COVID-19: Virus more dangerous than we thought; A new drug joins the race

By Paul Basilio, MDLinx
Published March 24, 2020

Key Takeaways

As of Tuesday afternoon, the total number of confirmed COVID-19 cases is 414,277, with 18,557 deaths globally. In the United States, the number of cases has increased to 51,542, with 674 deaths across all 50 states plus Washington, DC.

Today, the WHO announced that the United States has the potential to become the next COVID-19 epicenter. The organization cited the large, rapid acceleration in infections as the reason. During a recent 24-hour period, 85% of new cases were identified in Europe and the United States. Of those, 40% came from the United States.

“We are now seeing a very large acceleration in cases in the US. So, it does have that potential,” said WHO spokesperson Margaret Harris, MD, when asked whether the United States could become the new epicenter. “We cannot say that is the case yet, but it does have that potential.”

As the pandemic increases in reach and scope, researchers and healthcare providers (HCPs) on the front lines are learning more about SARS-CoV-2, the virus that causes COVID-19. New and old drugs alike are being studied for their safety and efficacy in treating the disease, and the severity of symptoms and the impact of underlying health conditions are beginning to come into focus.

Virus is more dangerous than we thought—healthcare workers are at increased risk

SARS-CoV-2 may be present in conjunctival secretions of infected patients, according to a recent study from China. 

One of 37 patients with mild or severe COVID-19 pneumonia in the study had evidence of the virus in conjunctival secretions on PCR testing. The authors note that the viral load of conjunctival sac secretion is low, and they estimate it is directly proportional to the severity of disease.

“When checking the patient's eyes, the doctor must wear protective goggles and gloves and wash hands after the exam,” wrote Liang Liang, MD, Yichang Central People’s Hospital, Hubei, China. Dr. Liang also recommended the use of ophthalmic equipment rather than manual detection in patients undergoing evaluation for eye diseases.

In a separate paper, another group of researchers speculated that the virus may enter through tear droplets, which may pass through nasolacrimal ducts and into the respiratory tract. Authors of that study have recommended that HCPs wear protective goggles.

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Silver lining: Healthcare workers receive additional training to decrease possibility of infection

The NIH is launching a new website for healthcare workers and first responders who are at risk of exposure to SARS-CoV-2 as part of their work duties.

The website is being created following Congressional appropriation of $10 million for worker-based training for hospital employees, emergency first responders, and others at occupational risk.

“These men and women are so dedicated and as they work so hard to serve and protect the public during this COVID-19 pandemic. I want to make sure they know how to protect their own health, too,” said Joseph “Chip” Hughes, MPH, branch chief, National Institute of Environmental Health Science. “We don’t need them getting sick, or taking the virus back to their families or their communities.”

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UK team uses an HIV drug combo to tackle COVID-19 

A team of scientists at Oxford University kicked off a clinical trial evaluating lopinavir-ritonavir—an HIV drug—and dexamethasone as a potential treatment for COVID-19.

The safety and adverse effect profiles of the drugs are well known, so the trial is focusing only on their potential activity against COVID-19.  

“Adults admitted to hospital with COVID-19 should be offered the opportunity to participate in this trial and contribute to improving care for everyone,” said Peter Horby, PhD, professor of emerging infectious diseases, Oxford University, said in a statement. “All patients will receive the standard full medical care, regardless of which treatment group they are placed in.”

In a small-scale Chinese study of lopinavir-ritonavir alone, investigators found that it had no discernable effect on viral replication.

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