Public Address | Cafe | Hard News: Has Iran found an effective Covid-19 treatment?

Thomas Lumley

Sun, 24 Apr 2022 13:33:10 +1200

There's now a publication in the Iranian trial, dated Feb 2022. It's negative (and this trial is, I think, bigger than all the positive trials combined):
open-access paper

"Between July and October 2020, 1083 patients were randomized to either the sofosbuvir/daclatasvir arm (n = 541) or the placebo arm…

Sacha

Sat, 09 Apr 2022 13:47:28 +1200

Haere mai

linger

Fri, 08 Apr 2022 12:29:51 +1200

A personal update: After a delay of two years, largely because of the pandemic, I have finally retired and relocated to New Zealand permanently. Now to work out how to join the NZ health system and get a booster! (I was vaccinated in Japan, but administration was left up to…

Russell Brown

Thu, 18 Jun 2020 11:12:34 +1200

Kia ora!

I have an update. There has been quite a bit happening around this, and the first publication, a pre-print, has landed a preclinical study from Brazil:

To rapidly respond to an unfolded pandemics, it is pivotal to catalogue preclinical data on the susceptibility of SARS-CoV-2 to clinically approved…

Alfie

Tue, 05 May 2020 12:41:25 +1200

the virus spines burst the elderberries...

Aha. That explains why the virus is almost always coloured blue in infographics. It's the elderberry juice.

linger

Tue, 05 May 2020 11:47:01 +1200

So that’s how it works: the virus spines burst the elderberries, and as a result the virus sites are jammed.
https://www.youtube.com/watch?v=FcArnepkhv0

Alfie

Tue, 05 May 2020 09:52:19 +1200

I am now picturing a virus covered in little elderberries, though I’m sure that’s not how it’s supposed to work. The scale is massively wrong for a start…

Nah... we've all seen the graphics and the coronavirus has little stalks sticking out, like upsidedown plungers or badly drawn daleks. Elderberries!…

Joe Wylie

Mon, 04 May 2020 19:12:48 +1200

Robitussin make me feel so fine
Robitussin and Elderberry wine
Hey Grandma
Hey Grandma...

Moby Grape, Hey Grandma, 1967.

Robitussin and similar cough remedies offered a cheap recreational altered state experience if you could drink enough of the stuff and keep it down. It was probably mostly due to a…

John Farrell

Mon, 04 May 2020 18:15:00 +1200

Small trials with self reported outcomes? Not interested.

linger

Mon, 04 May 2020 17:02:38 +1200

I am now picturing a virus covered in little elderberries, though I'm sure that's not how it's supposed to work. The scale is massively wrong for a start...

George Henderson

Mon, 04 May 2020 15:09:38 +1200

Elderberry has some ability to bind ACE2 and another coronavirus site. It looks good so far, is effective for flu of course, but like most of these things only studied in small trials with self-reported outcomes.
The best evidence I've found is for probiotics, it takes a few months but…

Bart Janssen

Mon, 27 Apr 2020 12:49:01 +1200

RdRp

FYI
RNA dependent RNA polymerase =RdRp
It's the enzyme that uses the viral RNA template to make viral RNA and is pretty much unique to viruses. There are enzymes that can do this in animals but they are very tightly regulated and quite different from the viral enzymes. that's…

Sacha

Mon, 27 Apr 2020 10:30:11 +1200

a traditional treatment for viral infections and cough

Are there others that might lower the load enough?

Russell Brown

Mon, 27 Apr 2020 10:23:56 +1200

I missed this at the time I wrote the post, but there’s a team at Columbia university working to develop compounds based on sofosbuvir – with Chinese funding.

And a modelling study from Egypt suggesting “the effectiveness of Ribavirin, Remdesivir, Sofosbuvir, Galidesivir, and Tenofovir as potent drugs against SARS-CoV-2 since…

George Henderson

Mon, 27 Apr 2020 09:20:50 +1200

These drugs are very specific for HCV and don't disrupt host processes to any meaningful extent. But different drug combos are specific for genotype 1 and genotype 3.
How could this work for a completely different virus?
Hep C drugs need to reduce viral load to "undetectable" because stealth features…

Bart Janssen

Mon, 27 Apr 2020 08:28:48 +1200

The SARS-CoV-2 genome is not converted to DNA during viral replication. It’s RNA to RNA.

Meep right you are. It does still mean the virus uses an RNA template to make the RNA strand which is the unusual step that doesn't really exist in humans.

It’s not immediately obvious why…

Bart Janssen

Mon, 27 Apr 2020 08:18:38 +1200

I still can’t get my head around what the endgame of a virus is –

Hi Ian, you can't anthropomorphize this, it's just a virus. It evolved in bats and exists now because it is well adapted to the bat biology. Bats have a very different immune system that allows…

Thomas Lumley

Sun, 26 Apr 2020 12:16:50 +1200

I'd actually be less surprised if it was the sofosbuvir having an effect. Like remdesivir, it's a nucleotide analog (a fake RNA base), which you could easily imagine confusing RNA polymerases from a different virus. Daclatasvir, on the other hand, targets a specific site on Hep C's polymerase and since…

dr. notakiwi hall

Sat, 25 Apr 2020 16:05:18 +1200

Evaluating the data, the purpose and quality of the trial design, and the outcomes are critical to the decision of whether this warrants further testing. Without seeing that, you really can not conclude whether this warrants further investigation or is simply a pipe dream. Many drug programs are terminated after…

Moz

Sat, 25 Apr 2020 11:55:33 +1200

wider trialling is warranted

I think so, especially given that the Iranians seem to have decided the same. Obviously their ability to conduct trials outside Iran is limited by the war, but that's no reason we shouldn't carry out our own trials.

Russell Brown

Sat, 25 Apr 2020 09:29:50 +1200

Not trying to be a downer here, it could be that the study is indeed promising depending upon what was measured, but it’s unlikely a slam dunk by any measure…In God We Trust, all others must bring data.

Fair enough. Would you agree that it suggests that wider trialling is…

dr. notakiwi hall

Sat, 25 Apr 2020 07:50:31 +1200

Is anyone able to access the actual results of the trial and have they been peer reviewed? Two pieces of food for thought – 1. the validity of the hypothesis of testing and repurposing Hep C drugs into covid 19 may be supported in overlap of the drug target in…

Pietro C

Sat, 25 Apr 2020 04:34:07 +1200

One of the best targets is the genome replication enzymes because they do something that is very uncommon in humans – convert RNA into DNA

The SARS-CoV-2 genome is not converted to DNA during viral replication. It's RNA to RNA.

... this means the viral enzyme that does that can…

linger

Fri, 24 Apr 2020 20:31:44 +1200

overwhelming the host seems counterproductive unless it can find other hosts easily in the time that takes to happen – as with this virus.
Individual viruses are parasitic on individual cells; a virus doesn’t have any vested interest in the survival of any host organism as a whole, as long…

Ian Dalziel

Fri, 24 Apr 2020 16:40:51 +1200

assuming the trials work out.
Trump will leading the trials on 'injecting disinfectant' and 'shining UV light into his dark interior' – I wait for those results with bated breath...

Ian Dalziel

Fri, 24 Apr 2020 16:38:25 +1200

Interesting to note there is evidence of a blood clotting problems with Covid-19, so anything that was aimed at a Haemorrhagic virus like Ebola might not work so well…
I still can’t get my head around what the endgame of a virus is – seemingly it is just ‘code’ that…

Moz

Fri, 24 Apr 2020 16:20:29 +1200

That sounds like excellent news, especially the manufacturing ability we already have and thus the price... assuming the trials work out.

One can only imagine how this will play out politically.

Bart Janssen

Fri, 24 Apr 2020 13:33:18 +1200

Interesting results.
TLDR entirely reasonable that these drugs work
also science funding is good

It's highly likely any effective treatment protocol will involve a nucleotide analog for reasons noted in the main post.
It's worth noting treatments for viral diseases are uncommon because the immune system handles viruses very very…

Hilary Stace

Fri, 24 Apr 2020 11:04:23 +1200

There seems to be some interesting work happening in Cuba too.

Public Address

Fri, 24 Apr 2020 11:04:23 +1200

Discussion from blog post.