Despite progress in the development of drugs against COVID-19, which are regularly reported by the media, by far the medicines with proven efficacy against coronaviruses are currently no. Meanwhile, approaches in the treatment of coronavirus infection during the pandemic has changed considerably. As told the chief pulmonologist of the Ministry of health, head of Department of pulmonology, medical faculty FGAOU First MSMU n. a. I. M. Sechenov, head of clinical Department of FGU”Institute of Pulmonology” FMBA of Russia Sergey Avdeev, speaking at the roundtable organized by the publishing house “Arguments and facts”. The event was dedicated to the results of the pandemic and it was in an online format.
Today, Russian doctors are guided by the seventh version of the clinical guidelines for the treatment COVID-19. Is no longer that of the drug, which started to treat the first patients davidnyc – ribavirin. According to the Professor, in a short time from the document and leave the famous to the whole world D. trump hydroxychloroquine, and with it other aminohinolina.
“Using them had some background – they worked during SARS-1, with MERS. This was reported by a small controversial study from the South of France, which has spurred the use of hydroxychloroquine in the world, — said the doctor. And today we say that perhaps we will soon exclude it from our lists, including the seventh version of the guideline because it did not show any effects. Thus, the Recovery study, recently presented by our British colleagues are shown the same mortality of patients with hydroxychloroquine without it. Lopinavir, ritonavir probably also go in inefficiencies”.
Recently in Russia with high hopes, was presented to the antiviral drug favipiravir. This drug, developed in Japan about 20 years ago to combat the flu, but as shown by preclinical studies, it works against SARS-CoV-2. The Ministry of health has registered the domestic drugs based on this molecule— Aviewer and Karanvir and allowed them to apply to the COVID-offices.
“Favipiravir beginning to be used more and more often in Russia, because we produce it from three pharmaceutical companies. But information about its effectiveness, which we used to obtain from sources of evidence-based medicine, there is no, — said Avdeev. — Going research in Russia, India, USA and Brazil. Some efficiency, but not such as we would like, it has. To date we have published studies that would say that this drug is effective at COVID-19. However, in Russia it is registered as antiviral drug against SARS-CoV-2”.
According to Avdeev, a revised attitude to the use in the rescue of patients with serious SARS-CoV-2 devices of artificial ventilation of lungs (IVL) – at the beginning of the pandemic, the connection to the ventilator was considered the main life-saving factor of patients with higher degree of lung disease. Since then it became clear: a worldwide mortality rate of patients on a ventilator is extremely high.
“Originally operated installation of early intubation of patients. Today, she’s gone, — said the speaker. We all are talking more about non-invasive ventilation and high-flow oxygen therapy. Because in all countries the mortality of patients on a ventilator is extremely high and is 50-88%. This is a statistic that has no significant differences between the countries.”