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Covid-19 antivirals ineffective: WHO

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Geneva: WHO’s Solidarity Trial has revealed that the Covid-19 anti-viral drugs have little or no effect on in-hospital patient mortality.

A new study by WHO, under the Solidarity Trial, deems all existent treatments to have little or no effect on the mortality of patients, initiation of ventilation, and duration of hospitalisation.

The Solidarity Trial is a global trial conducted under the World Health Organization(WHO) to find effective treatments for Covid-19 and reassess existing treatments. The study conducts one of the largest global-scaled randomized trials for Covid-19 treatments with 12,000 patients in 500 hospitals spread over 30 countries.

Through the trials, it was discovered that the four drugs—Remdesivir, Lopinavir, Hydroxychloroquine, and Interferon-β1a provided no solid evidence of an increase in the mortality of patients or decreasing the hospitalisation time. However, the study found that administering corticosteroids had a positive effect on both severe and critical patients. WHO also maintains that the decision to administer these unproven treatments must remain between patient and doctor, in compliance with the national laws.

Emphasising that in many countries, unproven medicines are being prescribed to patients—until, further favourable evidence can be gathered, WHO has warned physicians and medical associations against recommending unproven treatments to their patients.

According to the published study that made keen observations based on the Solidarity Trial, ‘Repurposed antiviral drugs for COVID-19 –interim WHO SOLIDARITY trial results’, antivirals, Remdesivir, Lopinavir Hydroxychloroquine, and Interferon-β1a were taken up for reassessment of their effectiveness. These drugs are currently among the top antiviral treatments being prescribed by doctors all over the globe.

In February this year, the WHO COVID-19 research forum suggested a large study to determine the efficacy of these four re-purposed anti-viral drugs, which were selected based on their possibility of influencing mortality rates among Covid patients. In March 2020, WHO began a large, simple, multi-country, open-label randomized trial among hospital inpatients on the effects of these four drugs on in-hospital mortality. During the study, Hydroxychloroquine and Lopinavir were dropped as they didn’t show promise. The trial lasted for a total of seven months.

It was concluded that the drugs in the study group did not affect patient mortality, initiation of ventilation, or hospitalization duration. Even though the study had expressed that 10 days of dosage could have a delay in the discharge of a patient, these drugs had no pharmacological impact in reducing time for recovery. Another study found that mixing Remdesivir with placebos reduced the recovery time considerably.

WHO highlighted the need to study and find more effective Covid-19 treatments. Emphasising the requirement for more such trials, WHO said, “Enrolling patients in one single randomized trial will help facilitate the robust worldwide comparison of unproven treatments. This will overcome the risk of multiple small trials not generating the strong evidence needed to determine the relative effectiveness of potential treatments.”

While the world battles with this deadly virus and the probability of a vaccine lies in the far future, the revelation of the ineffectiveness of these antiviral drugs is a deeply disconcerting issue.

India was also part of the study. The Indian Council of Medical Research(ICMR) conducted trials in 26 sites with 937 participants in coordination with ICMR- National AIDS Research Institute(ICMR-NARI). The Indian wing contributed to one-tenth of the entire study.

The ICMR also revealed the conclusions of the Solidarity Trial through its Twitter handle and claimed that Remdesivir has no benefits for patients with Covid-19 in all groups— asymptomatic, mild, moderate, severe and critical patients.

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Melvin Mathew

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