Coronavirus treatments: What we know after 6 months – Business Insider
  • Since the novel coronavirus emerged in January, hundreds of clinical trials have launched to test treatment options. 
  • Most trials are ongoing or have failed. But the few that have succeeded have given frontline doctors valuable tools to speed up recoveries from COVID-19 and prevent deaths. 
  • From the surprise hit dexamethasone to understanding more about the virus and its symptoms, here are the four biggest research breakthroughs from the past six months on how to treat coronavirus patients.
  • Visit Business Insider’s homepage for more stories.

The coronavirus pandemic has proved it is here to stay.

In the past month, the US has notched about 800,000 new cases and 20,000 deaths as many states have seen spikes in infections. More than 10 million people across the world have been infected, accounting for more than 500,000 deaths since the start of the outbreak, according to data from Johns Hopkins University.

In some ways, the crisis has only deepened in the US. Basic health measures, like wearing masks and social distancing, have been politicized. Government leaders haven’t pitched a plan to the public for navigating out of the pandemic.

But it’s not all bad news. Since the virus emerged late last year, we’ve made progress in the search for drugs and vaccines. Now several promising treatments have started human testing, along with more than a dozen vaccine candidates, and some trials have already identified effective coronavirus drugs.

Here’s what we’ve learned in the past six months about coronavirus treatments and vaccines. 

Hydroxychloroquine tablets.

Associated Press


1. Hydroxychloroquine captured the world’s attention. Then it flopped.

An obscure generic medication typically used to treat lupus or arthritis became one of the most talked-about treatment candidates in the world.

For much of March and April, hydroxychloroquine became a favorite talking point of President Donald Trump and was constantly discussed on Fox News.

The enticing narrative around the drug led people to jump to conclusions. While big drugmakers were revving up their research engines in a long slog to create a — likely expensive — new drug, hydroxychloroquine stood in stark contrast. The medication is a cheap, widely available pill first approved in the 1950s to treat malaria. If it worked, it would have been a remarkably simple and inexpensive solution to a worldwide pandemic.

But there was no high-quality clinical data to support its efficacy. A slew of poorly designed trials produced results that became a type of Rorschach test. Supporters of the drug could glean data they felt showed obvious benefit or promise, while skeptics often emphasized grave safety risks, which could be exaggerated to make it seem like a poisonous pill. 

Both sides were far more dramatic than the science. A pair of high-quality studies in June showed the antimalarial pills provided no benefit for hospitalized patients and that they weren’t a preventive treatment for people exposed to the virus. The studies also didn’t find any particularly troubling safety risks either. The drug simply didn’t do much against the coronavirus.

“This is not a treatment for COVID-19,” Martin Landray, the UK study’s lead researcher said on June 5. “It doesn’t work.”

The findings spurred several other trials to stop testing the drug, including studies run by the US National Institutes of Health, the World Health Organization, and the Swiss pharma giant Novartis. US regulators also yanked its emergency-use authorization to treat COVID-19. A few studies are still testing the pills as a preventive treatment for people not yet exposed to the virus, but June gave a major blow to the notion of hydroxychloroquine as a game changer.

Read more: The first high-quality study of malaria pill hydroxychloroquine just found it doesn’t help prevent coronavirus infections

Dexamethasone is a cheap generic steroid.

Associated Press


2. A cheap generic drug turned out to be a surprise success.

While hydroxychloroquine has disappointed, a cheap generic medication became a surprise success in treating hospitalized COVID-19 patients.

Dexamethasone reduced the rate of death by about one-third in COVID-19 patients on ventilators and by one-fifth for those needing oxygen. The finding comes from more than 6,000 hospitalized patients in the UK’s Recovery study, with 2,104 receiving dexamethasone and 4,321 patients randomized to standard care.

It’s not a cure, but it is a breakthrough because it’s the first COVID-19 drug to meaningfully lower the risk of death. The benefit is strictly limited to critically ill patients who need help breathing, as the steroid’s anti-inflammatory effect could harm COVID-19 patients with mild or moderate cases.

Read more: A cheap steroid dramatically reduced coronavirus deaths in a ‘major breakthrough’ trial

A vial of remdesivir at a Gilead manufacturing site.

Associated Press


3. Treating the virus is different from treating the symptoms, and both are important when caring for COVID-19 patients.

By the time a drug like dexamethasone is used, it’s working to confront a runaway immune response, rather than fight the viral infection itself. It builds off a better understanding researchers and doctors are getting of COVID-19 as a disease. 

There are two distinct stages of the disease that have major implications for treating patients. In the early stage, doctors want to boost the immune response using virus-fighting proteins called antibodies along with T-cells that can neutralize the coronavirus. Or they can use antiviral drugs, which seek to stop viruses from invading and hijacking healthy cells to copy themselves.

In the later stage, patients who are critically ill often suffer less from the virus and more from their overactive immune systems. For these patients, the priority is getting the immune response under control, which is where steroids like dexamethasone can help.

Encouragingly, the first six months of the outbreak have also brought an antiviral breakthrough: remdesivir. 

The antiviral drug helped patients recover 31% faster than a placebo group, according to study ran by the US National Institutes of Health. However, it didn’t show a marked reduction in deaths.

The results showed that antivirals could fight the coronavirus. Doctors have a treatment option for hospitalized patient who aren’t sick enough for dexamethasone. And researchers are now studying combinations of remdesivir with other treatment candidates, hoping to mimic how HIV was eventually cracked with a combination of three drugs.

Read more: Gilead turned a failed Ebola drug into the first effective coronavirus treatment. Here’s everything you need to know about remdesivir.




4. There haven’t been any major mutations. That bodes well for crafting an effective vaccine. 

A vaccine that can protect healthy people from infection is the best way to confront infectious diseases.

More than a dozen coronavirus vaccine candidates have started clinical testing in 2020, and by the end of the year, there should be more than 30 experimental vaccines in human trials, according to a Business Insider review.

While the experimental vaccines have been built with a variety of different technologies, they all have the same goal — prepare the body’s immune system to deal with the coronavirus. Vaccines basically show human cells a part of the virus. If the vaccine works, the body will start pumping out antibodies designed to fight that virus and protect against infection.

The first few months of research have found the virus mutating, but not in any way that’s particularly alarming. Viruses mutate all the time as part of their typical life cycle. Nearly all the coronavirus vaccine programs are focused on the virus’ spike protein, and epidemiologists and vaccine experts have yet to identify any concerning changes for this crucial protein.

Optimism has been rising around vaccines. Dr. Anthony Fauci, the nation’s top infectious-disease expert, has said he believes having a vaccine is a matter of “when and not if.”

Read more: Dozens of drugmakers are racing to develop coronavirus vaccines. Here’s how they see 2020 playing out and when the first vaccines might be available.


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