One of the major problems, the world is facing now is CORONA VIRUS (Covid-19) ; it is an infectious disease which can be spread easily through contact with the infected person and it is declared as a pandemic by the WHO. These Corona viruses are exists in large groups,the most important infections caused by these viruses are severe acute respiratory syndrome (SARS) and Middle East Respiratory Syndrome (MERS), ranges from common cold to most severe forms of cold. Covid-19 is different to these two other coronaviruses in the spectrum of disease is very broad, around 80 per cent of cases leading to a very mild infection. There may be some people carrying the disease and displaying no symptoms, making it even harder to control.
This new virus is first discovered in the wet market of Wuhan which sells the live animals like fish and birds , believed that the CORONA VIRUS acquired due to the eating of live bat’s by humans in China, December of 2019. The incubation period of the COVID 19 usually ranges from 1 to 14 days, most commonly around 5 days. The most common clinical presentations includes the fever, tiredness, dry cough , difficulty in breathing. some people may also have experiences the body aches and pains, nasal congestion, running nose. Whereas some people are asymptomatic. This disease can spread easily from one person to other through the inhalation of the droplets which are spread through the cough or sneeze of the infected person. This virus can also be present on the non-living objects like clothes, door knobs etc. It dies within 12 to 14 hours if the virus does not have any contact with the host cell or living cell. And the another way of transmission of this disease is by the touching of the things previously used by the affected person in which they keeps virus contained hands on the eyes,nose and mouth which leads to the entry of this virus into the human body. There is no specific medication for this COVID 19 because of its multiple levels of mutations by its own. The main way to eradicate this COVID 19 pandemic is by maintaining social distancing, staying at home, maintain personal hygiene through sanitisation, washing hands with soap or hand wash at least 20 seconds for 3 or 4 time’s per day. Keep avoiding the face , mouth, and the nose touching with the hands. By covering the nose with the elbow or tissues while coughing and then disposing it in a closed bin after use. If you are having the fever, cough and difficulty in breathing seek medical attention as soon as possible. since there is no vaccine available for this COVID 19 we have to follow these little steps to stay safe and save our lives.
- RESPONSE OF THE HYDROXYCHLOROQUINE ON CORONA VIRUS:
Hydroxy choloroquine (HCQS) is an antimalarial drug widely used in the treatment of Rheumatoid Arthritis and the Systemic Lupus Erythematosus. The main action of the HCQS and chloroquine (CQ) is to be the inhibition of infection by the SARS – CoV2 in in-vitro condition. It is also studied that, depending upon the type of pathogen and the action of CQ varies so that, the antiviral and anti-inflammatory actions of the CQ are very helpful in fighting against the COVID 19.
CQ acts in different ways,
1.It increases the endosomal PH and interferes with the glycosylation of cellular receptors of SARS-CoV therefore it can block the viral replication
2.It inhibits the sialic acid biosynthesis by inhibiting the quinone reductase 2 enzyme which leads to the broad antiviral activity.
3. It inhibits the cathepsins which leads to the formation of autophagosomes by altering the PH of the lysosomes which cleaves the SARS-CoV 2 spike proteins.
4. It blocks the glycosylation receptors at the virus cell surface, hence it cannot bind to the Angiotensin Converting Enzyme 2 (ACE 2) which is present in the heart, lungs and kidney, hence prevents the attachment with the host cells.
5. In vitro it is found that CQ is highly effective in reducing the viral replication due to its favourable penetration in to the tissues which can be achieved by proper dosing. The structure and mechanism of CQ and HCQS are similar except there is an additional hydroxy moiety in one of the terminals in HCQS. This hydroxy molecule present in the HCQS makes it less permeable to the blood retinal barrier which makes it to less toxic, compared with the CQ. Due to the narrow therapeutic index and safety index margin, HCQS is considered more safer than chloroquine. The side effects of these drugs include blindness which is caused due to retinal damage, loss of consciousness due to the low sugar levels, suicidal behaviour, heart failure, abnormal heart rhythm (arrhythmias) and even death. Since this drug may causes abnormal heart rhythm monitoring of ECG for QT, prolongation is recommended. Monitoring of the haematological functions such as RBC, WBC, Platelet and blood glucose levels and serum electrolytes. Coadministration of the drugs such as the anti-arrhythmic, anti-psychotic, anti-histamines, teneligliptin, ondansetron that causes QT prolongation.
COVID 19 confirmed-
A. Chloroquine Phosphate:
1.COVID 19 URTI: 500mg BID for 5 days
2.COVID 19 LRTI: 500mg BID FOR 10 days
B. Hydroxy chloroquine :
Loading dose:400 mg BID – day 1 then
Maintenance dose: 200 mg BID for 5-10 days
The potential treatments mentioned above all works by blocking some key element of the virus infection machinery using small molecules. Two other kinds of treatments are also being explored in trials that work in a different way.
- passive immunisation which is the transfer or transfusion of potential protective antibodies from the person who has been infected and recovered from COVID-19 to the person who is in the high-risk suffering from a SARS-CoV-2 infection.
- This is also called as convalescent sera i.e a purified blood product from someone who has recovered from COVID-19, this convalescent sera can block SARS-CoV-2 in the dish of cells in the lab and has the potential to help the treatment development. This Passive immunisation for COVID-19 is being tested in trials across the world and the results seems to suggest that it is safe to use so far.
The other way of possible treatment is blocking our own immune system. in this method, blocking the parts of our own immune system that are possibly overreacting to SARS-CoV-2 infection and causing damage in our lungs.
In the limited studies that have been conducted on the COVID-19, seems that some severe cases in our immune response goes into the overdrive without being able to clear the infection and this can increases the severity of the disease. When this occurs , high levels of inflammation is found in the lungs.
Potential treatments that blocking the immune components linked to this severity has begun. According to Some sources, extreme caution must be taken when manipulating the immune response during an infection as in the absence of other therapies we rely on our immune response to limit the virus replicating.
So that, the specific treatments for COVID-19 are not yet available, drugs are being tested and conducted clinical trials starting to yield results. This, combined with the further knowledge that scientists are gaining by the tests and clinical researches SARS-CoV-2 will help massively until a vaccine becomes available.
- WHY OTHER DRUGS ARE NOT EFFECTIVE AGAINST CORONA VIRUS:
The antiviral medications such as the Ritonavir and Lopinavir are also helpful in treating the corona virus. But these are not used as that of the HCQS and CQ, because these may causes the “DRUG INDUCED SUDDEN CARDIAC DEATH.” These blocks the potassium channels in the heart which leads to degeneration of heart rhythm which finally leads to cardiac arrest. REMDESIVIR which is a antiviral drug and used in the treatment of Ebola, was the first drug thought to be effective against corona virus but due to its serious adverse effects it was not used. It acts mainly by inhibiting the premature termination of RNA transcription and thus it inhibits the viral replication and finally leads to inhibition of virus reproduction. The combination of Ritonavir/ Lopinavir and Interferon ꞵ is helpful in treating and also control of corona virus, but the use of interferon ꞵ on patients with severe COVID 19 is highly risky. Favilavir is an antiviral medication which is used in treating the symptoms of COVID 19 and is used in china and japan and others , but it was not approved by the US-FDA. Whereas some of the drugs that are under clinical trials like Tocilizumab which is used to treat the rheumatoid arthritis, is also very effective in treating the COVID 19 patients. This is approved by the FDA and is under phase III clinical trials. Darunavir is also an anti-retroviral HIV-1 protease inhibitor. it is also having capability of inhibiting the replication of SARS-CoV2 in an invitro study.