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UP expert weighs in on supposed Covid-19 treatment options

As Covid-19 vaccines continue to arrive in the country in trickles, there has been a lot of talk about alternative prevention and treatment options for the virus.

With the way social-media pages have practically become online obituaries, it is not surprising that people are in a hurry to be protected from Covid-19 so as not to become a fatality statistic.

In fact, people will believe anything they read or hear even to the detriment of their own health.

That is why during last week’s “Stop COVID-19 Death” webinar organized by the University of the Philippines, one of the speakers talked about the various treatment options that are being talked about to help combat Covid-19, especially the most controversial ones.

Dr. Joseph Adrian Buensalido, Infectious Diseases Specialist; Chair, Infection Prevention and Control and Clinical Associate Professor of Medicine, UP-PGH, talked about the facts—and the fiction—on Covid-19 prevention and treatments. “People should first gather the facts, and not be too fast and furious in choosing certain supposed treatments against Covid-19 without being properly guided.”

The options

Here are some treatment options that have been the talk of the town in social media:

Ivermectin—It has been approved by the FDA as an anti-parasitic drug that deals with various parasitic conditions and has an anti-inflammatory effect. It is still being subjected to randomized studies around the world because a lot has yet to be discovered, and Ivermectin needs to prove itself more to the scientific and medical worlds. The consensus panel composed of technical reviewers declared that there is still insufficient (with very low quality) evidence for Ivermectin to be considered a treatment option for Covid-19. There are no benefits for Clinical Improvement, including time to symptom resolution or hospital discharge, though it is not seen to cause harm.

Based on the latest evidence from randomized trials, Ivermectin is not recommended as treatment for Covid-19. However, this recommendation will be updated as more evidence is generated from ongoing trials. It is also not advised that Ivermectin be used as prophylaxis (preventive health care) against Covid-19.

Ivermectin is unlike vaccines that undergo phases of clinical trials on small hundreds to several hundreds and then thousands of volunteers. This is done to determine if the vaccines developed are safe and effective, and to know if there are side effects. “Clearly, vaccines have more participants during trials compared to Ivermectin’s preventive capability assessment. Thus, the panel recommends against the use of Ivermectin prophylaxis for the general population, for household contacts of confirmed Covid-19 patients and healthcare workers,” Dr. Buensalido said.

Melatonin—It is used to treat sleep disorders, also for atherosclerosis, respiratory diseases, viral infections, with potent anti-inflammatory capacities. The panel also said there is insufficient (very low quality) evidence to recommend Melatonin as an adjunct treatment (or treatment in addition to the primary treatment) for Covid-19, where it displayed very low benefit for mortality, time to recovery, length of stay or pulmonary involvement. “Similar to Ivermectin, there are a lot of ongoing studies to help the panel decide if Melatonin can be used in the future.” In terms of prevention, Melatonin is also not recommended for use.

Zinc and its immune function—Zinc is an essential trace element for growth, development and maintenance of the immune function. “We have seen that high-dose [more than 75 mg] Elemental Zinc is much better in shortening/reducing [around two to three days] of viral URTIs’ [Upper Respiratory Tract Infections, where coronavirus is the number 2 cause] duration during observational studies and not Randomized Control Trials [RCTs], considered the “gold” standard in rating the quality of evidence. However, the panel still thinks there is insufficient evidence to recommend Zinc as adjunct treatment to Covid-19. There is also no direct evidence on Zinc supplements to prevent Covid-19.

Vitamin C and its immune function—Vitamin C is an essential micronutrient, a potent antioxidant, where supplementation of Vitamin C appears to be able to both prevent and treat respiratory and systemic infection. But there is also insufficient (low quality of) evidence to use Vitamin C as adjunct treatment to Covid-19, where the panel also saw that Therapeutic Vitamin C has no significant benefit for Covid-19 in terms of mortality and need for respirator. However, consumption of 8 grams/day of Vitamin C significantly shortens viral URTIs.

However, Dr. Buensalido noted that Harri Hemila, one of the most noted nutrient experts in the world, said in his expert opinion, “prophylactic daily dosing of Vitamin C does not seem worthwhile under normal circumstances.” But since many URTIs are caused by coronaviruses, “there is no reason to assume that Vitamin C would be completely ineffective against Covid-19.”

Lianhua Qingwen—A classic Chinese medical preparation used in the SARS outbreak in 2002-2003 in China, but also not recommended for use against Covid-19 because of very low quality of evidence just like the rest of the prevention and treatment options.

Steam inhalation—Called by others as suob or tuob, a traditional home remedy for treating common colds, it is seen to provide relief by loosening mucus, opening up the nasal passage, reducing mucosal inflammation, inhibiting viral replication by heat inactivation. Expert reviewers also recommended against the use of Steam Inhalation in the treatment of Covid-19, with very low quality of evidence.

The World Health Organization (WHO) continues to remind the public that in fighting Covid-19, people should be guided by science and evidence because there is no approved or recommended mode of prevention or treatment yet for Covid-19. This is why the WHO declared that until there is sufficient evidence, using (self-medicate) or recommending unproven treatments patients should be avoided or stopped immediately.

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