Coronavirus cure hopes have today been raised after an infected Italian man in his 70s recovered with the help of an experimental Ebola drug.
Doctors gave the unidentified 79-year-old remdesivir, which researchers around the world have tested in their desperate scramble to find a cure.
Officials in Liguria – the coastal region where the patient lives, which is south of Milan – announced he had recovered and could go home after 12 days in hospital.
The drug also showed success in a critically-ill woman in the US and 14 Americans who tested positive for the coronavirus after catching it on the Diamond Princess cruise ship.
It comes after scientists hunting a cure for COVID-19 were dealt a blow by a failed trial of another promising drug – one used to treat HIV patients.
Virologists described the results of the study on lopinavir–ritonavir, a combination which is branded as Kaletra and Aluvia, as ‘disappointing’.
Professor Jonathan Ball, of the University of Nottingham, said: ‘Other irons in the fire, so fingers crossed on one or more of those.’
Remdesivir was developed 10 years ago as a potential Ebola treatment. It was shelved but has potential as a general antiviral medication, experts say (stock image)
Doctors and scientists around the world are scrambling to find a treatment or a vaccine for the coronavirus. Pictured, a medical worker treats a patient in intensive care in Cremona, Italy
The Italian man given remdesivir was hospitalised on March 7 with the coronavirus, according to local newspaper Genova Today.
Doctors at San Martino Hospital in Genoa, where he was being treated, made the decision to give him the drug.
Professor Matteo Bassetti, director of the infectious disease clinic at the hospital, said remdesivir ‘seems to work’.
In a joint press conference with the president of Liguria, they announced the man would be allowed to go home because he no longer has the virus.
Professor Bassetti also revealed that other patients in the region had been given remdesivir, local journalists reported.
The promising anti-viral drug works by neutralising a vital enzyme viruses use to reproduce. It is called a RNA polymerase inhibitor.
It was developed 10 years ago by California-based drug firm Gilead Sciences, with the intention of it destroying the Ebola virus.
It effectively treated monkeys infected with Ebola, according to the US National Institutes of Health. But it had little success on humans.
However, it remains a functional antiviral drug which, in lab conditions, can destroy a variety of viruses. Researchers from the Wuhan Institute of Virology in China said it was ‘highly effective’ against the COVID-19 coronavirus.
Doctors in the US have tried it on patients and it managed to speed up the recovery of the first person to be treated for the virus there.
The a 35-year-old man in Washington state, close to Seattle – whose infection was announced on January 20 – recovered after being given the drug.
He had developed pneumonia after six days in hospital so doctors, desperate to find a way to treat him, started giving him remdesivir the next day, they revealed in a study in the New England Journal of Medicine.
The doctors wrote: ‘On hospital day 8 (illness day 12), the patient’s clinical condition improved’.
His symptoms, apart from the cough, all started to disappear, they said.
A woman who doctors ‘thought was going to pass away’ also recovered in the US after being given the drug.
George Thompson, an infectious disease specialist at the University of Davis Medical Center in California, was part of the team that administered the drug, remdesivir, to a sickly American woman who tested positive for the virus on February 26.
Within a day, the woman saw a drop in her ‘viral load’ and her condition began to improve, they revealed earlier this week.
HIV drug Kaletra had high hopes pinned to it but a new study has revealed that it doesn’t appear to speed up recovery, reduce death rates or reduce the amount of virus in the body
A medical worker is pictured in the room of a patient infected with coronavirus in Italy, which is battling the worst outbreak outside of China
And four passengers who had been diagnosed on-board the infamous Diamond Princess cruise ship were also given remdesivir at a hospital in Japan, the Washington Post reported.
A surgeon at the US National Institutes of Health said the patients all recovered and the drug appeared to have had positive effects.
Richard Childs told the Post: ‘Many of them were probably going to die in a short amount of time, and two weeks later nobody has died and more than half of them have recovered. It’s just absolutely amazing.’
He said, however, that the four were part of a group of 14 who all recovered thanks to the care of Japanese medics, adding: ‘It’s going to take us a while to figure out what the impact of the drug has been.’
A spokesman for the World Health Organization, Dr Bruce Aylward, said remdesivir was the greatest hope so far.
In February he said: ‘There’s only one drug right now that we think may have real efficacy. And that’s remdesivir,’ The Telegraph reported.
However, although the share price of manufacturer Gilead has been bucking the global trend and rising during the pandemic, investors are wary about hitching themselves to the speculative treatment.
Financial analysts RBC Capital Markets looked deeper into individual patient data and were sceptical about its prospects.
In a report the company said: ‘Based on our review of the clinical and virological courses, we believe remdesivir’s contribution to efficacy remains unclear, and with a side-effect profile that may not be completely benign,’ Stat News reported.
‘We continue to see a less than 50/50 possibility that the drug is ultimately proven effective.’
The drug is now being trialled on coronavirus patients in China and at the University of Nebraska, according to CNN.
Another drug doctors had high hopes for was a HIV therapy known as Kaletra, which is made of a combination of the medications lopinavir and ritonavir.
In a clinical trial application submitted in the US from Asan Medical Center, in Seoul, South Korea, scientists said: ‘In vitro [laboratory] studies revealed that lopinavir/ritonavir [has] antiviral activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).’
Chinese media reported that the drug was successfully used to cure patients with the coronavirus, but the reports have not been scientifically proven.
A paper published in the New England Journal of Medicine, however, has dashed these hopes.
Dozens of doctors working in China collaborated on a paper which revealed the lopinavir/ritonavir combination ‘was not associated with a difference from standard care’.
They tried it on a group of 99 patients and compared them to 100 receiving normal hospital care.
The team said their recovery did not happen faster, they were not less likely to die, and the detectable levels of virus in their bodies were similar.
The drug also caused unpleasant side effects for some – 14 people could not complete the two-week course of medication because of effects including rashes, diarrhoea and stomach pain.
Virus expert at the University of Nottingham, Professor Jonathan Ball, said the results were ‘disappointing, but perhaps not unsurprising’.
He added in a tweet: ‘Other irons in the fire, so fingers crossed on one or more of those…’
Flu, anti-malaria, arthritis and HIV medication: The promising therapies being tested on coronavirus patients around the world
Chloroquine phosphate (Malaria)
One drug being used by doctors fighting the coronavirus outbreak is chloroquine phosphate, an anti-malarial medication.
The drug – sold under the brand name Arlan – kills malaria parasites in the blood, stopping the tropical disease in its tracks.
But tests of the drug – which has been used for 70 years – on COVID-19 patients in China show it has potential in fighting the life-threatening virus.
One drug being used by doctors fighting the coronavirus outbreak is chloroquine phosphate, an anti-malarial medication. It is sold under the brand name Arlan
Chinese officials claimed the drug ‘demonstrated efficacy and acceptable safety in treating COVID-19 associated pneumonia’.
Experts at the University of Palermo in Italy, as well as a team in Israel, collated the research on the drug in treating the coronavirus.
In their report, they claimed officials in the Netherlands already suggest treating critically-ill patients with the drug.
South Korea and China both say the drug is an ‘effective’ antiviral treatment against the disease, according to a report by US virologists.
The Wuhan Institute of Virology – in the city where the crisis began – claimed the drug was ‘highly effective’ in petri dish tests.
Tests by those researchers, as well as others, showed it has the power to stop the virus replicating in cells, and taking hold in the body.
Twenty-three clinical trials on the drug are already underway on patients in China, and one is planned in the US and another in South Korea.
University of Minnesota experts are planning to test whether the drug – sometimes given to treat lupus and arthritis – prevents the progression of COVID-19.
Chloroquine was prescribed around 46,000 times in 2018 in the UK – but it is also available over-the-counter from pharmacies without a prescription.
Professor Robin May, an infectious disease specialist at Birmingham University, said the safety profile of the drug is ‘well-established’.
He added: ‘It is cheap and relatively easy to manufacture, so it would be fairly easy to accelerate into clinical trials and, if successful, eventually into treatment.’
Professor May suggested chloroquine may work by altering the acidity of the area of cells that it attacks, making it harder for the virus to replicate.
Hydroxychloroquine (Malaria)
Chinese scientists investigating the other form of chloroquine penned a letter to a prestigious journal saying its ‘less toxic’ derivative may also help.
Hydroxychloroquine, sold under the brand name Plaquenil, may treat COVID-19
In the comment to Cell Discovery – owned by publisher Nature, they said it shares similar chemical structures and mechanisms.
The team of experts added: ‘It is easy to conjure up the idea that hydroxychloroquine may be a potent candidate to treat infection by SARS-CoV-2.’
But the Wuhan Institute of Virology scientists admitted they are still lacking evidence to prove it is as effective as chloroquine phosphate.
Hydroxychloroquine, sold under the brand name Plaquenil, causes side effects such as skin rashes, nausea, diarrhoea and headaches.
Drug giant Sanofi carried out a study on 24 patients, which the French government described as ‘promising’.
Results showed three quarters of patients treated with the drug were cleared of the virus within six days. None of the placebo group were treated.
French health officials are now planning on a larger trial of the drug, which is used on the NHS to treat lupus and rheumatoid arthritis as well as malaria.
Lopinavir/ritonavir (HIV)
Lopinavir/ritonavir, marketed under the brand names Kaletra and Aluvia, is an anti-HIV medicine
Lopinavir/ritonavir, marketed as Kaletra and Aluvia, is an anti-HIV medicine given to people living with the virus to prevent it developing into AIDS.
The drug has shown promise as a way of tackling coronavirus, scientists say, because it is able to bind to the outside of the coronavirus.
It is a class of drug called a protease inhibitor, which essentially stick to an enzyme on a virus which is vital to the virus reproducing. By doing this it blocks the process the virus would normally use to clone itself and spread the infection further.
In a clinical trial application submitted in the US from Asan Medical Center, in Seoul, South Korea, scientists said: ‘In vitro [laboratory] studies revealed that lopinavir/ritonavir [has] antiviral activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).’
Chinese media reported that the drug was successfully used to cure patients with the coronavirus, but the reports have not been scientifically proven.
US-based manufacturer AbbVie has donated free supplies of Kaletra to health authorities in China, the US and Europe – it is not clear whether the UK is included.
The drug is available on the NHS and was prescribed around 1,400 times in 2018, either as Kaletra or ritonavir on its own.
Favipiravir (flu)
Favipiravir is the active ingredient in a flu drug called Avigan which is sold in Japan.
Doctors in China have claimed it was ‘clearly effective’ in patients with the coronavirus after they gave it to 80 people in the cities of Wuhan and Shenzen.
Favipiravir is the active ingredient in a flu drug called Avigan which is sold in Japan
They said it sped up patients’ recovery, reduced lung damage and did not cause any obvious side effects. It is also used to treat yellow fever and foot-and-mouth.
According to local media, patients who were given the medicine in Shenzhen had negative results for the coronavirus an average of four days after being diagnosed.
This compared with 11 days for those who were not treated with the drug. It is not clear what the results were of the trials in Wuhan, the worst-hit part of China.
The drug is an anti-viral medication which neutralises a vital enzyme that viruses use to reproduce. It is called a RNA polymerase inhibitor.
It is not used by the NHS. It’s produced by the Japanese company Fujifilm Toyama Chemical.
Remdesivir (Ebola)
Remdesivir is an anti-viral drug that works in essentially the same way as favipiravir – by crippling the RNA polymerase enzyme, stopping a virus from reproducing.
It was developed around 10 years ago by the pharmaceutical company Gilead Sciences with the intention of it destroying the Ebola virus. It was pushed aside, however, when other, better candidates emerged.
But it remained an anti-viral drug with the ability to destroy various viruses in lab tests, scientists said. Doctors in the US tried it on three hospitalised coronavirus patients but results were mixed.
The drug is now being trialled on coronavirus patients in China and at the University of Nebraska, CNN reports.
Doctors writing in a study led by the Wuhan Institute of Virology, published in the prestigious scientific journal Nature last month, said: ‘Our findings reveal that remdesivir [is] highly effective in the control of 2019-nCoV infection in vitro.’
They added that, since the drug is proven to be safe in humans, it ‘should be assessed in human patients suffering from the novel coronavirus disease’.
Remdesivir is not prescribed on the NHS.
Sarilumab (Rheumatoid arthritis)
Sarilumab, a rheumatoid arthritis drug which is marketed as Kevzara in the US, is set to be trialled on patients in the US
Sarilumab, a rheumatoid arthritis drug which is marketed as Kevzara and is available to be prescribed on the NHS, is set to be trialled on patients in the US.
Pharmaceutical companies Sanofi and Regeneron plan to give the medication to people with the coronavirus to see if it can help calm their immune response.
The drug works by blocking part of the immune system which can cause inflammation, or swelling, which is overactive in people with rheumatoid arthritis.
Inflammation is the body’s natural response to infection but, in patients with coronavirus, it can get out of control, making symptoms significantly worse and even trigger multiple organ failure.
Regeneron, which makes the drug, said Chinese doctors say it has worked for their patients, the Financial Times reported. He said the drug could provide ‘temporary support’ by reducing the severity of patients’ symptoms to help hospitals to cope.
John Reed, from Sanofi, told the FT: ‘We expect to rapidly initiate trials outside the US in the coming weeks, including areas most affected by the pandemic such as Italy’.