Thread by @abledoc

This is a thread on use of drugs for #COVID19
Hydroxychloroquine (Lupus, RA) Lopinavir/Ritonavir (HIV/AIDS) Remdisivir and Favipiravir (Ebola) and Camostat (Pancreatitis, Japan) are drugs that seem to have activity against SARSCov2
Some of these are used on Emergency Basis. 1/n

Hydroxychloroquine is widely used for Rheumatoid Arthritis and Lups with good safety margin. It is similar to chloroquine without antimalarial activity. It is also safer than Chloroquine. It inhibits many enveloped viruses including Coronavirus and Ebola #COVID19 #SARSCov2 2/n

Hydroxychloroquine has superior activity against coronavirus compared to Chloroquine in concentrations achievable in practice.
400 mg Twice Daily for 1 day
400m daily for 6 days
5-6 mg/day maintenance would be sufficient. #COVID19 #SARSCov2 3/n
academic.oup.com/cid/advance-ar…

Although there are no trials proving Hydroxychloroquine efficacy, it is being used where no other treatments are available for prophylaxis among medical personnel.
Side effects
Photosensitivity (take at bedtime)
Gastritis
Retinal toxicity on long term use.
Rare skin rash 4/n

Use of Hydroxychloroquine at bedtime reduces common side effects. Retinal toxicity on long term use occurs when maintenance dose of >6mg more than 4 years. Unlikely <5mgkg (actual weight)
Corneal toxicity (reversible) seen with chlroroquine are rare with hhdroxychloroquine 5/n

Lopinavir/Ritonavir LPV/r are protease inhibitors approved for HIV as second line agents.
Use of LPV/r reduced ARDS and death in patients with SARS suggesting it may be useful in #COVID19
LPV/r group had 2.4% ARDS/Death v 28.8% historical controls 7/n
thorax.bmj.com/content/59/3/2…

Camostat Mesylate is a protease inhibitor approved for Pancreatitis treatment in Japan which has shown activity against SARSCov2 viral entry. Camostat uses the lysosomal enzyme TMPRSS2. #COVID19 #SARS_COV_2 #SARSCov2 #coronavirus 8/n
cell.com/cell/pdf/S0092…

Interview with Markus Hoffman, Infectious Disease researcher from Germany working on COVID19 regarding prospects for antiviral therapies. Camostat warrants a trial in #COVID19 #coronavirus #SARS_COV_2 #SARSCov2 #Camostat 9/n
openthemagazine.com/interview/eval…

A small study in France has shown preliminary efficacy of Hydroxychloroquine in reducing viral load in #COVID19 patients.
connexionfrance.com/French-news/Fr…

https://twitter.com/AndyBiotech/status/1239963224298016768?s=19

Favipiravir is an antiviral drug developed for Ebola that has been shown to be active against #COVID19 #SARSCov2 in China 9/n
thelancet.com/journals/lanin…

Reports from China say that Favipiravir has been approved in China against #COVID19 #SARSCov2 10/n
coinspeaker.com/china-favipira…

Here is a review of drugs with activity against #SARSCov2 And Remdisivir developed by Gilead against Ebola tops the list Anecodotal social media news also supports efficacy (awaiting actual results) 11/n
ncbi.nlm.nih.gov/pubmed/32152082

Here is another review that lists all drugs that have some activity against the coronavirus #COVID19 #SARSCov2
Not surprisingly CyclosporinA is in the list (Many viruses need Cyclophilins for hijacking the cells). #Drugs4Corona 12/n
pubmed.ncbi.nlm.nih.gov/32147628/?from…

A detailed review on the prospects of nucleoside drugs against respiratory viruses. 13/n #COVID19 #SARSCov2
pubmed.ncbi.nlm.nih.gov/29562753/?from…

Link to Tocilizumab experience in #COVID19
Tocilizumab is a monoclobal directed against soluble IL6 receptor.

https://twitter.com/abledoc/status/1240332014848331777?s=20

Here is another study that looks at the in vitro mechanism of Hydroxychloroquine and Chloroquine. #coronavirus #COVID2019 #Covid_19 #SARS_CoV_2 #Hydroxychloroquine #Chloroquine

https://twitter.com/madamscientist/status/1240665750152470529?s=19