Seven Important Questions About Covid Antivirals Answered

Although vaccines have greatly reduced the number of cases of Covid-19-related complications, doctors do not have many options for treating those who are infected. They have prescribed dexamethasone to the most severely ill patients. This corticosteroid works to calm an overactive immune system that can cause havoc in our bodies. In order to prevent dangerous clots from occurring, they have used blood-thinners. Monoclonal antibodies have been prescribed by doctors. They can be used to treat certain illnesses, such as those that are not treated in time. However, they are expensive and must be administered via an IV.
To treat Covid, only one antiviral drug has been approved. It is a medication that specifically targets to stop a virus overwhelming your body. The treatment must be administered intravenously in the hospital as it is an infusion. It is not a breakthrough treatment, but it can help some patients get out of the hospital quicker.

However, several companies are currently testing antiviral medications that people can take immediately after being diagnosed with Covid. This will help stop the virus from spreading and protect them from serious illness. Merck announced interim results of a Phase 3 trial on Friday October 1. These showed that molnupiravir could reduce the number of Covid hospitalizations by half. The FDA received data ten days later in the hope of obtaining emergency use authorization.

Many have called the drug "a game-changer" in fighting Covid-19. Others are more cautious and say that the hype surrounding the drug is due to the failure of the country to prevent Covid-19 through vaccination. We've answered seven questions about antivirals to help you understand their role in managing the pandemic.

1. What is the Work of Antivirals?

A virus can't just get into your body and cause havoc, it must also reproduce. Fortunately, viruses do not have the organelles to create copies of themselves. Unfortunately, your cells do. Your cells are capable of creating an army by simply following the instructions. Cells then cause cellular destruction.

This is how antiviral medications work. Remdesivir is the only antiviral approved to combat SARS-CoV-2. It works by blocking an enzyme needed for replication.

Molnupiravir works by deceit. The drug can be used to replace some of the missing pieces while your cells build new strands viral RNA. These imposters can cause instability in the virus by causing mutations. Too many mutations and the virus will collapse before it has even been built. Imagine that you are trying to build your house from bricks but that 25% of the bricks are made out of red paper instead of clay. It wouldn't be possible to get anywhere.

Similar antivirals are also being developed by Roche and Pfizer, two pharmaceutical companies.

Bettie Steinberg, a virologist at Feinstein Institutes for Medical Research, says that antivirals all work in the same way. They all block viral replication. They do it in different ways.

Your immune system can quickly overwhelm the virus if it doesn't reproduce. It is the difference between fighting off just a few scattered soldiers and an army that is growing exponentially.

2. What and when would you take them?

Remdesivir can only be administered via IV to patients who have been admitted to the hospital. It was shown in clinical trials that it decreased the length of stay for patients from 15 to 10 days. However, it did not increase survival rates.

Doctors and scientists love molnupiravir because it can be taken orally. If you are positive for Covid, you can stop by your local pharmacy to pick up the pills, and then take them home. You could begin taking the pills almost immediately after you have been diagnosed with the disease. For a total of 40 pills, you would need to take four tablets twice daily for five days.

Merck administered molnupiravir in a clinical trial to patients who experienced symptoms within the past five days. These individuals were high-risk for serious illness such as those over 60 years old or with preexisting conditions like diabetes or heart disease. The risk of hospitalization was cut in half by the drug. Only 7.3 percent of patients who received molnupiravir were admitted to the hospital while 14.1 percent of patients taking a placebo did so. Eight people who received a placebo were able to live without the drug, while none who took it died.

Monica Gandhi, an infectious diseases specialist at the University of California San Francisco, says "This is a vision for me."

3. Are You Vaccinated and Could an Antiviral Benefit You?

All the trial participants in molnupiravir were not vaccinated. Steinberg explained that this was a strategic move to speed up data collection. They wanted to prove that it prevented death and hospitalization. You would need to work with a larger population to demonstrate the effect, and it would take longer to do so if you had previously vaccinated people.

Gandhi claims that the FDA authorization did not cover these patients. However, once it is approved, "all bets have been off" and doctors will be able to prescribe it to patients they believe will benefit. Steinberg says that antivirals and vaccines work in different ways, so there is no reason to not use antiviral drugs if you are vaccinated and have a breakthrough illness.

4. What Does Antivirals Do to Transmission?

Remdesivir has a limited effect on transmission because it is not given until you are already very ill. However, antivirals that can be used sooner, such as molnupiravir might slow down the spread of the disease.

Previous studies on molnupiravir have shown that patients who were given the drug had less virus in their noses compared to those who weren't. Five days after beginning treatment, no molnupiravir patient had detected levels of virus in the nose. However, 11.1 percent of those who received a placebo had. Gandhi explained that patients with fewer viral particles in their nostrils, which is a place where they can spread easily to others through breathing, coughing, or sneezing, meant that they were less likely to infect other people.

5. Are Antivirals Effective against New Variants Like Delta?

Merck claims that more than three quarters of patients in Phase 3 were infected by the Delta, Gamma, or Mu variants. The drug causes random mutations in the virus and does not target only spike proteins. Merck expects that it will continue to be effective against future variants. It remains to be determined if the other drugs will work against existing variants.

6. Are there side effects to antivirals?

Remdesivir can cause liver damage and severe allergic reactions in some patients. Although the Phase 3 safety data for molnupiravir is not yet available, the press release stated that adverse reactions were more common in the placebo than in the treatment group.

Gandhi says, "It was really well accepted."

Steinberg warns that we should be aware of one long-term side effect. It works by inserting genetic mutations in the viral RNA. This means that it is possible for the drug to introduce mutations in our DNA. This could result in babies being born with birth defect. It has been seen with antivirals. She says that she has seen it with other drugs.

A Smithsonian article in May 2020 warned that broad-spectrum Antivirals had caused similar effects before. Reporter Lila Thulin wrote that ribavirin (a broad-spectrum antiviral which fights Hepatitis C as well as respiratory syncytial viruses) can cause birth defects and kill blood cells.

Women who were pregnant were not allowed to participate in molnupiravir trials. Both men and women who are capable of reproducing were advised to use effective contraception during and after taking the drug. Gandhi states that although these guidelines are standard for antivirals that work the same way as molnupiravir, they are unlikely to cause birth defects if taken for five days. Furthermore, Gandhi says that "four days is enough time for the drug to be eliminated from your body."

7. When will they be available?

Merck submitted a request for FDA approval of molnupiravir Monday, October 11. Merck applied for FDA approval for molnupiravir on Monday, October 11. The U.S., along with several other countries, including Australia, Malaysia, South Korea and Singapore, have already signed deals to buy batches of the drug.

They may be able to help alleviate a shortage in the future if they are approved by the other antivirals currently under development.