Mar
13
Coronavirus Pandemic Update 35: New Outbreaks & Travel Restrictions, Possible COVID-19 Treatments


welcome to another MedCram COVID-19
update. we are in pandemic Italy has shot up dramatically to 12,000 cases
South Korea is still around 7800 we’ve been looking at those two wondering what
the difference is between Italy and South Korea Italy has an excellent
healthcare delivery system as does South Korea many possible explanations for the
differences in those two here in the United States we have a total of 1,300
cases total deaths 38 total recovered 15 serious or critical 10 and that’s around
4 cases per million population number of things have happened
politically which you probably already know about the president has banned
lights in from Europe except for Great Britain the National Basketball
Association has essentially canceled the season at this point Tom Hanks and his
wife who are in Australia report that they are infected with corona virus and
there are a number of new cases here and especially around on the west coast and
East Coast in cities our last update we did talk about zinc and zinc ionophores
and the ability of chloroquine to inhibit RNA dependent RNA polymerase
from corona virus essentially we’re looking at chloroquine and its
derivatives as an antiviral medication in prevention and we said that it’s
potentially possible that the mechanism that this chloroquine or
hydroxychloroquine works through is through a zinc ionophore mechanism well
I wanted to show you this paper that was published just three days ago and it
looked specifically at the in vitro antiviral activity and optimized dosing
regimen for hydroxychloroquine which is a better tolerated and more available
medication and chloroquine for the treatment of kovat 19 they looked at
hydroxychloroquine because it’s an immunomodulator
it might be able to attenuate this quote cytokine storm which is involved with a
RDS which we’ve talked about before I want to stress that there currently is
no evidence to support the use of hydroxychloroquine own in SARS Cove to
infection we don’t have any randomized controlled trials and that’s exactly why
they are using this medication and trying to figure out the appropriate
dosing before they are able to start a randomised controlled trial so if you
look here they took cells and they incubated them
in this medication and they subjected them to the actual SARS cuff to virus
and they also did it the other direction they had the virus in the cells and then
they treated the with this hydroxychloroquine in
different concentrations they also looked at chloroquine as well the
conclusion of the research was that hydroxychloroquine was found to be more
potent than chloroquine to inhibit SARS cough – and the key word here is in
vitro so here’s the data we can see here chloroquine on the left and
hydroxychloroquine here on the right and as we increase the concentrations of
either one whether or not the drug was there for 24 hours or 48 hours as the
concentration of the drug goes up the percent of inhibition goes up for
instance in the hydroxychloroquine we were able to see these values going up
higher therefore inhibiting more virus and of course if it was there for 48
hours we would have seen it inhibiting even more than if it was there for only
24 hours letting you believe that the drug is starting to accumulate more and
more in those first 24 to 48 hours you can also see that given
hydroxychloroquine at one micromolar at 48 hours it’s able to hit 50% of
inhibition whereas over here you need a much higher concentration to hit 50% of
inhibition and that’s exactly what these numbers are so the lower the e number
the better and you can see here for hydroxychloroquine these numbers are
smaller than the corresponding chloroquine numbers down here they have
prophylactic treatment which means that they were incubated with this medication
before the virus was given and you can see here that the numbers are much
better for hydroxychloroquine because the values go up fairly high and they
stay up in other words in this case if you were on hydroxychloroquine for 48
hours prior to infection with the actual corona virus SARS cough – and it was at
this concentration there would be absolutely no viral replication
occurring the way they did this was using reverse transcriptase PCR they
also looked at the dosing and they could see here how often would they need to
actually dose this medication and they found that if they gave for just four
five days it stayed in the system for quite a long time and the plasma
concentration didn’t decrease and it was still affected here we can see blood
concentration not dropping too much and here in the lung concentration where it
would be needed the most it hardly dropped at all it was concentrated in
the lungs so even though it was stopped at day number five it still hung around
for an additional at least five days so the overall study results were that
based on these models a loading dose of 400 milligrams twice for the first day
and then followed by a maintenance dose of 200 milligrams given twice daily for
four days is recommended for SARS cub to infection and again I wanted to mention
this because we had talked previously about that
so as hospitals across the country start to see this kind of an infection coming
in this may be one type of treatment that you consider if the mechanism of
action for hydroxychloroquine and chloroquine in vitro in stopping the
virus is related at all to the fact that it’s also a zinc ionophore then the
question is obvious do other zinc ionophores do the same thing and here’s
the zinc ionophore quercetin this quercetin also do the same thing in
terms of increasing zinc intracellular and blocking viral production well here
we have some data that was published and we’ll put a link to this article in the
description below and you can see here clearly that when you add zinc in an
increasing concentration zinc does get inside the cell but when you add
quercetin it’s going to increase the amount of zinc inside the cell so the
next question is does it actually reduce virus
well again an in vitro study quercetin as an antiviral agent inhibits influenza
A virus entry this study indicates that quercetin showing inhibitory activity in
the early stage of influenza infection provides a future therapeutic option to
develop effective safe and affordable natural products for the treatment and
prophylaxis of influenza infections this is not kovat 19 this is influenza and
here we can see that at zero quercetin we see a lot of
viral particles here that are illuminated with the fluorescent
antibodies and as we increase the dose of quercetin you can see that the number
of particles decreases rapidly until it’s not seen at all as we can see here
there is some evidence that quercetin had already been proven successful at
treating Ebola and Zika virus ‘as the question is what’s going on with kovat
19 and here we have a story from cbc which is the news organization of canada
spread speeds up montreal researchers will trial an antiviral treatment for
kovat 19 in china these two researchers here out of Montreal are wanting to
tests for setzen in the arena of Cova 19 now this drug is derived from plants and
you don’t need a prescription for it and you can actually get this
over-the-counter now in a number of studies that I’ve seen and researched on
the Internet this medication was tested in Zika and
Ebola viruses at a dose of around fifty to a hundred milligrams per kilogram
which would mean that you’re talking about three to seven grams a day of this
medication which is just astounding I don’t know if that’s the dose that is
actually needed but that’s what the studies were showing let’s summarize
what we found out here for zinc ionophores and we may come back to this
first of all we have no randomized controlled trials for any of this so we
can’t say that any of this actually works but the Chinese have just
published a paper a couple days ago showing that hydroxychloroquine is
superior to chloroquine in terms of potency and their proposed dosing
regimen would be 400 milligrams twice a day for one day and then 200 milligrams
orally twice a day for four days Pio means per ostomy n–‘s in the mouth the
ID means twice a day in terms of course seven we don’t know it is
over-the-counter we don’t know dosing again no randomized
controlled trials this is what they’re actually working on trying to do at this
point it should be noted and there were some questions about this
if this is a zinc ionna for question is should you take a zinc supplement I
think it’s more important that you’re not zinc deficient than it is that you
try to boost up your zinc blood levels because again those are regulated if you
have more zinc in your blood then you should be having your body’s gonna
regulate that by trying to get it out of your system and trying to pee it out of
course that can be overwhelmed if you take too much zinc so you don’t want to
do that either so I think the key here is don’t be zinc deficient so question
on zinc supplements thanks for joining us