The Covid-19 pandemic is an ongoing threat to the general welfare of humanity. Although effective vaccines for Covid-19 are currently being produced, concern regarding novel variants of the virus and uncertainty of when the virus will be eradicated continues to drive research into medical management of Covid-19 patients.
Dozens of medications have been studied as promising pharmacological interventions for severe cases of Covid-19, as well as for the management of the illness in high-risk patients. Three of these medications,
- fluvoxamine, and
have demonstrated potential utility in recent studies of their effectiveness. Coming alongside advances in supportive care for severe cases of Covid-19 or high-risk patients, the results from these studies are promising, and concerned patients or physicians will find their conclusions encouraging.
Budesonide is a corticosteroid available in several forms. For the purpose of treating Covid-19, the researchers focused their attention on the inhaled formulation, which is regularly prescribed as a metered-dose inhaler or administered through a nebulizer to treat complications arising from asthma. Budesonide has the benefit of being well-understood; it has been used to treat asthma since the early 1980s and remains a frequently prescribed medication. Side effects from budesonide are typically mild and the drug is well-tolerated by most patients.
Interest in Budesonide as a potential treatment of Covid-19 began to rise considerably following the results of the PRINCIPLE study. This study, conducted in the United Kingdom, consisted of Covid-19 patients either over the age of 65 or over the age of 50 with a pre-existing condition that substantially increased their risk of severe Covid-19 complications. Nearly 1,800 of these high-risk patients participated in the first round of the PRINCIPLE study. Patients were at home or in community settings and self-reported their recovery to the PRINCIPLE study researchers.
Overall, the study indicated promising results. Patients who were prescribed budesonide reported a median recovery time over three days shorter than patients who received standard care without budesonide. In addition, a significantly greater number of patients who received budesonide recovered completely within 14 days of symptom onset compared to the group who received standard care. There is also some limited evidence that budesonide reduces the risk of hospitalization in high-risk Covid-19 patients. However, additional research is required before this conclusion can be established.
An interesting candidate for the treatment of Covid-19 is Fluvoxamine. This medication is a selective serotonin reuptake inhibitor, and has so far found the greatest utility in the treatment of obsessive-compulsive disorder. Fluvoxamine is well-known in the psychiatric community for additional utility in the treatment of anxiety disorders and depression. Prescribed as an oral tablet, Fluvoxamine produces few side effects and is well-tolerated. It is also readily available and affordable to most patients.
It may surprise some to discover that an anxiolytic/antidepressant medication has demonstrated some promise in treating Covid-19. In a recent article researchers describe the impact of fluvoxamine and how it may help patients battling Covid-19. In addition to increasing serotonin levels in the body, fluvoxamine also has some action on receptors associated with cytokine production. Cytokines are chemical messengers that increase the activity of a patient’s immune system. In some cases when the body is fighting infection the production of cytokines can be increased to dangerous levels.
This condition, commonly termed a “cytokine storm,” can lead to dangerous levels of inflammation in a patient’s body. It is thought that fluvoxamine has the effect of blocking some cytokine production in the patients to whom it is prescribed. In practice, this means that when the body fights a tough infection like Covid-19, the patient has some protection against complications from their immune system’s over-zealous response to the virus.
Preliminary research has demonstrated tentative support for this theory. In a recent small-scale clinical study of Covid-19 patients none who were prescribed fluvoxamine experienced symptoms severe enough to warrant hospitalization, whereas 12.5% of patients who did not take fluvoxamine were hospitalized, and one passed away due to complications of Covid-19. While the results of this research are promising, the researchers are careful to specify that additional investigation is required before fluvoxamine’s utility is proven.
Another interesting potential agent for the treatment of Covid-19 is ivermectin. This medication has been used for forty years as a broad-spectrum antiparasitic. It is commonly prescribed as first-line treatment when a patient is infected by a parasite. It produces generally mild side effects, is readily available, and affordable. Ivermectin has begun to demonstrate utility as an antiviral medication against not only Covid-19 but similar viruses as well.
The method through which ivermectin achieves its antiviral effects is still being investigated. Early theories suggest that the medication interferes with transport proteins that viral invaders use to enter a cell, and it may also reduce the effectiveness of the Covid-19 spike protein, which the virus uses to attach to human cells. Ivermectin has been shown to inhibit Covid-19 replication in cell cultures in a laboratory setting, and research into its effectiveness in patients experiencing severe Covid-19 symptoms is ongoing.
A comprehensive, real-time meta-analysis is available for ivermectin. It is a collection of over 50 studies examining the effectiveness of ivermectin for treating Covid-19, of which 27 were randomized controlled studies. Results from these studies are promising. Ivermectin demonstrated utility in reducing Covid-19 symptoms in all stages of the illness. It has also demonstrated utility as a prophylactic agent, lowering or suppressing symptoms of patients who took the medication prior to the development of Covid-19 symptoms. Overall, ivermectin has one of the most well-established research bases among medications being investigated to treat Covid-19. However, despite the promising evidence, additional research is required to confirm ivermectin’s ability to treat Covid-19.
Since the early days of the Covid-19 pandemic, medical researchers have worked tirelessly to identify potential treatments for the virus. The results of their research have produced the strong candidates discussed above, and their investigation has offered medical providers additional tools in the fight against Covid-19.
Budesonide, fluvoxamine, and ivermectin are all cheap, easy-to-access medications. This makes them appealing options for the treatment of Covid-19, as they are already deployed and available to medical providers. Even as vaccines roll out, research into these medications is increasing, and the medical community will soon have the final word on the utility of these drugs in the treatment of Covid-19.
This article was created for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.