The latest researched information on vaccines and treatments for COVID-19 as well as boosting your immune system by alternative medicine.
Facing the New World: A COVID-19 Reality Part 4
Written by: Akshaya, Kavya, Haritha
Over the years, several coronaviruses have emerged to cause lethal pneumonias in human beings. Major coronavirus outbreaks include the Spanish Flu, MERS-CoV, SARS-CoV and SARS-CoV-2. SARS-CoV-2, also known as COVID-19, emerged in December 2019 in Wuhan, China and caused a large, uncontrolled pandemic, which has resulted in half a million deaths. Countries have been struggling to get this under control and there is an urgent need for therapeutic and prophylactic measures. In this blog we discuss how COVID-19 is tested for, the current treatments, and also alternative medicines that have been shown to have antiviral properties.
TESTING:
As of now, the only sure way to reduce the number of cases and deaths that we are seeing is by increasing the supply of tests to diagnose individuals. This is because there are many people who could be potential carriers of the virus who are spreading it to others without their awareness. Of course, other than testing, everyone should continue to stay home and maintain social distancing in order to stop the spread of COVID-19. The recent rise in cases in America is the direct effect of people not willing to follow the proper regulations to stop/reduce the spread of the virus. In terms of testing for treatment of COVID-19, there are no products that have been shown to be efficient but there are medications that have been suggested for investigational therapies and clinical trials. In order to diagnose an individual, there are specific and non-specific tests.
Non-Specific Tests:
1) White cell count test - abnormal levels of white blood cells (typically high levels) indicate an infection.
2) Lymphocyte count where less than 1000 can be linked to severe disease (5).
3) Chest X-ray which reveals bilateral infiltrates (a substance that is abnormal in the lung cavity such as pus, blood, mucus, etc.) but is less sensitive than the use of a CT scan, which can be more specific due to its sensitivity (5). Abnormal CT scans were used to diagnose the virus in suspect cases where there were negative diagnoses by the Chest X-ray but CT scan results showed positive results for COVID-19 (5).
COVID-19 Diagnostic tests:
Now, let’s talk further about diagnostic tests and how we determine whether someone tests positive for COVID-19. This is confirmed by the presence of viral RNA which is detected through molecular testing, typically RT-PCR (Reverse Transcriptase - Polymerase Chain Reaction) (2). You can learn more about RT-PCR by reading this report from the FDA (LabCorp COVID-19 RT-PCR test ). But, it is important to understand that simply identifying the viral RNA does not actually mean that someone is infected and is a carrier of the virus. The risk of spreading the virus to another individual depends whether the virus can still replicate and if the patient is experiencing any symptoms. Additionally, the behavior and environmental factors of the infected individual plays a role in determining the risk of transmission. The risk is predicted to be reduced when there are antibodies that are produced as a result of the individual contracting the virus. For COVID-19, it takes between 5 to 10 days after the initial infection for the body to produce the neutralizing antibodies (2). The viral RNA has been detected in the upper respiratory tract and the lower respiratory tract, as well as feces, with no specificity to the severity of the disease. There are also studies which utilize the viral culture of samples from infected individuals to analyze the presence of COVID-19, but they are much more limited (2). As of July 01, 2020, the FDA, or U.S. Food and Drug Administration, has confirmed the extended support for evaluating diagnostic tests for COVID-19. This will be done by distributing the first round of SARS-CoV-2 reference panel materials, which is an independent performance validation step that is used for clinical tests (4). The panel aids in determining the level of detection and can identify the relative sensitivity among the tests. Diagnosis for more specific information is done through molecular tests on respiratory samples, which include a throat swab, nasopharyngeal (nose) swab, sputum, endotracheal aspirates (sample collected from intubation) and bronchoalveolar lavage (washing of the lung through mouth or nose to obtain fluid for examination) (5). The FDA has also issued Emergency Use Authorizations (EUA) to a few companies for different tests on June 30th. The COVID-19 RT-PCR Peptide Nucleic Acid (PNA) is to detect the nucleic acid of SARS-CoV-2 in respiratory specimens (4). Learn more about PNA by clicking on the following link: Bio TNS COVID-19 RT-PCR PNA. Another testing kit that the FDA issues authorization to is to the Kroger Company, called the Kroger Health COVID-19 Test Home Collection Kit: Kroger Health COVID-19 Test Home Collection Kit. This is performed by collecting nasal swab specimens from home, while being video-observed by a health care provider. Lastly, the Psoma COVID-19 RT Test (Psomagen, Inc. Psoma COVID-19 RT Test) is created to obtain a qualitative detection of nucleic acid from SARS-CoV-2 from upper respiratory swab specimens as well as bronchoalveolar lavage specimens (4). The FDA has thus far authorized 161 tests under EUAs which include 135 molecular tests, 25 antibody tests, and 1 antigen test (4). We have talked about diagnostic tests, but tests for treatment of COVID-19 are simultaneously being researched and tested for.
CURRENT TREATMENTS:
Convalescent plasma therapy:
Among several proposed treatments, a popular method of treating COVID-19 patients has been by using passive antibody therapy (1). But what exactly is this method of treatment? Passive antibody therapy or convalescent plasma treatment involves transfusing convalescent plasma (plasma of patients that recovered from COVID-19) into those individuals currently infected with COVID-19. What is plasma? And how does this treatment work? Plasma is the liquid part of blood and comprises around 55% of it (7). The other components of blood are red blood cells, platelets and white blood cells. White blood cells are responsible for immune response (7). Antibodies are a type of white blood cells which travel in the blood to detect foreign pathogens such as bacteria and viruses. Convalescent plasma donors have developed an effective antibody response to a pathogen (in our case, COVID-19). Antiviral monoclonal antibodies, which are a type of antibody, can be isolated from the plasma of these donors. The coronavirus has an ‘S’ protein (the antigen) which is the target for these isolated antibodies (1). There are two parts to this protein - ‘S1’ and ‘S2’ (1). S1 binds to the antiviral and S2 facilitates the fusion of the host and viral cells. This method of treatment was shown to be very effective against the Argentine Hemorrhagic Fever, however it was not effective against the Ebola Virus (1). For SARS-CoV-2; however, a study has shown that patients who were given convalescent plasma therapy were discharged from the hospital earlier than those who were not administered the same treatment (1). Nevertheless, the blood samples need to be screened for HIV, hepatitis viruses and parasites, which is time consuming and tedious.
Vaccine:
There has been a lot of discussion about the COVID-19 vaccine. Although it hasn’t been successfully created, there have been 19 candidates for human clinical trials (6). Eight of these clinical trials are by Chinese companies such as Sinovac and they have been using a well-known technology called ‘inactivated vaccine technology’ wherein the vaccine pathogen cannot replicate or spread between hosts (6). In other words, the virus is modified in such a way that it does not produce adverse effects. This technology has been used to produce effective vaccines for influenza. Western companies such as CureVac (Germany) and Moderna (USA) are, in contrast, using a technology based on messenger RNA (mRNA) (6). However, this technology has not produced a vaccine approved by regulators yet. Although several candidates reached clinical trials, only two have reached the final phase (Phase III).
Despite the fact that progress has been made on the vaccine, there are several challenges to overcome such as countries not willing to collaborate with each other (6). There is a need for countries to thwart the sale of fake/ low quality vaccines which is another possibility in the rush to be the first to get the vaccine out in the market.
ALTERNATIVE TREATMENTS:
There is a lot of talk about boosting your immune system. What exactly does this mean? “Boosting” refers to increasing the activity of our immune system where it can fight off infections successfully. However, it is important to note that we want to maintain our immune system at a balance, where it is not so weak that it cannot fight off foregin bodies, but also not too strong that it starts attacking our own bodies. Therefore, keeping a balanced immune system requires a nutritious diet, sufficient sleep, and overall, a healthy lifestyle. In order to ensure that our body has the capacity to fight off pathogens, we must strive for a healthy lifestyle. In other words, it is not sufficient to eat vitamins and other immune boosters while there is a lack of sufficient sleep. The integrity of our health depends on the combination of choices we make and maintain.
With that said, let’s look at some herbal medications shown to boost our immune system.
*NOTE: this is not professional advice. Please contact your doctor before use of any medications.*
But first, a few words about medicinal plants. Plants have been traditionally used to treat all kinds of illnesses. Natural remedies are desirable as they have been used for centuries and seem less harmful. However, it is important to understand that herbal treatments should be taken with precaution and after consultation with an expert. Herbal medications can produce side effects and some can even be toxic at high doses. In short, we all must conduct proper research and seek proper advice before using herbal medications, especially when taking other medications.
The best reference we have that can help narrow down what natural treatments work for COVID-19 is to see what research has been done with coronaviruses of previous outbreaks, SARS and MERS. Research shows that western treatment along with traditional herbal medications have a positive impact in combating SARS infections (10). Unfortunately there has been very little research conducted to isolate the benefits of natural herbal medicines for coronaviruses. Therefore, we will discuss a few of the natural herbal medicines that have been shown to exhibit antiviral properties. Most of these herbal plants contain compounds that interfere with the replication process of the virus.
Glycyrrhiza glabra, commonly known as Licorice is considered to be one of the oldest antiviral medicinal plants (11). Licorice (root) contains a chemical compound known as anethole, responsible for the sweet taste. Other chemical compounds in licorice such as glycyrrhizic acid, triterpenoids, and flavonoids are particularly involved in antiviral activity. Specifically, the presence of glycyrrhizic acid has been shown to curtail viral growth in plants. Research has shown that out of the 20 triterpenoids (cyclic, carbon molecules) that licorice contains, two of them referred to as GL and GA have been identified to have antiviral properties (12). These properties include inhibiting viral replication and minimizing the adherence of viral particles to the cell and to our DNA. The flavonoids present in licorice more actively aid in combating bacterial infections (12). It is important to note that these compounds enhance the immune activity overall and are not a targeted process.
Ocimum sanctum, commonly known as Tulsi has been traditionally used to treat various ailments including but not limited to viral, fungal, and bacterial infections (11). Tulsi is commonly used to treat chronic fever, cold, cough, and other respiratory related illnesses making it pertinent to use for COVID-19 (11). The compound eugenol in Tulsi has been shown to have antiviral properties. Among many benefits of Tulsi consumption is detoxification. When Tulsi is consumed, detoxification occurs as it increases the antioxidant molecule levels in the blood which in turn remove harmful radicals in our body (13).
Cocos nucifera - coconut, specifically coconut oil. Coconut oil has been used as a natural remedy for many illnesses such as asthma, sore throat, flu, constipation and many others (11). Research shows that when coconut oil is consumed, it is broken down into smaller fatty molecules, called Medium-chain fatty acids (MCFA). These MCFAs are responsible for the antiviral properties as it interacts with the lipid layer of the viral particle and helps deactivate it (11).
Tinospora cordifolia, commonly known as Guduchi is found across India. It contains compounds that have immunomodulating properties (11). Immunomodulatory means that the certain compound changes (modulates) the behavior of the immune system, such as enhancing antibody production. Guduchi consumption has shown to increase antibodies in the serum of the blood (11). Antibody production is important when it comes to combating any viral infection.
Other natural remedies include and are not limited to Ginger, Garlic, Labiatae, and Neem.
This website has many more alternative natural medicines that are used in Ayurveda that have been proven scientifically to have medicinal properties: Potential of Complementary and Alternative Medicine in Preventive Management of Novel H1N1 Flu (Swine Flu) Pandemic: Thwarting Potential Disasters in the Bud
Despite the availability of several treatments, none of them have been proven to be 100% effective. Although a good amount of progress has been made on the vaccine for COVID-19, clinical trials take a long time and it might be a while before the vaccine is available to the public. For now, the best we can do is take care of our health by getting a good amount of sleep each night, eating healthy, exercising well, and taking precautions such as social distancing when in public.
Stay informed, stay tuned, stay safe!
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