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COVID-19 – Treatment

MORE ABOUT VACCINES

COVID-19 is a rapidly evolving disease.  Information will change as management of this disease develops and improves. Medinformer aims to bring you up-to-date information from verified sources. Last revised: 9 July 2021

 

There is currently no specific antiviral treatment for COVID-19. There are many treatments under investigation. Current treatment is supportive and aims at treating the symptoms of the disease. 

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STANDARD COVID-19 DRUG-REGIMEN PRESCRIBED FOR POSITIVE CASES

Treatment of COVID-19 will differ based on individual preferences from the responsible healthcare professional and symptoms shown by each patient.

Patients who are asymptomatic (showing no symptoms) or have mild disease can be managed at home provided they can safely self-isolate.1

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TREATING MILD ILLNESS FROM HOME

Patients with mild illness can be treated at home, provided they can safely isolate. It is vital that they do not spread the disease

Treatment is symptomatic and may include:

  • Paracetamol or NSAIDs (e.g., ibuprofen: symptomatic relief of fever or pain.
  • Keep hydrated: be sure to drink plenty of fluids.
  • Rest: plenty of rest will allow the body to fight the virus.

Despite the fact the use of this repurposed medicine is being heavily promoted via social media, to date, there is insufficient robust evidence for or against the use of ivermectin in the prevention or treatment of COVID-19.

Ivermectin has been added to the world’s largest clinical trial of possible COVID-19 non-hospital setting treatments in the UK, the PRINCIPLE trial.

Some patients initially assessed as having mild disease may worsen over the course and subsequently require hospitalisation. It is important to watch for the following signs (or any other worsening of symptoms) and seek prompt medical care if they appear:

  • Any deterioration in the ability to perform activities of daily living.
  • Trouble breathing.
  • Persistent pressure or pain in the chest.
  • Inability to wake or stay awake.
  • Pale, grey, or blue-coloured skin, lips, or nail beds.

Patients managed at home should keep the contact details of their doctor or healthcare facility close, in case of any clinical worsening.

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COVID-19 TREATMENT FOR SEVERE DISEASE (IN HOSPITAL)

COVID-19 TREATMENT FOR SEVERE DISEASE (IN HOSPITAL)

Treatment in hospital is also currently supportive, although there are many treatments currently undergoing investigation. Each patient will be treated on a case-by-case basis, by the doctor, according to their clinical picture.

Treatment may include:

  • Oxygen: oxygen therapy remains the mainstay of therapy for most hospitalised patients.
  • Fluids: intravenous fluids may be needed due to prolonged fever.
  • Ventilation: patients with respiratory failure may require intubation and mechanical ventilatory support.
  • Dexamethasone: a potent corticosteroid drug with an anti-inflammatory action that assists and inhibits the immune system’s reaction in patients requiring supplemental oxygen/ventilation.
  • Interleukin-6 receptor blockers e.g., tocilizumab: suppresses the overreaction of the immune system.
  • Anticoagulants (heparin, enoxaparin): helps prevents the development of blood clots in hospitalised patients.
 

It is important to note that each individual will be treated according to their needs and co-existing conditions. The decision to treat is under the supervision of the prescribing doctor. Patients are encouraged to seek medical advice on their individual treatment options.

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DRUGS THAT HAVE BEEN CONSIDERED FOR USE BUT DIFFER IN RECOMMENDATION BETWEEN DIFFERENT COUNTRIES

  • Hydroxychloroquine/chloroquine: hydroxychloroquine or chloroquine are drugs used for the treatment of malaria and auto-immune disorders. Current evidence shows that this drug does not reduce deaths related to COVID-19 and does not help with moderate disease. Its use is not indicated for COVID-19 and using it for can cause serious side effects.
  • Remdesivir: remdesivir is an antiviral drug approved in the United States (US) for hospitalised COVID-19 patients. It is not routinely recommended in South Africa at the present time.
  • Ivermectin: ivermectin is used as an antiparasitic drug in humans and animals but is not registered for human use in South Africa. Current evidence on its use for COVID-19 is inconclusive and the WHO has recommended that it only be used in the context of clinical trials.

In South Africa, there has been widespread, unregulated use of ivermectin with the consequence that the quality and content of the ivermectin being prescribed, cannot be guaranteed. With no standard dosing, there is the risk of adverse effects.

To restrain uncontrolled use of the drug, SAPHRA allows controlled and monitored access to reliable quality ivermectin through Section 21 application from health care professionals or prescribers, to treat COVID-19. 

The responsibility for monitoring adverse events and therapy outcomes lies with the applicant and they (usually prescribers) are required to provide feedback on this to SAPHRA.

Despite the fact the use of this repurposed medicine is being heavily promoted via social media, to date, there is insufficient robust evidence for or against the use of ivermectin in the prevention or treatment of COVID-19.

SAPHRA will continue to update its position as needed, after appraisal of any new data that becomes available.

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PREVENTION

Building your immunity against COVID 19: What vitamins should you be taking daily?

Vitamin and mineral supplements cannot cure COVID-19.  They are, however, critical for a well-functioning immune system. Three supplements that adults could consider taking to keep their immune system strong are:

  • Vitamin C
  • Vitamin D
  • Zinc

COVID-19 is a rapidly emerging disease.  Treatment and prevention protocols change as and when we know more about this disease. Always ask your healthcare professional for advice on specific treatment and continue to practice safe public health measures to help limit the spread of COVID-19.

For medical advice or further information, please consult your healthcare provider.

24-hour hotline number is: 0800 029 999

 

Medical References

  1. National Institute for Communicable Diseases (NICD). COVID-19 vaccination information. Available at: https://www.nicd.ac.za/diseases-a-z-index/covid-19/covid-19-guidelines/clinical-management-of-suspected-or-confirmed-covid-19-disease/. Accessed 2021 June 20.
  2. Centers for Disease Control and Prevention (CDC). Treatments Your Healthcare Provider Might Recommend if You Are Sick. Available at: https://www.cdc.gov/coronavirus/2019-ncov/your-health/treatments-for-severe-illness.html. Accessed 2021 June 20.
  3. World Health Organisation (WHO). The use of non-steroidal anti-inflammatory drugs (NSAIDs) in patients with COVID-19. Available at: https://www.who.int/news-room/commentaries/detail/the-use-of-non-steroidal-anti-inflammatory-drugs-(nsaids)-in-patients-with-covid-19. Accessed 2021 June 21.
  4. World Health Organisation (WHO). WHO advises that ivermectin only be used to treat COVID-19 within clinical trials. Available at: https://www.who.int/news-room/feature-stories/detail/who-advises-that-ivermectin-only-be-used-to-treat-covid-19-within-clinical-trials. Accessed 2021 June 20.
  5. Harvard Health Publishing. Harvard Medical School. Treatments for COVID-19. What helps, what doesn’t, and what’s in the pipeline. Available at: https://www.health.harvard.edu/diseases-and-conditions/treatments-for-covid-19. Accessed 2021 June 20.
  6. Medical Brief. 2021 June 23. Ivermectin added to world’s largest clinical trial of possible COVID-19 treatments. Available at: https://www.medicalbrief.co.za/archives/ivermectin-added-to-worlds-largest-clinical-trial-of-possible-covid-19-treatments/. Accessed 2021 June 24.
     
  7. World Health Organisation (WHO). WHO recommends life-saving interleukin-6 receptor blockers for COVID-19 and urges producers to join efforts to rapidly increase access. Available at: https://www.who.int/news/item/06-07-2021-who-recommends-life-saving-interleukin-6-receptor-blockers-for-covid-19-and-urges-producers-to-join-efforts-to-rapidly-increase-access. Accessed 2021 July 
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