Covid-19: Razvoj vakcine, imunitet i primena medikamenata

[steins]

24 minutes ago, Krošek said:

u srbiji se koristi hlorohin, a u nisu su nabavili hidroksihlorohin

 

 

 

Može, ali mora da se kombinuje sa Azitromicinom zbog sinergističkog efekta.

Kinezi ne preporučuju onu antivirusnu kombinaciju. Njihove studije su pokazale da to nema neki spektakularni učinak. 

 

Elem, zna li neko - da li se vrše ikakva ispitavanja zdravih, odnosno onih koji nisu fasovali virus, u klasterima? TO bi moglo da bude vrlo interesantno i korisno istraživanje? Ja nigde nisam uspeo da nadjem neku studiju/prikaz slučaja

[Dankan Ajdaho]

4 hours ago, steins said:

 

Može, ali mora da se kombinuje sa Azitromicinom zbog sinergističkog efekta.

Kinezi ne preporučuju onu antivirusnu kombinaciju. Njihove studije su pokazale da to nema neki spektakularni učinak. 

 

Elem, zna li neko - da li se vrše ikakva ispitavanja zdravih, odnosno onih koji nisu fasovali virus, u klasterima? TO bi moglo da bude vrlo interesantno i korisno istraživanje? Ja nigde nisam uspeo da nadjem neku studiju/prikaz slučaja

 

Koju "onu"?

[djili]

ko ima 3D printer moze da printa stitnike ili kako se kaze za lice.

 

https://www.cbc.ca/radio/asithappens/as-it-happens-thursday-edition-1.5502954/canadian-doctor-who-works-in-gaza-makes-3d-printed-face-shields-for-covid-19-1.5502964

 

https://github.com/GliaX

 

[Krošek]

23 minutes ago, Dankan Ajdaho said:

 

Koju "onu"?

lopinavir-ritonavir

[borris_]

Sada me kopka nešto. U Francuskoj se vodi zestoka polemika o ovom lijeku. Neki kazu da treba masovno da se koristi drugi kazu da ne treba jer ga treba provjeriti. 

 

Pitam da li se drugi lijekovi daju kovid bolesnicima ili samo infuzija i respirator?

Ako daju, zašto se onda ne priča o tim lijekovima?

 

Kao što sam već napisao i ja sam koristio te lijekove na bazi hlorokina. Lijek se zvao Savarine, trebala se uzimati jedna tableta dnevno. Slobodno se mogao kupovati u apotekama ali bilo je važno provjeriti u koju zemlju se ide jer je bio "efikasan" samo u nekim zemljama. Nisam imao nikakvih tegoba uzimajući taj lijek. Drugi lijek, Larium je bio mnogo jaci (uzimao se jedanput sedmicno)  i opasniji sa mnogo mogućih problema.

 

Ako sam ja mogao taj Savarine uzimati bez neke preporuke doktora, kako je sada odjendaput taj lijek postao toliko opasan? Znao sam da može biti toksičan i pazio sam se ali kako to da nije bilo nekih većih preporuka od doktora?

Edited March 24, 2020 by borris_

[steins]

Sada me lopta nešto. U Francuskoj se vodi zestoka polemika o ovom lijeku. Neki kazu da treba masovno da se koristi drugi kazu da ne trebeva jer ga treba provjeriti. 
 
Pitam da li se drugi lijekovi daju kovid bolesnicima ili samo infuziju i respirator?
Ako daju, zašto se onda ne priča o tim lijekovima?
 
Kao što sam već napisao i ja sam koristio te lijekove na bazi hlorokina. Lijek se zvao Savarine, trebala se uzimati jedna tableta dnevno. Slobodno se mogao kupovati u apotekama ali bilo je važno provjeriti u koju zemlju se ide jer je bio "efikasan" samo u nekim zemljama. Nisam imao nikakvih tegoba uzimajući taj lijek. Drugi lijek, Larium je bio mnogo jaci (uzimao se jedanput sedmicno)  i opasniji sa mnogo mogućih problema.
 
Tu sada ako sam ja mogao taj Savarine uzimati bez neke preporuke doktora, kako je sada odjendaput taj lijek postao toliko opasan? Znao da može biti toksičan i pazio sam se ali kako to da nije bilo nekih većih preporuka od doktora?

Druze ima u priči oko lekova svega, od glasina do krupnih interesa.
Kinezi su radili studiju (200 ljudi) na kojoj su dokazali da Kaletra ne radi posao. Ona je postala popularna jer je bila dostupna i jeftina pa se naširoko koristila u kućnom lečenju u Kini pošto su je kupovali na crnom tržištu.
Opet ekipa koja pravi Kaletru je osporila gorepomenutu studiju pošto je lek primenjivan u kasnijim fazama bolesti.
Obzirom da se u terapiji sada koristi sve što može, niko živi ne može (još uvek) da kaže sa sigurnošću šta deluje.
Zato su studije tako bitne.



Послато са Mi 9T помоћу Тапатока

[Kelt]

2 hours ago, borris_ said:

Sada me kopka nešto. U Francuskoj se vodi zestoka polemika o ovom lijeku. Neki kazu da treba masovno da se koristi drugi kazu da ne treba jer ga treba provjeriti. 

 

Skinuo sam Didijeovu studiju - šta je problem, pratio je prisustvo virusa putem PCR-a šest dana nakon uvođenja terapije, ne zna se clinical outcome, malo je pacijenata, dosta ih odustalo od studije, nije randomizovana... dokazi su jako tanki. Više podataka će da pruži ova multicentrična studija WHO.

 

Mehanizam dejstva antimalaričnih lekova je to što podižu kiselost endozoma kojima ćelija od spolja uvlači razne potrebne elemente i tako potencijalno blokira "snabdevanje", kao i svaki drugi antibiotik, ne deluje na virus.

[Krošek]

kratak pregled trenutne situacije s lekovima, ko nije u toku (nema znacajnih novosti zadnjih par dana): 

 

Quote

We haven’t identified any new drugs for severe covid-19 cases yet

Michael Le Page

---

Despite what you may have heard, although several potential drugs for covid-19 are being trialled around the world, few results have been reported yet, and we don’t know if any could help save people who are already seriously ill when diagnosed.

Some enthusiastic news stories and claims being spread on social media are based on little more than anecdotal reports. However, the World Health Organization (WHO) is coordinating an international trial of the most promising drugs – and with case numbers soaring, we should find out soon if any of them work.

“This trial focuses on the key priority questions for public health. Do any of these drugs reduce the mortality? Do any of these drugs reduce the time the patient is in hospital? And whether or not the patients receiving any of the drugs needed ventilation or an intensive care unit,” said Ana Maria Henao-Restrepo of the WHO at a briefing on 18 March.

The WHO trial will include the long-used antimalarial drugs chloroquine and hydroxychloroquine, a new antiviral drug called remdesivir and a combination of two HIV drugs called lopinavir and ritonavir. The HIV drugs will also be tested in combination with an antiviral called interferon beta.

On 22 March, several countries in Europe, including the UK, launched a collaborative trial of the same drugs, which will complement the WHO effort.

There has been a tremendous buzz about chloroquine after it was highlighted first by entrepreneur Elon Musk and then US president Donald Trump, who wrongly claimed it was already approved in the US for treating covid-19.

There is some evidence that chloroquine and the closely related hydroxychloroquine are effective against related viruses such as the one that causes SARS. There have also been reports from China that chloroquine is beneficial when given to people with covid-19 associated pneumonia, but the findings have yet to be published. “It looks promising,” says Robin May at the University of Birmingham, UK.

However, some excitement over these drugs stems from a study of just 42 people in France that said those who received hydroxychloroquine cleared the coronavirus from their bodies days faster, with the effect being even greater in those also given the antibiotic azithromycin (medRxiv, doi.org/dqbv).

The researchers speculated that hydroxychloroquine can prevent infection as well, but other researchers say the small size of the study and other issues mean we can’t rely on its results.

What’s more, while hydroxychloroquine and chloroquine are safe when taken properly, there are already reports of people overdosing on chloroquine in an attempt to protect themselves, which can cause lethal heart problems.

Meanwhile, people who need this drug for lupus or arthritis are finding it hard to get hold of.

Hunting for antibodies

Even if chloroquine does stop people becoming severely ill if given when symptoms are still mild, it wouldn’t necessarily be a game changer. At the moment, most countries are detecting coronavirus infections only once people develop severe symptoms, so what we urgently need is a drug that can save lives at this stage. “Whether that’s going to crop up is anyone’s guess,” says May.

Unfortunately, it already seems that the lopinavir and ritonavir combination doesn’t do this. A randomised trial in China found no evidence of any benefit (NEJM, doi.org/ggpcms). As for remdesivir, the results of trials in China haven’t been made public yet.

Many other potential treatments are being explored, particularly the possibility of developing antibodies against covid-19. Antibodies are the proteins our immune systems use to kill the virus, but it takes weeks for our bodies to ramp up production after we are infected.

In theory, injecting antibodies made in a factory should be an effective way to both prevent and treat covid-19. US company Regeneron says it has already identified hundreds of antibodies against the coronavirus and plans to start mass-producing the most potent ones in mid-April.

Another way to get antibodies is to extract them from the blood of people who have recovered from covid-19. At least 250 people in China have received treatments made this way. According to the Xinhua news agency, it was safe and effective, but the findings don’t yet appear to have been published.

All the approaches described above are based on trying to kill the virus or prevent it replicating. However, it appears that most deaths from covid-19 are the result of a severe immune reaction called a cytokine storm. So another path is finding ways to prevent or dampen this response. A small study in only 19 people suggests that an immunosuppressive antibody called tocilizumab is highly effective (ChinaXiv, DOI: 10.12074/202003.00026).

This approach can be risky, though. “Immunotherapy is really challenging because you’re messing with the immune system of people who are very sick,” says May.

 

[Gojko & Stojko]

 

Još jedan intervju sa nobelovcem Piterom Doertijem, jedan video sa njim sam već ranije kačio na ovoj temi. U naslovu je link na ceo članak, ja sam ovde kopirao neke detalje od kojih sam podebljao par interesantnih detalja, uključujući primer države Vašington koji pokazuje da i u the best democracy that money can buy umeju da se snađu kada im se u posao ne meša riđokoso govedo^tm

 

Nobel Prize winner says virus curve will flatten in 'couple of weeks'

 

...

"Basically, government is stepping up to the plate," he says. The federal government, he quips, is "fit for purpose for a short-term emergency - they're quick to lock people up."

 

The strict new measures will not produce any instant slowdown in the number of reported cases, he expects.

 

The number of new infections detected in Australia has accelerated exponentially. It was doubling every five or six days a couple of weeks ago. It's now doubling every three days.

 

"We may see an upward trajectory for another week - a lot of the people on Bondi may have been infected," says Doherty, who literally wrote the book on the topic - "Pandemics: What Everyone Needs to Know" - in 2013.

 

But he expects that the measures introduced this week will work: "With a lag of a week or so, because the average time to [display] symptoms is five to six days and maybe longer," and only people showing symptoms have been allowed tests so far.

 

So a short-term surge is already baked in.

 

"I think the steps announced by the Prime Minister and the premiers will dampen this down. I would expect to see the curve flatten in the next couple of weeks, see it start to come down," he says.

...

 

Professor Doherty cites the example of the effectiveness of such measures in US state of Washington. It was the site of the first big outbreak of COVID-19 in America.

 

But after Governor Jay Inslee imposed the same social controls as the Morrison government has announced, plus closing the schools, some 10 days ago, the outbreak appears to have been brought in check: "They expected a big surge in cases, but nothing came."

 

Doherty has been pleased with the intensification of testing in Australia in recent days.

 

"It's now a matter of time, of numbers and of human behaviour", says Doherty, patron of the Doherty Institute at the University of Melbourne.

 

Professor Doherty, who trained as a vet, is involved in strategy and advice on the research effort, including the search for a vaccine.

...

 

The Doherty Institute, one of the world's research leaders and the first lab outside China to decode the COVID-19's structure and distribute the data to labs worldwide, has received federal and state funding for research and "a lot of money" from private donors and philanthropists, he says.

 

Important donors include the Chinese Australian community, the Ramsay Foundation, Chinese billionaire Jack Ma of Alibaba who gave $US3.2 million, and an anonymous donor who gave $1 million.

 

"We are moving faster on this than on anything in human history. One vaccine in the US is already on trial, it's already gone into people's arms, and the University of Queensland vaccine is being progressed here and with CSIRO," he said.

 

"Batches are being made by CSIRO now on a scale that will allow us to move rapidly to animal trials and then human trials." Indeed, says Professor Doherty, "it's already in animals and is progressing well".

 

The US and Australian vaccines "are two completely different technologies, very new, and there are many more being trialled around the world." New ideas are being offered every day, he says.

...

 

Other urgent clinical work is needed, not just a vaccine, he says. For example, "we need a rapid antibody test for people who've had the virus and recovered".

 

Why? Because such people, who may not have shown any symptoms and not know that they've had the virus, "are perfectly okay to go out and work and live and do anything - they won't spread the disease".

 

Some 20-30 per cent of the population probably will fall into this category eventually. They could constitute an speedily available workforce and alleviate the economic problem.

 

And once you have people who've recovered, "you can bleed them, separate off their serum, and give that serum back to vulnerable people". It can be used as a preventative measure to protect people from the virus, so-called "passive immunisation," while a vaccine is still being developed.

...

 

Share & Enjoy

[Krošek]

ispituje se da li bi be-se-že vakcina mogla imati neki efekat 

 

Quote

Can a century-old TB vaccine steel the immune system against the new coronavirus?
By Jop de VriezeMar. 23, 2020 , 6:25 AM

Researchers in four countries will soon start a clinical trial of an unorthodox approach to the new coronavirus. They will test whether a century-old vaccine against tuberculosis (TB), a bacterial disease, can rev up the human immune system in a broad way, allowing it to better fight the virus that causes coronavirus disease 2019 and, perhaps, prevent infection with it altogether. The studies will be done in physicians and nurses, who are at higher risk of becoming infected with the respiratory disease than the general population, and in the elderly, who are at higher risk of serious illness if they become infected.

 

A team in the Netherlands will kick off the first of the trials this week. They will recruit 1000 health care workers in eight Dutch hospitals who will either receive the vaccine, called bacillus Calmette-Guérin (BCG), or a placebo.

BCG contains a live, weakened strain of Mycobacterium bovis, a cousin of M. tuberculosis, the microbe that causes TB. (The vaccine is named after French microbiologists Albert Calmette and Camille Guérin, who developed it in the early 20th century.) The vaccine is given to children in their first year of life in most countries of the world, and is safe and cheap—but far from perfect: It prevents about 60% of TB cases in children on average, with large differences between countries.

Vaccines generally raise immune responses specific to a targeted pathogen, such as antibodies that bind and neutralize one type of virus but not others. But BCG may also increase the ability of the immune system to fight off pathogens other than the TB bacterium, according to clinical and observational studies published over several decades by Danish researchers Peter Aaby and Christine Stabell Benn, who live and work in Guinea-Bissau. They concluded the vaccine prevents about 30% of infections with any known pathogen, including viruses, in the first year after it’s given. The studies published in this field have been criticized for their methodology, however; a 2014 review ordered by the World Health Organization concluded that BCG appeared to lower overall mortality in children, but rated confidence in the findings as “very low.” A 2016 review was a bit more positive about BCG’s potential benefits but said randomized trials were needed.

...

Eleanor Fish, an immunologist at the of the University of Toronto, says the vaccine probably won’t eliminate infections with the new coronavirus completely, but is likely to dampen its impact on individuals. Fish says she’d take the vaccine herself if she could get a hold of it, and even wonders whether it’s ethical to withhold its potential benefits from trial subjects in the placebo arm.

But Netea says the randomized design is critical: “Otherwise we would never know if this is good for people.” The team may have answers within a few months.

 

[Milosh76]

Da se ogradim odmah, video sam na FB drugarice iz Srednje koja je lekar... ima linkova koji lice na pouzdane...

 

Info je od pre 5-6 dana

----------------------

 

Pogledao sam najnoviji rad o sekvenciranju gena novog virusa 2019-nCoV koji moj izdavac Elsevir upravo stampa. Iz ugla nauke o kodiranju kojom se bavim,jasno je da po genetskom kodu novi virus pripada porodici betakorono virusa (kao i SARS-CoV). Ono sto me izuzetno iznenadilo je otkrice da na mestu na kome SARS ima “blanko” gene (zaokruzeno zelenim na prilozenoj slici),novi virus ima furin-like sekvencu (12 nukleotida) u svom S-proteinu (zaokruzeno crvenim pravouganikom). To znaci,da novi virus prepoznaje humani protein furin,koji se u visokoj koncetraciji nalazi upravo u epitelnim celijama pluca/organa za disanje! Na planeti Zemlji prvi put vidimo da betakorono virusi,koji su stotinama hiljada godina cirkulisali iskljucivo medju zivotinjama (na primer slepim misevima),u relativno kratkom vremenskom roku od 17 godina, prirodnom mutacijom, dobiju novo "znanje" tako da sada prepoznaju ljudske celije u respiratornom sistemu,na koje ciljaju.

 

Zbog toga je Covid-19 neuporedivo opasniji cak i od SARS-a, koji je “slep” u tom smislu. Aplauz za otkrice francusko-kanadskog istrazivackog tima! Link za preuzimanje rada: https://www.sciencedirect.com/…/artic…/pii/S0166354220300528

- U novim istrazivanjima pokazano je da SARS-CoV i novi 2019-nCoV koriste isti receptor ACE2 humanih celija,tako da se ocigledna izuzetno vece patogenost novog virusa moze pripisati jedino prisustvu nove sekvence u S-proteinu.

- NOVO! Japanski lek Favipiravir je prosao klinicka testiranja za lecenje Covid-19,pokazao odlicne rezultate i preporuceno je da se uvede u tretman lecenja sto je moguce pre. Rezultati objavljeni u naucnom radu na Elsevir-u na linku: https://www.sciencedirect.com/…/artic…/pii/S2095809920300631

 

--------------------------

Edited March 26, 2020 by Milosh76

[renne]

pričalo se o ovome još pre deset dana

[Milosh76]

Da, kasno sam video datum objave... izvinjavam se

[kud u maglu Simoviću]

https://issuu.com/28jun/docs/handbook_of_covid-19_prevention_and_treatment_srps

 

 

e

 

Prirucnik o prevenciji i lecenju COVID-19 infekcije bolnice u Kini koja je imala 0% mortalitet Poštovane kolege, čast nam je i zadovoljstvo da vam predstavimo srpsko izdanje “Priručnika za prevenciju i lečenje COVID-19 infekcije”. Ovaj priručnik sastavile su kolege i stručnjaci iz Prve pridružene bolnice Medicinskog fakulteta Univerziteta u Zheijang-u, NR Kina, a na osnovu svoje teške borbe sa novim COVID-19 virusom

Edited March 27, 2020 by kud u maglu Simoviću

[Krošek]

Njujorska bolnica kaze da je spremna da vec u toku sedmice pocne sa seroloskim testiranjem i transfuzijom plazme

 

Quote

Mount Sinai to Begin the Transfer of COVID-19 Antibodies into Critically Ill Patients

Mar 24, 2020 | Featured, Infectious Diseases, Research 

The Mount Sinai Health System this week plans to initiate a procedure known as plasmapheresis, where the antibodies from patients who have recovered from COVID-19 will be transferred into critically ill patients with the disease, with the expectation that the antibodies will neutralize it.

...

Late last week, researchers at the Icahn School of Medicine, in collaboration with scientists in Australia and Finland, were among the first to create an antibody test that detects the disease’s antibodies in a person’s blood.

...

Dr. Krammer says his preliminary findings also show that humans have no natural immunity to the SARS-CoV-2 virus, which would help explain why it spreads so quickly. But once the antibody sets in humans do become protected. He also says that at this early stage in the research, there is no evidence that people can lose their immunity and become re-infected.

 

Edited March 27, 2020 by Krošek