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How to treat covid? Recommendations of German doctors

What drugs are used in the treatment of covid and is there anything more effective than coronavirus vaccines? German doctors developed general recommendations, which DW got acquainted with.

First of all, it must be said - nothing works more effectively against covid than vaccination. Only vaccination can prevent or mitigate the severe course of the disease. And ideally, you should not bring things to a situation where intensive care is required to treat covid. But so far this is not possible. Around the world, 5 billion doses of the coronavirus vaccine have been used, primarily in rich industrialized countries. Based on the fact that each person needs two vaccinations, then this amount is enough for only a third of the world's population. Around 650,000 people around the world fall ill with covid every day. Almost 5 percent of this number have a severe illness and require intensive care in the hospital. As of the end of August 2021, almost 10,000 people around the world die every day from the effects of covid.

Nevertheless, some progress has been made in the treatment of covid over the past year and a half. The most important methods of treatment and medicines against this disease are collected in a general instruction, which is used by doctors in Germany. DW got to know her.

When should you go to the hospital for covid?

If the patient has breathing problems, he should immediately go to the hospital. Decisive here is rapid breathing and low blood oxygen saturation (less than 90 percent). The patient is sent to the intensive care unit if the lungs can no longer deliver enough oxygen to the blood - the so-called hypoxemic respiratory failure occurs. In this case, patients often experience acute shortness of breath and respiratory failure with a frequency of 25-30 breaths / exhalations per minute. In violation of the respiratory regime and oxygen exchange, fresh air no longer reaches the depths of the lungs. Therefore, they cannot be properly supplied with oxygen and fail.

What maintenance drugs are used for severe covid

As maintenance therapy for patients in cases where there are no contraindications, doctors prescribe heparin to reduce the risk of thrombosis. Also used is the corticosteroid dexamethasone or, in certain cases, the glucocorticoid hydrocortisone. These drugs should act as immunomodulators and prevent inflammatory processes. However, corticosteroids are not a panacea in the treatment of seriously ill patients. Mortality in patients who receive artificial respiration is reduced by only 3 to 12 percent when using such drugs, but it's still better than nothing. In addition, these drugs are readily available and are generally well tolerated by patients.

As a maintenance medication, doctors also use tocilizumab in addition to dexamethasone. This drug is based on monoclonal antibodies that support immunity. In studies, its use has only had a limited effect, but in patients who receive oxygen artificially and whose condition worsens, it may help prevent death. For patients who do not require an oxygen mask or require very little artificial oxygen, this drug is not recommended.

Treatment with monoclonal antibodies

Monoclonal antibodies are on the list of drugs with which certain hopes are associated in the treatment of covid, since they directly affect the causative agent of the disease. For example, former US President Donald Trump was treated for coronavirus with REGN-COV2 drug manufactured by Regeneron.

A substance consisting of a mixture of two monoclonal antibodies has received emergency access for use in the United States. The third phase of research has shown that in people who have contracted covid, but have not yet developed symptoms of infection, the risk of a severe form of the disease is reduced by the use of monoclonal antibodies. Those who show symptoms recover faster. However, German doctors do not mention this drug as recommended.

But another drug - bamlanivimab, which works in a similar way as REGN-COV2, but on a spike protein, is mentioned in the recommendations. But German doctors do not recommend it in the treatment of patients with severe covid who are in the hospital, because there may be unwanted side effects. Some patients even have to undergo dialysis. Only in one case, doctors make an exception: patients who are at risk are allowed to use monoclonal antibodies. They assume that someone who develops antibodies early enough will experience only mild or no symptoms of the disease.