COVID-19 – Treatment, medicinal products, long-term effects

Treatment of mild cases of COVID-19

The infectious disease COVID-19 is caused by the SARS-CoV-2 pathogen. Of
course, a vaccine is the best prevention against infection. Around 80% of
infections are of mild to moderate severity. People who are infected can, ideally having consulted with their doctor, recover in home isolation. In such a case, they should support their immune system through plenty of relaxation and sleep, as well as a balanced diet. It is also important to drink more than usual, since the body requires more liquid when fighting infections than when healthy.

Treatment of severe COVID-19 disease progressions

Around seven percent of persons infected with the coronavirus are hospitalised on account of a severe disease progression. The SARS-CoV-2 virus primarily affects the respiratory tract and can lead to pneumonia in critical cases. Severe cases are often heralded by shortness of breath and oxygen deficiency in the blood.In addition, other organs, such as the heart, kidneys and nervous system, may also be affected. 

The lung – the organ most affected by COVID-19

The lung is affected especially heavily by a COVID-19 infection, which is why treatments focus on respiratory diseases in particular. When a critical disease
progression leads to pneumonia, liquid collects in the lung. The lung can
therefore only supply the blood with an insufficient amount of oxygen. In many
cases, oxygen administration may be required, for instance using a respiratory
mask or breathing hood. Should the situation deteriorate further, then the
patient must be artificially ventilated on an intensive care ward.

Supportive measures at the hospital

A specific treatment directed at the coronavirus itself is not yet available. The virus must be fought using the body’s own internal defences. Most treatments involve supportive measures such as oxygen administration, medication to support the circulatory system, or antibiotics to combat bacterial alternative infections or co-infections. Moreover, relevant underlying chronic illnesses are treated. The measures serve to support the infected person’s body in its fight against the virus and to mitigate severe progressions as far as possible. 

Under development: Biomedicines against COVID-19

Various medicinal products against the SARS-CoV-2 coronavirus are currently under development, with over 4,500 studies being conducted on over 400 active substances. Some medicinal products have already been approved. These include antiviral monoclonal antibodies: These artificially produced antibodies can prevent the virus from latching onto cells and can, under certain conditions, be utilised in early stages of COVID-19. Other medicinal products that have been authorised:

Antibodies from persons who have recovered (convalescent plasma)

Convalescent plasma refers to blood plasma from people who have
successfully recovered from a SARS-CoV-2 infection and have developed an
immunity – it contains antibodies against the pathogen. People with a severe
infection receive the convalescent plasma or the purified antibodies harvested
from it. The antibodies bind and neutralise the virus, thereby supporting the
immune system in fighting the infection. However, proof of the efficacy of this
approach still needs to be demonstrated through controlled clinical studies.

Remdesivir

Remdesivir, which became known as a medication against Ebola, is an antiviral drug: in other words, an active substance that inhibits the propagation of viruses. It has been authorised for the treatment of COVID-19 and should stop the spread of SARS-CoV-2 among people who are infected, as well as shorten their recovery time. However, remdesivir’s initial results have not been overly compelling. The Robert Koch Institute recommends remdesivir be used as early as possible for patients who do not require ventilation. 

Mesenchymal stem cells

These cells are precursors of various cell types and responsible for the maintenance and regeneration, among other things, of connective tissue, bones and muscles in the human body. For people who suffer from a severe COVID-19 progression, it acts as an anti-inflammatory thereby protecting lung tissue and regenerating damaged lung tissue. In Germany, its manufacture for use on humans must always adhere to the highest quality standards (Good Manufacturing Practice – GMP). 

Dexamethasone

The cortisone preparation dexamethasone is anti-inflammatory. It is used with people with a severe COVID-19 infection who need to be artificially ventilated, checking the excessive immune reaction that frequently occurs. Studies have shown that dexamethasone can lower the risk of fatality in severe progressions by a third.

Recovery and long-term effects of COVID-19

Whereas in mild cases, a COVID-19 infection lasts for about 2-3 weeks, in severe cases the acute phase of the disease may last twice as long. Long-term effects on specific organs have often been observed after intensive treatments. After an acute infection, some people develop chronic tiredness and fatigue, even shortness of breath, neurological disorders, sudden vomiting or extreme
dizziness. This phenomenon is known as “long-COVID” or also “post-COVID-19
syndrome”. Reliable, representative data regarding the proportion of infected
people experiencing long-term effects are as yet unavailable.

“Long-COVID” – not just with severe disease progressions

Delayed sequelae from a coronavirus infection are affecting more and more people. Some still suffer from a variety of symptoms weeks and months later. Meanwhile, researchers have published new findings on “long-COVID”.

Answers to the most frequently asked questions on coronavirus infection, potential symptoms and the most important preventive measures can be found here.