How the way of treating the coronavirus changed in eight months: the Italian experience

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Hydroxychloroquine or remdesivir? Many drugs that seemed promising were forgotten and others were revealing.

After eight months of battle against the pandemic many drugs that were used in March, at the worst moment of the coronavirus attack in Italy, have been Left aside and others have entered the doctors’ closet. Professor Mario Ciceri, deputy scientific director of the San Raffaele hospital in Milan, has lived on the front lines to save thousands of patients. Elena Dusi from “La Repubblica” explained how some remedies considered lifesavers, “have been mouths”. Like chloroquine and antivirals born to fight HIV, the AIDS virus.

Today, a patient in the most serious condition, in intensive therapy tubed and with oxygen, is given Remdesivir, an antiviral and Metasona, an effective cortisone, which according to an English study reduce el 30% of the mortality of patients in the worst condition.

“We use them as standard treatment”Explains Ciceri. Also supplied is Eparin, a traditional anticoagulant to combat thrombi that cause occlusions and that represent a complication of infection due to the very strong reaction of the patient’s immune system.Anti-inflammatories help reduce symptoms.

Professor Ciceri explains that the three arrows anti-coronavirus, Remdesivir, Methaone and Eparin, are in the pharmacological trade. The problem is concentrated in Remdesivir, produced by the American laboratories Galead.

American President Donald Trump monopolized production until the end of this month at a price of $ 2,300 for a five-day cycle.

La Repubblica journalist Elena Dusi noted that the European drug agency has bought all the Remdesivir it found after Trump’s announcement. Professor Ciceri maintains that “the reserves are sufficient for now, but if the number of patients increases a lot We will have problems”.

Another evolutionary change in these eight months of pandemic in Italy is the use of less oxygen to the patients. “We supply it only if it is unavoidable and we also try to avoid intubation as much as possible because it is always better for the patient to breathe alone.”

In the most serious internees “pronation is useful”, a method invented by an Italian resuscitator. The patient is turned, placed face down on the bed. The goal is to recruit pulmonary alveoli and redistribute extravascular water, mobilize secretion and other advantages that improve oxygenation in 70-80% of patients and decreases the mortality rate, explains a scientific study.

Those infected who are isolated at home receive anti-inflammatory to reduce symptoms. They have taken the Plaquenil tablets, hydroxychloroquine, which proved ineffective.

Patients who are admitted to hospitals but are not seriously ill receive a new therapy based on the experience accumulated in these months of fighting against Covid 19.

They are supplied with anti-inflammatories to reduce the brutal storm of the patient’s immune system reacting to the invasion of the coronavirus. Convalescent plasma injected into the patient had become popular, but Professor Ciceri explains that its efficacy “It is not proven.”

The scientist at the San Raffaele hospital in Milan adds that “to our surprise and displeasure, the drugs used to reduce excess inflammation, such as Tocilizumab and some drugs with similar action, were not shown to be effective. Although the trial is still suspended, some experiments were not effective. they have kept their promises. “

On the horizon, the greatest hopes are focused on the monoclonal antibodies, which are produced in the laboratory copying the natural ones.

Also drugs that reactivate the function of the Interferon 1, an important player in the immune system. Professor Ciceri believes that these remedies may be ready by early 2021along with vaccines.

“Advanced studies on monoclonal antibodies and the functions of Interferon 1 are 1084 in the world ”, he concluded.

Rome, correspondent

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