As the crisis and the battle with the coronavirus, SARS-CoV-2 continues in more than 200 countries with more than 4 270 000 confirmed infections and sadly, more than280 000 deceased, new antiviral and antiseptic drugs emerge every day. Most of the drugs have long been used for the treatment of influenza, severe acute respiratory syndromes and upper respiratory tract infections caused by influenza virus A and B. Some other clinics have also tried using some other drugs used in the treatment of Ebola virus, HIV, malaria and so on, mostly antiviral drugs, with hopes that one of them or a combination of drugs will have an effect on the SARS-CoV-2 virus, or at least that the drugs will impact the growth of the virus or ease the symptoms.
In the past two months, there has been a lot of talk about a drug called Arbidol (Umifenovir), which you can even buy online, an antiviral and immune-modulating drug that was used for the treatment of Covid-19 in China, and showed good results at the beginning. It is hard to say for anyone, anecdotally or scientifically, whether drugs are effective or not in such a short time without a wide extensive analysis, studies, and clinical trials. Usually, these trials last for years, because despite if the drug cures the illness or not, you have to take all the precautions and possible side-effects in consideration.
What is Arbidol?
Arbidol is immunomodulation and antiviral drug used for treatment and prevention of influenza, SARS, respiratory syncytial virus, and upper respiratory infections caused by influenza. It acts as a suppressor of the virus replication and prevents hemagglutinin mediated membrane fusion. Arbidol also stimulated the production of interferons, humoral, and cell-mediated immunity and prevents complication developments. In plain language, the drug blocks the entry of the virus into targeted cells by suppressing the fusion of the virus lipid envelope with the cell membrane. This applies to influenza A and influenza B viruses (H1N1, H2N2, H3N2, H9N2, H6N1, and H5N1).
What do the studies say?
Arbidol is currently the highest-selling drug in Russia, and it has been used officially in hospitals all over Russia, and there has to be a good reason why. A study published in the journals of the Chinese Academy of Sciences by Dr. Hu Bo has shown that the usage of Arbidol could act as a post-exposure prophylaxis pf Covid-19 transmission among healthcare workers. The study observed 27 families and 124 healthcare workers, all with a high risk of exposure to the virus, using Arbidol, Oseltamivir, and placebo, and all were being tested after 24 days. The results showed that the group that used Arbidol has shown a very low number of contracted with Covid-19, while the rest who used Oseltamivir and placebo have shown no signs of preventive transmission.
Despite the lack of evidence and clinical trials, this was enough for many healthcare workers throughout China to adopt using Arbidol as a standard protocol for post-exposure prophylaxis. The medicine has been available only in China and Russia, and it is no wonder that the National Health Commission expert Li Lanjuan proposed using this drug in combination with darunavir (antiviral drug) as a potential treatment against Covid-19. Other experts also claim Arbidol inhibits the replication of the virus.
Another study coming from China has shown not so optimistic results, coming from the Vice Director for the Center for Infectious Diseases of Guangzhou Eight People’s Hospital in Guangzhou, Linghua Li. The study assessed 86 patients with mild to moderate Covid-19 symptoms, hoping that the drug will affect the spread of the disease and prevent rising to severe levels and reduce the mortality rate. In the study 34 patients received Lopinavir/ritonavir, 35 received Arbidol and 17 received no antiviral drug and were considered a control group. After 7-14 days all three groups showed very similar results, with no difference in the rates of fever reduction, or any other symptom. Both groups taking antiviral drugs showed the same side-effects of the drug, which are loss of appetite, diarrhea, and nausea, 12 from the Lopinavir/ritonavir group and only 5 from the Arbidol group.
Another more extensive study observed the effectiveness of Arbidol, however, it is an in vitro study published on 02 May 2020, and the results are interesting least to say. The study evaluated six available and licensed anti-influenza drugs, among which Arbidol, baloxavir, laninamivir, oseltamivir, peramivir, and zanamivir, and used them over infected cells and non-infected cells, which were later infected with SARS-CoV-2 at a certain controlled multiplicity of infection. All the drugs showed similar results except for Arbidol, which has shown a high inhibition effect. The observed cell were African green monkey kidney cells, and the same study tried some human lung cells, however, human cells showed they are not very efficient for SARS-CoV-2 replication. The study concludes that Arbidol efficiently inhibits SARS-CoV-2 infection, and shows anti-inflammatory activity in infected cells, and can be potentially used for the treatment of COVID-19 patients. However, the recommended dose of orally taken Arbidol by the Chinese Guidelines of 200 mg, 3 times a day, might not be able to achieve the efficiency of the drug in inhibiting SARS-CoV-2 infection. Also, this is only an in vitro study and has to be backed up with clinical trials, and be more through ugly researched.
The end of the pandemic is hopefully near, and never in the history of mankind have people never been more devoted to finding a cure or a vaccine as they have been in the past five months. In the meantime, listen to the recommendation of the experts, keep social distance, and wash your hand as often as needed. And never, absolutely never, do not try a drug without consulting your physician. Unsupervised usage of any antiviral drug is extremely dangerous, far more dangerous than any of the above-mentioned viruses, because you might not be a suitable candidate for this treatment, and uncontrolled usage may lead to death. Always consult your physician, no exceptions, ever!