So, we know more about SARS-CoV-2.  (Yesterday was but just the newest update.)

I didn’t include this on yesterday’s post, because the focus wasn’t on dying from COVID-19.  It was about it’s spread.

But, we had good ideas about who suffers most acutely when infected with SARS-CoV-2.  Now, with new studies, we can be far more accurate.

More than ¾ (76.4%) of those who die from COVID-19 had at least one other medical condition that put the patients over the edge.  (Up until mid-July- when this was written- only 73 of the 4071 COVID-19 deaths in Massachusetts had no other underlying condition.)

One of the findings that blew me away was that asthma is not such a condition.  According to the study by the London School of Hygiene and Tropical Medicine and Oxford University  researchers, being asthmatic or not having the condition makes no difference to one’s survival from COVID-19.  (Interestingly, there was no study if that rendered one more likely to contract COVID-19.)

But, what we don’t know is what would be the perfect therapy- to eradicate it promptly from those unfortunates who get infected.

Sure, we have remdesivir, an antiviral.  At least, remdesivir works if the COVID-19 is manifesting adverse respiratory effects.   But, the studies only show that this drug, approved for emergency use by the FDA, shortens the hospital stay.  (And, one has to be hospitalized, since the drug- that was being developed to treat Ebola- must be administered intravenously.)

And, for those on mechanical ventilators (the sorriest of the cases), we have dexamethasone.  It’s really not directly for coronavirus treatment; it just reduces deaths (by 30%) for those patients on ventilators or on high flow oxygen (by 20%).   If COVID-19 patients are not so treated, administration (or using other corticosteroids) will actually exacerbate the situation.

But, we are still looking for viable treatments.

Which is why some 78 folks from the European Bioinformatics Institute, UC San Francisco, Howard Hughes Medical Institute, the Institut Pasteur, and the University of Freiburg have been studying how the virus works in our bodies.  As is true for most viral attacks, the virus hijacks our cell apparati.  This particular coronavirus subverts our phosphorylation processes and/or kinase signaling.  As was reported in Cell, these findings mean that drugs and compounds that interfere with phosphorylation processes are our perfect therapeutic choices.  And, this group has narrowed down the field from 87 to 7 primary candidates for clinical trials.  We’ll have to see if these pan out.

There’s also immunotherapy avenues of approach.  The immunity is conferred by harvesting the plasma from those folks who recovered from COVID-19.  Right now, it’s only being directed to those with the most virulent form of the infection. But, there’s a creative test (verification of results) that may change that situation.  (We’ve used ‘convalescent plasma’ for a long time- for Ebola, for the flu- without being positive that the results are what we intend.  This will be the first such research venture.)

Folks from NYU (Langone Health), Albert Einstein College of Medicine, and Montefiore Medical are going to pool data from at least 10 different trials- in REAL TIME- to produce a larger data set that can provide definitive results.  (Amazingly, no corporate sponsor is involved- but I’m guessing that’s because no one will get to “own” the convalescent plasma that gets donated.)

Why a pooled study? Because no one center has enough patients to verify that convalescent plasma injections produce the anticipated results.  And, we are desperate for viable treatments for COVID-19.

(Normally pooled data occurs long after disparate studies have been completed and published.   Now, the data will be collected every two weeks and analyzed. Should the results depict patient safety issues, the investigators will receive stop treatment orders.)

We’ve already treated some 40,000 patients with convalescent plasma using compassionate-use regulations, with the Mayo Clinic (Rochester MN) in the lead position.  So, we can believe the process is safe- but since every test subject got the plasma, there’s no control to know if the therapy truly provides benefits.

Soon, we will know if our gut feel has any basis in fact.