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How Coronavirus Drugs Are Helping Patients

Steroids and antivirals are driving down death rates while testing continues on monoclonal antibodies

iStock / Getty Images For all the difficult news about the in the last nine months — the global death toll of more than 1 million people, failed drug trials, survivors’ — new drug and other therapies for COVID-19 are starting to emerge. Even as the world waits for a , researchers are confident they are making progress on treatments that can increase survival rates.
"We know so much more now than we did in March or April,” says Gopi Patel, M.D., associate professor of infectious diseases in the department of medicine at the Mount Sinai Hospital in New York City. Get instant access to members-only products and hundreds of discounts, a free second membership, and a subscription to AARP the Magazine. For one thing, she says, as hospital caseloads exploded early in the pandemic, patients with milder symptoms were asked to stay at home unless their condition worsened. When patients got sicker and returned to the hospital, they needed , sometimes requiring a ventilator. And once patients are on a ventilator, “the mortality rate is more than staggering,” Patel notes. Now, more COVID-19 patients are sent to the hospital for treatment before they get seriously ill, saving lives and resources. In other cases, new therapies can help keep a subset of patients out of the hospital entirely. Here's what doctors say is making a difference now, and what may do so in the future.

Remdesivir and other antivirals

The antiviral remdesivir was approved by the U.S. Food and Drug Administration this week as the first treatment to fight COVID-19, after being shown in clinical trials to help hospitalized patients recover faster from the disease. The drug had previously been used — for months — . Doctors such as John Beigel, M.D., associate director for clinical research in the division of microbiology and infectious diseases at the National Institute of Allergy and Infectious Diseases, called it “the one antiviral we know that works for SARS-CoV-2 [the coronavirus that causes COVID-19].” Remdesivir (brand name Veklury), which is given by injection, is now approved for use only in a hospital or a health care setting “capable of providing acute care comparable to inpatient hospital care,” according to the FDA. In announcing their approval, FDA Commissioner Stephen M. Hahn, M.D., stressed that it was supported by safety data from multiple clinical trials and that it represented “an important scientific milestone in the COVID-19 pandemic.” Clinical trials assessing the safety and efficacy of the drug for smaller children are still ongoing, and the drug so far is approved only for those over 12.
A small study published in the New England Journal of Medicine in June showed that when the drug was administered over a 10-day period, 68 percent of hospitalized patients in the study showed clinical improvement. Research also shows that remdesivir works by stopping the virus from spreading in the body.
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Dexamethasone steroid

In some patients, COVID-19 triggers a massive that can cause lung damage and lead to respiratory failure and even death. Doctors can now reduce the inflammatory damage with the powerful steroid In a recent study published in the New England Journal of Medicine in July, the drug was found to cut the risk of death among hospitalized patients compared with patients receiving either oxygen alone, or invasive mechanical ventilation.

Monoclonal antibody cocktails

Another potential drug is one you may have heard of as being part of the president's COVID-19 treatment: monoclonal antibodies, which have long been used in cancer therapy. Produced in a laboratory by cloning antibodies from patients who have had coronavirus, they're intended to boost new patients’ immune response to the virus. Developed by Regeneron Pharmaceuticals, the experimental treatment in the headlines consists of a cocktail of two monoclonal antibodies called REGN-COV2, which are in clinical trials for both hospitalized and nonhospitalized patients infected with the coronavirus. Eli Lilly and other pharmaceutical companies are also testing their own versions of monoclonal antibodies — though Eli Lilly's trial has been paused to look into safety concerns. Since President Trump received his Regeneron cocktail, Patel says she has “already had conversations with patients asking for what Trump had,” although the drug is officially available only on a “compassionate use” basis directly from the company. Both Regeneron and Eli Lilly submitted applications to the Food and Drug Administration for EUA recently, which would make the drug more widely available before clinical trial results are concluded. AARP Membership — $12 for your first year when you sign up for Automatic Renewal Get instant access to members-only products and hundreds of discounts, a free second membership, and a subscription to AARP the Magazine. . A ventilator buys time for the lungs to heal from infection, but if it is managed incorrectly it can cause respiratory distress syndrome, or acute respiratory distress syndrome. Proning, or placing a patient on their belly, is one technique being used to improve oxygen exchange, says Brian Garibaldi, M.D., associate professor of medicine at Johns Hopkins University School of Medicine and director of the Johns Hopkins Biocontainment Unit, “I honestly don't know yet if proning decreases mortality or gets [patients] out of the ICU faster, or prevents them from going on a breathing machine, but it is certainly effective for someone with really low oxygen levels." Jonathan Abraham, M.D., assistant professor of molecular biology, immunology and structural biology at Harvard Medical School in Boston, says doctors are also avoiding mechanical ventilation by delivering oxygen via things like a heated and humidified high flow nasal cannula. However, Abraham adds, “I don't want anyone to believe mechanical ventilation should be avoided at all costs. The physicians taking care of patients will know when it is required and when the benefits outweigh the risks.”

Keeping pace for the future

Garibaldi says the number of new drugs in development is exciting. “Things continue to move at a mind-blowing pace when you think how the normal process of developing therapeutics happens,” he says. And for all the promise of new drugs and procedures, COVID-19 still has significant morbidity and mortality rates. "This is a disease we are not ready to stop yet. We've come a long way, but we still have a lot to do,” offers Beigel, who notes that faster by COVID-19 patients will speed results. “I would encourage anybody that is hospitalized to participate in any clinical trial that is offered. This story, originally published Oct. 15, has been updated to reflect new information. More on health AARP Membership — $12 for your first year when you sign up for Automatic Renewal Get instant access to members-only products and hundreds of discounts, a free second membership, and a subscription to AARP the Magazine. AARP VALUE & MEMBER BENEFITS See more Health & Wellness offers > See more Flights & Vacation Packages offers > See more Finances offers > See more Health & Wellness offers > SAVE MONEY WITH THESE LIMITED-TIME OFFERS