From JMS on Yahoo: A physician on the covid battle -
There are some excellent opinions on leronlimab from people with finance backgrounds. I’m a physician and an investment novice. But I work at large hospital with some of the highest number of Covid patients in my state. I’d like to lend my clinical perspective regarding leronlimab and Covid.
1. Covid is out of control. It is much more infectious than the flu. We were initially successful at flattening the curve, but as you can see, the curve is rising again across the country for multiple reasons. We are seeing more and more cases by the day. And while we may be able to slow things down periodically by going into quarantine, we will keep having spikes of this virus for the foreseeable future. Moreover, as we get into the fall and winter most experts predict a massive rise in the virus which could overwhelm our hospital system.
2. A vaccine isn’t coming any time soon. The fastest a vaccine has ever been developed was the mumps vaccine which took 4 years. Granted the entire world and pharmaceutical industry is working toward developing a vaccine but I’m not optimistic that we will have anything for at least another year. I’m also not sure how effective the vaccine will be- not to mention if it will be safe. Think about it. We’ve had influenza for over a hundred years. We spend millions of dollars a year developing a flu vaccine and it’s only partially effective at preventing us from getting sick. How are we going to develop a vaccine that is 100% effective against a virus that we’ve never seen before in 6-12 months? Even if we do, how will we make sure it’s safe and how will we produce enough for the entire country/world?
3. Our current treatments for Covid are next to useless.
We started out using hydroxychloroquine. It has no effect on clinical outcome which has been shown in multiple studies. Dexamethasone is a steroid. We use steroids often in patients with severe respiratory illnesses such as viral or bacterial pneumonia, especially when they develop ARDS- adult respiratory distress syndrome. ARDS is the result of multiple inflammatory mediators that effectively are turned on by an infection- i.e. pneumonia. When ARDS occurs the lungs become stiff and fill up with fluid. Oxygen cannot be effectively be delivered, even with a ventilator. Ultimately this is what kills patients with bad pneumonia and its what kills people with Covid. In Covid we are using dexamethasone but it’s really an act of desperation. It may help decrease inflammation in the lung but only partially. It also is risky to use because it has the side effect of suppressing the immune system further, which can make the infection get worse.
Remdesevir has almost no effect. In the main study quoted by the FDA, it only shortens illness from 15 to 11 days. It has no effect on survival and hasn’t been shown to suppress the virus. It also does nothing to prevent the cytokine storm that leads to ARDS. In my hospital we were one of the early adopters of Remdesevir and I’m just not seeing much of a difference.
4. Leronlimab seems tailor made to help decrease mortality from Covid. Cytokine storm is the main mechanism through which Covid kills patients. Think about a critically ill patient like you would a boulder on the edge of a cliff. Once the boulder gets rolling, the more damage it will cause. Leronlimab blocks inflammatory mediators from coming to the site of infection, effectively stopping the boulder in its tracks. As Dr. Patterson highlighted, it also helps reduce the viral load in the blood and helps restore the immune system so the patient can start to fight the infection on their own.
5. Leronlimab is safe as demonstrated in the HIV data.
6. The mechanism through which leronlimab shuts down inflammation could be useful in the treatment of many other diseases besides Covid.
Sorry for the long post but the more research I do on this drug the more I believe in it. I’m hoping to have it available soon so we can start using it on our patients. I think its going to change the entire course of this pandemic.
AI
