Capitol Hill Blue Forums Thread Like Summary - Medications that might help against SARS-CoV-2

There are many medications being proposed as potentially repurposed (existing drugs for other conditions that might work for COVID-19.

This thread is started as a place to talk about new research, results from existing randomized controlled trials, promising news about medications, etc.

Studies already published have included repurposed drugs, as listed below.

These are mainly against non-structural proteins of SARS-CoV2: the main 3C-like protease (Lopinavir, Ritonavir, Indinavir, Atazanavir, Nelfinavir, and Clocortolone), RNA-dependent RNA polymerase (Remdesivir and Ribavirin), and the papain-like protease (Mycophenolic acid, Telaprevir, Boceprevir, Grazoprevir, Darunavir, Chloroquine, Hydroxychloroquine, and Formoterol).

The best-documented multi-target drugs repurposed for COVID-19 therapy are as follows: antiviral drugs commonly used to treat AIDS/HIV (Atazanavir, Efavirenz, and Dolutegravir Ritonavir, Raltegravir, and Darunavir, Lopinavir, Saquinavir, Nelfinavir, and Indinavir), HCV (Grazoprevir, Lomibuvir, Asunaprevir, Ribavirin, and Simeprevir), HBV (Entecavir), HSV (Penciclovir), CMV (Ganciclovir), parasites (Ivermectin), bacterial infections (Azithromycin) and Ebola (Remdesivir), anticoagulant drug (Dabigatran), and an antifungal drug (Itraconazole).

Interesting news today: A paper just came out that studied remdesivir given early, in the viral replication phase of Covid. This is after exposure and before any severe symptoms, like in the first week. The test arm got three infusions of remdesivir and the control arm got placebo. Remdesivir was 87% effective in reducing hospitalizations! So it actually DOES work, but only when there is replicating virus for it to stop.

If you give it later, it's not very effective at all, only shortening virus clearance time by a couple of days. Not preventing hospitalizations or death. This phenomenon is very familiar: Researchers assumed Covid was one "disease" and death was caused by the virus "winning". So a lot of their trials and treatments used drugs under test on the most ill patients. (And FDA Emergency Use approval enforced this!) The only drug found back then to help was dexamethasone, a steroid known to make viral infections worse. Doctors started looking at various clues that Covid was actually two different diseases: Viral infection, followed by immune system over-reaction. So all antiviral drug trials that started after most of the virus was inactivated were useless.

Monoclonal antibodies work the same way: They are quite effective, but only in the first week after exposure. So maybe some other "antiviral" drugs are actually effective in that first "golden hour". It would be ironic if studies found that HCQ+zinc, and ivermectin worked during this same phase. This was Dr. Marik's criticism of groups that failed to replicate his IV Vitamin C for septic shock treatment: He said they started that therapy days late, when it was an ER "first hour" treatment.

A very interesting paper on existing drugs that might help with Covid came out recently:

The TOGETHER randomised, platform clinical trial

And this is not in Billy-Bob's Cool Drugs You Might Like, this is in Lancet, one of the premier medical journals in the world. This was a large random blind drug trial that tried a number of drugs, including hydroxychloroquine and ivermectin. All the other drug trials were stopped because they found no benefit, but the fluvoxamine trial had to be stopped because it was so effective. After enough data was collected it became unethical to keep on giving the control group placebo.

Fluvoxamine is a SSRI anti-depressant used to treat depression, OCD, and PTSD. It is effective but it usually takes months before it's benefits are seen. In this trial it was given to high-risk Covid-positive patients for a short course.

Three very important points:
1) Ivermectin, even given early and in a recommended dose, does not work!
2) Fluvoxamine is not a steroid. It does not suppress most of the immune system like steroids, just cytokine production. So unlike steroids, it can be started in the early viral replication phase without harming the immune response to the virus. At $4 per course, we should be giving this immediately to everybody with any symptoms, a positive PCR test, or a positive rapid antigen test. This could very significantly reduce Covid hospitalizations world-wide. Almost all of the serious side effects occur after months of use.
3) Fluvoxamine therapy will not interfere with a Covid patient's immune system T and B-cell activation and production of antibodies. It is also compatible with vaccination or Monoclonal Antibody treatment.

Here is a MedCram Youtube video that discusses it:

MedCram Video

Got a Moderna booster today. It's been six months, one week, and one day since my 2nd dose.

Beautiful animation that covers all the immunilogical processes around SARS-COVID2 infection. All to proper scale! It runs just two minutes.

Short Animation Worth Watching