By Anselmo Abdo – Oct 8, 2020
Until October 2, 2020, the pandemic caused by the SARS-CoV-2 infection has caused, according to reported data, 34,975,593 patients in the world and 1,034,403 deceased patients [1]. Some media have claimed higher figures.
Prevention strategies are the only ones that have proven effective in dealing with the pandemic. There is no medical treatment of choice for the disease and the results should be interpreted with caution given the interests of commercial companies ; to the point that in prestigious scientific journals apology notes have appeared after articles published in which rigorous research methodology was not used [2].
On Thursday, October 1, 2020, President Donald Trump was diagnosed with COVID-19 and on Friday he entered the Walter Reed Military Medical Center. The main information media in the world have transmitted the medical reports in real time.
Thus we have learned that the clinical picture was characterized by fever and two episodes of decreased oxygen levels in the blood. The doctors specified that the president was treated with Remdesivir along with dexamethasone (steroid), after experiencing the second drop in oxygen levels [3].
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The president has also been treated with a cocktail of experimental antibodies and immunity stimulants (vitamin D and Zinc). His doctors say that he has not experienced any side effects from the drugs and that his liver and kidney functions are normal.
Remdesivir is an antiviral drug that was initially developed for Ebola virus disease, it has shown in vitro activity against SARS-CoV-2; so it was used in clinical trials. Data from a randomized, double-blind, placebo-controlled clinical trial (NIAID / CO-US-540-5776 Study ACTT-1) in hospitalized patients with COVID-19 showed that severely ill patients who received Remdesivir had a shorter recovery time than those who received placebo.
However, no difference in the rate of recovery was observed between patients receiving mechanical ventilation. In the same study cited above, no clinical benefit was seen in patients with mild or moderate disease [4]. Serious adverse events produced by its use are around 21%.
In relation to dexamethasone, the first data provided by the Oxford University confirmed that the drug, in doses of 6 mg once a day for ten days, reduced mortality in a third of patients who required artificial ventilation, however, showed no benefit among those patients who did not require ventilation. Its use is not without risk due to the development of serious adverse effects, such as immunosuppression with the possibility of developing bacterial and / or fungal superinfections [5].
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The US blockade of Cuba has prevented President Trump’s medical team from evaluating other antiviral treatment alternatives such as HeberFERON® and drugs with an anti-inflammatory profile such as the monoclonal antibody Itolizumab® and the peptide Jusvinza®.
HeberFERON®, created and produced by the Center for Genetic Engineering and Biotechnology (CIGB), in Havana, Cuba; combines recombinant human interferon alpha 2b with recombinant human gamma interferon. The combination has been shown to improve the biological activity of interferons, with fewer adverse reactions. In a group of Cuban patients diagnosed with COVID-19, 77% had rtPCR negative for SARS-CoV-2 at 4 days (96 hr) after the administration of the first dose [6].
Itolizumab® is a humanized recombinant anti-CD6 monoclonal antibody (MAb) of the immunoglobulin G1 (IgG1) isotype that binds to domain 1 of human CD6 and modulates the activation and proliferation of T lymphocytes induced by CD6 costimulation. This MAb was developed at the Center for Molecular Immunology (CIM, Havana, Cuba) [7].
Jusvinza® is an immunomodulatory peptide, derived from the cellular stress response protein (heat shock protein 60) , designed by bioinformatics tools and obtained by chemical synthesis at the CIGB, Havana, Cuba [8].
The two drugs have shown satisfactory results in modulating the hyperinflammatory response that can occur in SARS-CoV-2 infection with few adverse events, including immunosuppression.
The Cuban biopharmaceutical industry in the fight against the COVID-19 pandemic
Until October 1, 2020, the fatality rate in Cuba was 2.13. In comparison, the global fatality rate was 2.98 and in the Americas region it was 3.33 [9].
Health is a universal right of every human being. Ban the use of effective drugs against the new SARS-CoV-2 coronavirus, any American patient, including its president, must be condemned and amended.
Notes
[1] Confirmed cases of coronavirus in Spain and in the world. https://elpais.com/
[2] The Lancet and New England Journal of Medicine retract studies on hydroxychloroquine and heart disease in COVID-19. Medscape – Jun 4, 2020. https://espanol.medscape.com/
[3] Trump’s medical team claims that the president has experienced low blood oxygen levels. https://actualidad.rt.
[4] Recommendations for remdesivir treatment of COVID-19 patients. https://www.aemps.
[5 ] Coronavirus and dexamethasone: in which patients is it effective and why. https://www.bbc.com/
[6] HeberFERON®. https://www.
[7] Saavedra D, et al. An Anti-CD6 Monoclonal Antibody (Itolizumab) Reduces Circulating IL-6 in Severe Covid-19 Elderly Patients. Research Square pre print. DOI: doi.org/10.21203/
[8] Venegas-Rodriguez R, Santana-Sanchez R, Peña-Ruiz R, Bequet-Romero M, Hernandez-Cedeño M, Santiesteban-Licea B, et al. CIGB-258 Immunomodulatory Peptide: Compassionate Use for Critical and Severe COVID-19 Patients. Austin J Pharmacol Ther. 2020; 8 (1). 1119.
[9] Closing part of October 1 at 12 at night. https://salud.msp.gob.
Featured image: Donald Trump leaves Walter Reed Hospital. October 5, 2020. Photo: Reuters.
Translation: Walter Lippmann
