Which medications help with coronavirus?
For Covid-19 patients who have to be treated in hospital, doctors use two treatment strategies in acute drug therapy:
- Immunomodulatory drugs: These slow down an excessive (self-damaging) reaction of the immune system.
- Antiviral drugs: These slow down the multiplication of the coronavirus in the body.
In addition, doctors may use other concomitant medications in individual cases after individual consideration.
Immunomodulatory medication
Anti-inflammatory drugs (immunosuppressants) help with severe cases of Covid-19. They prevent the immune system of affected patients in such cases from often being misdirected in its defense against the virus and also attacking its own body.
Dexamethasone: Hospital patients who have an increased oxygen requirement or need artificial respiration, for example, currently receive corticosteroids as standard treatment. The active ingredient dexamethasone plays a key role here. It reduces the risk of dying from a serious infection.
Interleukin-6 antagonists (IL-6 antagonists): Another group of anti-inflammatory drugs are the so-called interleukin-6 antagonists – in particular the active ingredient tocilizumab. However, it is only considered in patients with rapidly deteriorating health after an individual risk-benefit assessment.
Fluvoxamine: A few years ago, doctors discovered that certain drugs for depression – so-called selective serotonin reuptake inhibitors (SSRIs) – also have an anti-inflammatory effect. Doctors can therefore use fluvoxamine in individual cases in high-risk patients – i.e. older people or people with previous illnesses – with a confirmed Sars-CoV-2 infection.
Detailed information on the active substance dexamethasone can be found here.
Antiviral medication
Since the beginning of the pandemic, various new antiviral drugs have been developed to treat Covid-19. However, doctors have also repurposed already known antivirals for Covid-19 treatment.
The term antiviral drugs covers a broad spectrum of drug groups. They range from classic small molecules (with individually different mechanisms of action) to biotechnologically produced antibody preparations.
Monoclonal antibodies
As a rule, these monoclonal antibody drugs bind the spike protein. As the virus particles are then no longer able to penetrate the human cell, this is also known in specialist circles as “neutralization”. The result: the multiplication of the viruses is slowed down or, ideally, stopped completely.
A well-known antibody preparation approved by the European Medicines Agency (EMA) is Ronapreve. This is a combination of casirivimab plus imdevimab. The two antibodies are usually only effective in the early phase of the disease and should therefore ideally be administered within a maximum period of seven days after the onset of symptoms.
However, it has been shown that the efficacy of these drugs is in some cases significantly lower than that of the Omikron variant. As the spike protein of the virus has changed due to mutations, the antibodies are now less effective at recognizing it. The antibody drug Sotrovimab, which is now available on the European market, is intended to close this supply gap and offer protection against Omikron.
Detailed information on the active substance Sotrovimab can be found here.
Detailed information on the active ingredients tixagevimab and cilgavimab can be found here.
In addition, other drugs with the same mode of action are currently undergoing clinical trials and are being assessed by the authorities.
Plasma therapy: Therapeutic antibodies against the coronavirus can also be obtained from blood plasma donations from recovered patients. However, this treatment option is only available to a very limited extent. The effectiveness and tolerability is also very individual and therefore varies greatly.
The use of plasma therapy outside of clinical trials is therefore not currently recommended.
Antivirals
Antivirals intervene directly or indirectly in the reproduction mechanism of viruses within the human cell:
Paxlovid: This preparation from Pfizer can be taken as a tablet and combines two substances: the “actual active ingredient” nirmatrelvir, which inhibits the replication of the virus as a so-called protease inhibitor, and its active enhancer ritonavir. The latter prevents nirmatrelvir from being broken down too quickly by the liver. Paxlovid has been provisionally approved for the European market since January 2021.
Detailed information on the active substance paxlovid can be found here.
Molnupiravir is still being evaluated by European authorities. It is therefore not yet available in practice. It is also not yet possible to make any conclusive statements on its efficacy, tolerability and safety.
Detailed information on the active substance molnupiravir can be found here.
Remdesivir: The antiviral agent Remdesivir was the first drug to be reclassified by the European Medicines Agency (EMA) and thus also approved for the treatment of Covid-19. Depending on the study, the assessments of efficacy against Sars-CoV-2 vary greatly – the benefits of such Covid-19 treatment are considered controversial. Therefore, there is currently no clear recommendation for the routine use of remdesivir as a Covid-19 drug.
Concomitant medications
Antibiotics are not effective against the coronavirus. However, the administration of antibiotics may be useful if a concomitant bacterial infection or a septic course (bacterial blood poisoning) is suspected.
Detailed information on the use of antibiotics can be found here.
In some cases, doctors initiate thromboembolism prophylaxis. This applies in particular if there is severe pneumonia caused by Covid-19. In such cases, the formation of blood clots in the tissues of the lungs is frequently observed.
You can find detailed information on the active ingredient heparin here.
Which medication alleviates the symptoms?
In the vast majority of cases, coronavirus vaccinations reliably protect healthy (immunocompetent) people from severe courses. Nevertheless, even a supposedly “mild” course can be accompanied by symptoms.
A well-stocked first-aid kit is then helpful. It should contain the following remedies to alleviate possible symptoms
- Antipyretic medication – such as acetylsalicylic acid, paracetamol or ibuprofen
- Decongestant nasal drops or saltwater-based nasal drops
- Soothing lozenges or gargle solutions for sore throats
- bronchodilator and soothing ointments (e.g. with eucalyptus)
- Chamomile, eucalyptus or sage for inhalation
- Nasal douche with salt water solutions
- Vitamin C, vitamin D and zinc as a supplement – after consulting a doctor
Pulse oximeter: In addition to a clinical thermometer, a pulse oximeter can help you monitor your state of health. A pulse oximeter is a device that you place on your fingertip, where it measures the oxygen saturation of your blood.
If the oxygen saturation drops, this indicates a deteriorating state of health and an increased need for oxygen.
This allows the necessary care to be arranged in hospital at an early stage. Others, however, point to the inaccuracy of the measurement method itself and the high acquisition costs. They therefore do not see a general necessity.
Treatment with over-the-counter (pharmacy-only) medication can at best supplement the Covid-19 recovery. If the symptoms persist over a longer period of time, do not improve or even worsen, you should always seek medical advice immediately.
