Early therapy of patients with COVID-19
- Guillem Cebrian
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At the beginning of February, the most important magazine in the world in the category of infectious diseases (according to the Journal Citation Reports), Lancet of Infectious Diseases, published a scientific article on the study of transmission of Covid-19 in Catalonia between March 17 and April 28, 2020. This article is derived from a previous study that began with the outbreak of the pandemic in Spain and has has led to other publications in leading journals in biomedicine, such as the Journal of Infectious or the New England Journal of Medicine (NEJM).
One of the members of this line of research is Marc Corbacho, a researcher at the Parc Taulí Research and Innovation Institute (I3PT), a specialist in oncological dermatology and experienced in the treatment of community diseases such as yaws in Papua New Guinea.
Then Corbacho will tell us what the research process has been like since the beginning of the pandemic, at what point is the research of the Fight AIDS and Infectious Diseases Foundation and what are the next steps in his fight against the Covid-19.
Having already experience in the treatment of community diseases, how did all this lead you to start researching on Covid-19?
At the end of 2019 I had the opportunity to work with Dr. Oriol Mitjà in one of the projects he coordinates for the eradication of Pian in Papua New Guinea, specifically one that compared the effectiveness of treating with one or three doses of Azithromycin. In March 2020, a new round of treatment was planned in which he went as a researcher, coordinating the fieldwork.
As with many research groups, the outbreak of the pandemic meant the halting of many projects. But for Dr. Media, who has experience in rethinking the use of drugs already approved by new indications, knew how to move a team that was prepared for Pian and Azithromycin in the Pacific, and changed the chip for hydroxychloroquine and COVID- 19.
This study runs from the start of the pandemic, in March, until May 28. What were the main issues you had to deal with?
There were many, mainly due to the constant change in the epidemiological situation. The study was proposed before strict confinement and was launched when it was established. This required rethinking aspects of methods, procedures and logistics, such as the mobility of teams in an alarm state, expanding the sample size to compensate for the reduction in the number of contacts which, in turn, meant hiring more researchers and extend the study.
In addition, at that time little information was still available on the lethality and transmissibility of the disease and, as we all had fears and doubts. Luckily, we were lucky enough to find many brave toilets, willing to carry out the study.
Acceptance of your publication in the NEJM takes place on October 21st. The results rule out the presumed effectiveness of hydroxychloroquine, neither in early treatment nor in prophylactic studies. Where is your research moving?
Our study, along with 3 others that also did not find the effectiveness of hydroxychloroquine as a drug in the first moments of the disease, slowed down the intentions of some countries to use it en masse. This would have been a giant lack of resources, not to mention the unnecessary adverse effects.
The huge well-structured database we generated has been served by other findings that have added knowledge of the disease. Not to mention that it has given us a huge experience in the team, which is now continuing to do research in prevention and treatment, now in a more normalized situation.
This whole database that you developed during the start of the pandemic and this whole line of research has caught the attention of other research groups. What studies have been derived from it?
To begin with, positive PCR samples have been able to be used to test the performance of current antigen tests and have contributed to supporting their current use in the diagnosis of exposed cases and contacts. Also, the viral RNA of these samples has been sequenced by the Institute of Biomedicine of Valencia and will provide much information on genomic variants and their transmission potential, their changes in the evolution of the pandemic.
On the other hand, an analysis in conjunction with the London School of Hygiene & Tropical Medicine, using data from the study, found that high viral load carries a higher risk of infection and of developing symptoms of COVID-19. In addition, we work with other teams that have completed studies with hydroxychloroquine to merge the data and review the results we obtained separately. This will allow a more robust conclusion to be made.
At present, the database continues to be freely shared with researchers who request it from us to test their hypotheses in transmission dynamics or statistics applied to clinical trials, among others. ” says Corbacho
It will soon be a year since the start of the pandemic in Europe. At what point is your research and how do you think we could all be involved in helping the fight against Covid-19 move even faster?
Currently and taking advantage of the experience of the research team, we are testing convalescent plasma in early therapy of patients with COVID-19. We think that administering plasma rich in specific antibodies against SARS-CoV-2 can prevent the evolution to a serious disease. The problem is that it is difficult for us to recruit at the same speed as in the first wave of the pandemic. And it is a pity, as there is a well-designed clinical trial published in the NEJM that has already found its effectiveness if given in the first moments of the disease. And I say curious, because hydroxychloroquine is not effective we have heard everywhere, but nothing is said about plasma. We hope to be able to change this in the coming months with the conclusion of the current ongoing study.
I think it is essential that health care providers, when faced with an illness without effective treatments, inform us of ongoing trials and encourage patients to participate. It’s the way to move forward safely and give them an option to benefit from it.
Graduate in Information and Documentation (UB) and Master in Management and Direction of Libraries and Information Services (UB). At I3PT I am in charge of the Knowledge Management Unit and I am in charge of collecting and disseminating its scientific production. I am passionate about new technologies, data management and open science.All stories by: Guillem Cebrian
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