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Credit: Scott Olson/Gettyīut even as researchers scrambled to test approved drugs, pharmaceutical companies and biotechnology firms were scouring their libraries for any compounds with known antiviral activity that might stop the SARS-CoV-2 coronavirus. The US Food and Drug Administration has authorized remdesivir, an intravenously administered antiviral, only for use in people hospitalized with COVID-19. The FDA has not authorized the drug for this purpose, but it's widely used to treat the sickest people. Initial efforts to find treatments focused on drugs already approved by regulators, and yielded only one winner: dexamethasone, a steroid aimed at dampening an overblown inflammatory response in the sickest people.
IS CUTE WRITER A VIRUS TRIAL
So when the first cases of COVID-19 emerged in late 2019, “there wasn’t a portfolio of antivirals waiting”, says Saye Khoo, an infectious-disease physician at the University of Liverpool, UK, who has led a clinical trial of molnupiravir. But the 2002–04 severe acute respiratory syndrome (SARS) epidemic fizzled out quickly, and the Middle East respiratory syndrome (MERS) outbreak in 2012 never became widespread - meaning that drugmakers had little incentive to develop antivirals against these diseases. A COVID-19 pill, which simply requires a prescription and a trip to the pharmacy once symptoms appear, would make early treatment much easier.ĬOVID-19 is not the first disease caused by a coronavirus to seriously impact humans.
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The sicker the patient, the less effective the drugs are at treating the illness. Yet it’s better to “hit early, hit hard” with antivirals, says Richard Plemper, a virologist at Georgia State University in Atlanta. And remdesivir is approved only for those who are already hospitalized with COVID-19.Ĭoronavirus breakthrough: dexamethasone is first drug shown to save lives That makes it difficult for people to access the therapies before they are sick enough to land in hospital. The other therapies on offer against COVID-19, Gilead Science’s antiviral remdesivir and a monoclonal antibody cocktail from biotech firm Regeneron, must be administered intravenously or by injection. A spokesperson for Merck points out that moderate COVID-19 cases in India are defined as being more severe than in the United States and involve hospitalization.
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Merck’s findings, which were disclosed in a press release and have yet to be pored over by scientists and submitted to regulators for approval, applied to people with mild-to-moderate cases of COVID-19 who were not hospitalized. This week, two Indian drugmakers independently testing generic molnupiravir in people with moderate illness due to COVID-19 sought to end their trials because they saw no “significant efficacy” for the experimental drug, although they plan to continue trials for people with mild illness. Even if lower-income countries can afford the medicine, they might not have the diagnostic capacity to treat patients with molnupiravir early in the course of their illness, when treatment could make a difference. Molnupiravir was so effective in a phase 3 trial involving COVID-19-positive people at risk of severe illness that clinicians halted enrolment early.īut whether this clinical-trial success story will translate into a global game-changer in the fight against the pandemic isn’t yet clear. It could also keep hospitals from overflowing, especially in places where vaccination rates are still low, such as many low- and lower-middle-income countries. The race for antiviral drugs to beat COVID - and the next pandemicĪ pill could make treating patients earlier on in their infection much easier - and more effective.