Treatment of COVID-19

You may have read and heard about various medicines used / suggested for treating COVID-19 in the news.

Antibiotics

Coronavirus is not a bacterial infection. It is a virus. Antibiotics do not have any effect on viruses.
In instances where antibiotics are prescribed for patients with COVID-19, it is usually because there is also a confirmed or suspected bacterial infection.

Antivirals

Remdesivir is an antiviral drug that works by stopping viruses from replicating that has been shown to improve recovery time in patients with severe disease and may prevent patients from progressing to more serious medical issues, particularly with their breathing.

Monoclonal antibodies

Antibodies are proteins made by the body in response to infection, and bind to a target e.g. a virus or a bacteria. By doing this, they slow down the action of the virus / bacteria. This is also how the immune system then fights infection, as it then recognises these as foreign and can work to clear them.

Monoclonal antibodies are made in a laboratory and some particular ones, such as sotrovimab, have been shown to reduce hospitalization risk in those more likely to develop severe COVID-19, for example, those with diabetes, high blood pressure and heart failure.

At present, their usage is limited to these patients. Those who do not have symptoms and not at risk of developing severe COVID-19 will not require it.

Steroids

Systemic steroids (such as dexamethasone) have both anti-inflammatory and immunosuppressant effects and can be given orally or directly into the bloodstream via a cannula. Dexamethasone has been shown to be effective in moderate to severe illness and reduce the risk of death. It is not recommended for use in mild illness.

Early studies have suggested localised steroids via an inhaler, such as budesonide, can be effective.

Ivermectin

This is predominantly used in veterinary medicine and has some very limited uses in humans for parasitic infection.

There has been much press around this – it is not an approved treatment and there is no clinical evidence that it has any significant effect in the management of COVID-19. Unpleasant but mild side effects include nausea, diarrhoea and vomiting and drowsiness. Life threatening side effects include seizure and coma.