The corona outbreak has now been going on for ten months. People survive a corona infection more often and spend less time in hospital. Good news, but how come?
This is partly because the newly infected patients are on average younger than those from the first wave and because they are admitted earlier. But what also plays a role is that care has improved. Doctors are learning every day about the treatment of COVID-19. What’s up with that?
There are roughly two strategies in the treatment of covid according to The Lancet Infectious disease: drugs against the virus itself and drugs or treatments that support the body in fighting the virus attack. At the beginning of the outbreak, there was still hope for the old antimalarial drug chloroquine or the similar hydroxychloroquine.
However, after clinical studies, these drugs fell through the basket. They are no longer recommended. Many other viral inhibitors have also been tried in research, so far without resounding success. The only remdesivir has made it to the finish line: it is registered as medicine for COVID-19 in Europe and America.
Even though US President Trump was given redeliver – this drug is not a panacea. Research shows that you recover a little faster with it. Severely ill patients have a shorter hospital stay if they are given this medicine. In the Netherlands, remdesivir is given in combination with dexamethasone. Remdesivir has no effect on mortality from COVID-19, according to the studies. In addition, the drug is available in limited quantities – many hospitals have run out.
Real success in the treatment of COVID is dexamethasone, another drug that Trump has used. This old corticosteroid really knows how to reduce mortality. The number of deaths among people on ventilators decreased by 35 percent when they received dexamethasone in the RECOVERY study.
Patients with COVID relatively often have a deep vein thrombosis or a pulmonary embolism, even more so than with other serious infectious diseases. These people went downhill fast. When this was discovered by Dutch doctors, the use of anticoagulants was introduced in seriously ill patients.
Anticoagulation is not recommended for everyone. People who are sick at home with COVID only need anticoagulation if they are bedridden and have had a pulmonary embolism or a deep vein thrombosis in the past, or if they have active cancer, according to the GP association NHG. They receive heparin injections, which they can administer themselves.
Antibodies from plasma
It’s not available yet, but President Trump has got it anyway, according to US newspapers: plasma with antibodies. If you still have too few antibodies against the coronavirus yourself, a dose of someone else’s antibodies can help fight the virus. That is the thinking behind the plasma treatment. Sanquin has been collecting plasma for months and is currently testing whether it indeed works for COVID. But the answers aren’t there yet, the big studios don’t have results yet. Meanwhile, an artificial plasma product has been developed by Eli Lilly and Regeneron.