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July 21, 2020

NIH-wide strategic plan

How can we determine the long-term effects of a disease that has only been in the human environment for a few months? We don’t even have a year’s worth of data to look at. But there are already indications that COVID-19 is more than a short-term respiratory disease. It can initiate a life-threatening hyper-immune response, it can trigger blood clots that damage multiple organs, and it can haunt you long after recovery in the form of “brain fog” and chronic fatigue.

Evidence for this is based on hospital observations, autopsies, patient reports, comparison to other viral diseases, and an increasing number of studies throughout the world. Here are a few articles that help explain those three major effects (links below):

  1. “Drug that calms ‘cytokine storm’ may reduce COVID-19 mortality,” Medical News Today, July 17, 2020.
  2. “What Is Known About COVID-19 and Abnormal Blood Clotting,” Newsroom, Weill Cornell Medicine, July 2, 2020.
  3. “COVID-19 patients could be at risk for chronic fatigue: ‘Your whole life can change if you get this,’” By Dacel Rockett, Chicago Tribune, July 21, 2020.

Fortunately there are therapeutics under development aimed at prevention, lower mortality rates, and faster, more complete recovery. Some of them are already in use for other diseases, but are now being tested specifically for their efficacy in treating COVID-19 patients. This means they are likely to be available sooner than a vaccine. Living in this pandemic is all about managing expectations. (To see why we should be cautious in our hopes for a vaccine, see Day 113: Vaccines.)

I’ve done a little on-line investigating today, going beyond news articles to look up biotech and pharmaceutical web sites along with research articles. The examples below are just a few of the promising treatments out there. A simple search will give you many more. I just want to share some of the encouraging areas of research that give us reason for hope. Here they are (see links below) :

  1. Sorrento Therapeutics is testing Abivertinib, an anti-inflammatory that could help prevent the cytokine storm and get people out of the ICU sooner. Tests may start in August.
  2. AstraZeneca, a British-Swedish multinational pharmaceutical company, is testing an oncology medicine to reduce the cytokine storm, testing another medicine to reduce organ damage, and developing monoclonal antibodies that may help prevent disease in people who have been exposed and treat people already infected.
  3. Tocilizumab is an anti-inflammatory I’ve seen mentioned which show promise in treating cytokine storm syndrome.
  4. The NIH (National Institutes of Health) has put together a public-private partnership to investigate treatments called Accelerated COVID-19 Therapeutic Interventions and Vaccines (ACTIV). They have projects actively testing treatments to prevent the blood clotting seen in COVID.
ACTIV information available on https://www.nih.gov/research-training/medical-research-initiatives/activ

The NIH has newly updated information on current treatment guidelines here: https://www.covid19treatmentguidelines.nih.gov/whats-new/

Last week, speaking in a “Fireside Chat” from Stanford University, Dr. Fauci said that we should be seeing good therapeutics in the fall. So, while I do not want to catch this disease, I most emphatically do not want to catch it this summer. Now is the time to take care and play it safe. Hope is in the pipeline.

Related Articles:

Cytokine Storm:

“Drug that calms ‘cytokine storm’ may reduce COVID-19 mortality,” Medical News Today, July 17, 2020. https://www.medicalnewstoday.com/articles/drug-that-calms-cytokine-storm-may-reduce-covid-19-mortality

“FDA clears Abivertinib for Phase 2 safety and efficacy study in hospitalized patients with moderate to severe COVID-19,” Sorrento Therapeutics News Release, July 20, 2020. https://investors.sorrentotherapeutics.com/news-releases/news-release-details/fda-clears-abivertinib-phase-2-safety-and-efficacy-study

“Tocilizumab Lowers Mortality in COVID-19 With Cytokine Release Syndrome,” Pulmonology Advisor, July 20, 2020. https://www.pulmonologyadvisor.com/home/topics/lung-infection/tocilizumab-lowers-mortality-in-covid-19-with-cytokine-release-syndrome/

“Tocilizumab in patients with severe COVID-19: a retrospective cohort study,” The Lancet, June 24, 2020. https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(20)30173-9/fulltext

Blood Clotting:

“What Is Known About COVID-19 and Abnormal Blood Clotting,” Newsroom, Weill Cornell Medicine, July 2, 2020. https://news.weill.cornell.edu/news/2020/07/what-is-known-about-covid-19-and-abnormal-blood-clotting

“Searching for Ways to Prevent Life-Threatening Blood Clots in COVID-19,” Director’s Blog, nih.gov, June 11, 2020, https://directorsblog.nih.gov/2020/06/11/searching-for-ways-to-prevent-life-threatening-blood-clots-in-covid-19/

“Coronavirus Pandemic Update 92: Blood Clots & COVID-19 – New Research,” July 13, 2020. Coronavirus Pandemic Update 92 with Dr. Seheult. Available on You Tube. For those who want technical details.

Chronic Fatigue:

“COVID-19 patients could be at risk for chronic fatigue: ‘Your whole life can change if you get this,’” By Dacel Rockett, Chicago Tribune, July 21, 2020. https://www.seattletimes.com/seattle-news/health/covid-19-patients-could-be-at-risk-for-chronic-fatigue-your-whole-life-can-change-if-you-get-this/

“Chronic fatigue syndrome may hold keys to understanding post-Covid syndrome,” STAT, July 21, 2020. https://www.statnews.com/2020/07/21/chronic-fatigue-syndrome-keys-understanding-post-covid-syndrome/

“Dr. Fauci says it will take ‘months to a year or more’ to know whether lingering COVID-19 symptoms in young people could be chronic illnesses,” Business Insider, July 16, 2020. https://www.businessinsider.com/fauci-young-coronavirus-patients-lasting-symptoms-chronic-illness-fatigue-2020-7

General:

“Symptoms, spread and other essential information about the new coronavirus and COVID-19,” Harvard Medical School. March, 2020, updated July 10, 2020. https://www.health.harvard.edu/diseases-and-conditions/covid-19-basics#:~:text=COVID%2D19%20does%20appear,seizures%2C%20and%20stroke. Information about cytokine storms, strokes, and neurological damage.

Frequently Asked Questions, AstraZeneca Pharmaceutical company. British-Swedish multinational company. https://www.astrazeneca.com/media-centre/articles/2020/covid-19-frequently-asked-questions.html

Why am I doing this?

The coronavirus pandemic will be indelibly written on our memories just as the Great Depression or the Battle of Britain left their mark on past generations. It is my intention to journal the events of these days from three perspectives: as a retired medical technologist, a historian (Ph.D., 2014), and an ordinary person living through an extraordinary crisis.

You are on History’s Edge.

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