part of the discussion, I just read this:

Infectious disease specialists increasingly believe the perplexing randomness of who gets sickest may have less to do with SARS-CoV-2, the virus that causes the disease, than it does with some people’s overly robust immune responses to the infection.
https://www.sfchronicle.com/science/...r-15177609.php
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Old 04-03-20, 03:57 PM
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Originally Posted by canklecat View Post
I'm seeing a lot of woo about NSAIDs lately, pro and con.

This seemed to start even before one French doctor recommended against taking ibuprofen. The WHO took some flack for that but that one doctor wasn't speaking on behalf of the WHO, and there was little evidence that ibuprofen was particularly bad for COVID-19. There have also been sketchy cautions about ACE inhibitors too.

Best I can figure, the anti-NSAID hysteria stemmed from an older article about massive doses of aspirin causing complications and deaths during the 1918 flu pandemic. That article started recirculating earlier this year, when the coronavirus was still being conflated with "the flu." But in 1918 they were taking up to 30 grams a day, far more than any reasonable amount by contemporary standards. I take two 325mg tablets twice a day for chronic sinus inflammation. Taking 30 grams a day sounds like a recipe for burning up the GI lining.
I wasn't suggesting NSAIDs. Rather Corticosteroids as anti-inflamatories.

Aspirin, and some salicylate containing drugs such as Pepto Bismol, of course, are also associated with Reye’s syndrome. Apparently ibuprophen and other NSAIDS are not associated with Reye’s.

Personally I wouldn't treat a fever unless the fever itself got to a point where it was dangerous. (> 105°), and a fever specific treatment would only be to mildly reduce the temperature.
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Old 04-03-20, 04:08 PM
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Originally Posted by wgscott View Post
Apropos to this part of the discussion, I just read this:



https://www.sfchronicle.com/science/...r-15177609.php
Interesting... Thanks,

So, with the immune system, damned if you do, damned if you don't.

An autoimmune disorder triggered by a virus similar to Type 1 Diabetes, or Lupus would be interesting, but terrifying.
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Old 04-03-20, 07:16 PM
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Originally Posted by wgscott View Post
canklecat

My wife, an immunologist/virlogist, agrees. She says the whole idea of "boosting the immune system" is science-fiction, and in the case of this virus, a huge part of the problem is immune system over-response.
Nonsense. We go through most of life with our immune system turned down to 1 in order to play hard mode. Thousands die from paper cuts, but when somebody survives an encounter with a tooth brush, it's exciting. Do you really think the president would have such great ratings if our immune systems just worked properly all the time? If you're ever in a bind, you can boost your immune system by drinking essential oils like lavender, cinnamon, and bleach.
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Old 04-03-20, 07:30 PM
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Originally Posted by Seattle Forrest View Post
Nonsense. We go through most of life with our immune system turned down to 1 in order to play hard mode. Thousands die from paper cuts, but when somebody survives an encounter with a tooth brush, it's exciting. Do you really think the president would have such great ratings if our immune systems just worked properly all the time? If you're ever in a bind, you can boost your immune system by drinking essential oils like lavender, cinnamon, and bleach.
Hey, stay a safe social distance away from irony right now. Some folks are taking that stuff seriously.
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Old 04-03-20, 07:38 PM
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Originally Posted by coffeesnob View Post
elderberry gummies with zinc
That's what my doc *and* pharmacist recommended. They won't swear to it, but figure it "couldn't hoit!"
I'm also going to get back on my multivitamin. Sure it might just make for expensive pee, but it isn't a mega-anything that could have any negative side effects.
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Old 04-03-20, 08:00 PM
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James Watson, the father of DNA... without which, we'd still be back in the age of the 1918 flu, really liked Vitamin C. And, of course, the benefits of fruit.
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