A Chinese woman infected with the new coronavirus showed a dramatic improvement after she was treated with a cocktail of anti-virals used to treat flu and HIV, Thailand's health ministry said Sunday.
The 71-year-old patient tested negative for the virus 48 hours after Thai doctors administered the combination, doctor Kriengsak Attipornwanich said during the ministry's daily press briefing.
"The lab result of positive on the coronavirus turned negative in 48 hours," Kriengsak said.
"From being exhausted before, she could sit up in bed 12 hours later."
The doctors combined the anti-flu drug oseltamivir with lopinavir and ritonavir, anti-virals used to treat HIV, Kriengsak said, adding the ministry was awaiting research results to prove the findings.
The news comes as the new virus claimed its first life outside China – a 44-year-old Chinese man who died in the Philippines – while the death toll in China has soared above 300.
Thailand so far has detected 19 confirmed cases of the virus believed to have originated in the central Chinese city of Wuhan, which is under lockdown.
That is the second-highest number of cases outside of China, with Japan recording 20.
So far, eight patients in Thailand have recovered and returned home, while 11 remain in the hospital.
In a video released Sunday, Thai health minister Anutin Charnvirakul visited a patient from Wuhan who had recovered from the coronavirus, chatting with her amicably in Mandarin as she thanked him and the medical staff.
Thai authorities are trying to balance the screening of inbound Chinese visitors with the economic needs of its tourist sector, which is heavily reliant on arrivals from the mainland.
Messages of support saying "Our hearts to Wuhan" in English, Chinese and Thai were plastered on a Bangkok mall popular with tourists.
The bulk of confirmed cases have been Chinese visitors to Thailand, but on Thursday the kingdom recorded its first human-to-human transmission when a Thai taxi driver was diagnosed with the disease.
The taxi driver had not traveled to China but may have had contact with tourists.
Thailand's government is also battling public criticism that it has been slow to evacuate scores of its citizens from Hubei province, at the center of the outbreak.
Anutin said the evacuation would happen Tuesday, and the returnees would be quarantined for 14 days.
ScaryChange on February 2nd, 2020 at 20:41 UTC »
HIV drugs, like lopinavir (ritonavir is mixed in to delay the breakdown of lopinavir in the body so that it has time to make its way to the infected cells), binds to certain protease enzymes that are typically encoded in viral genetic material. These proteases are required to "chop" up the long virus proteins that are generated when they hijack a cell's machinery to make copies of themselves. These chopped up protein segments are assembled to create copies of the virus.
The HIV drug binds to the protease enzyme to inhibit its function, which subsequently inhibits the virus's ability to assemble copies of itself.
I recall Chinese scientists were able to determine the 3D structure of the "3CL protease" of the 2019-nCoV virus, which may be a target of interest for the use of these retroviral HIV drugs. Because HIV drugs are designed particularly for HIV, I imagine they may not work completely effectively for this coronavirus strain, but with further research on the structure of this virus's protease enzyme, modifications to this drug may improve its binding affinity with the enzyme's active site to improve inhibition.
I went into a bit more detail in the way that these proteases typically work in an earlier comment I made last week, for anyone who is interested.
https://np.reddit.com/r/China_Flu/comments/euflx1/chinese_scientists_established_crystal_structure/ffp1qyo/
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Influenza drugs, like oseltamivir, act as "competitive inhibitors" that target viral neuraminidase (also called sialidase) enzymes.
In order to enter a new cell, the influenza virus must use a glycoprotein (sugar linked to protein) on the surface of its membrane, called hemagglutinin (HA), to recognize and bind to sialic acid residues that are located on the cell surface to initiate the internalization process. When the viruses are finished assembling themselves, they are ready to exit their host cell and spread to infect new hosts. The budding/exiting process forms a growing bubble from the cell's membrane, and the resulting curvature of the budding membrane sometimes orients the HA in such a way that it binds with nearby sialic acid residues that protrude outwards, which anchors the virus to the cell (visual). The virus overcomes this anchoring problem with neuraminidase enzymes (also found on the virus's outer membrane surface), which cleave the sialic acid residues from any bound HA to free the virus (along with other proteins that facilitate in freeing the rest of the virus).
Oseltamivir is a competitive inhibitor, which means that it "competes" with the sialic acid residues in being acted on by neuraminidase. If the environment is flooded with lots of oseltamivir, then neuraminidase will bind with it more frequently than the sialic acid residues, and subsequently slow down (but not completely block) the number of viruses that can escape from their old, infected hosts, which ultimately slows the spread of the virus to other cells.
Although 2019-nCoV is NOT an influenza virus, but a coronavirus strain, it contains hemagglutinin-esterase proteins on its surface, which unlike Influenza A and B's HA that binds sialic acid, binds 9-O-acetylsialic acid instead. I assume that the similarities between these two receptor molecules are what lead doctors to use this influenza drug, in hopes that it also inhibits coronavirus HA-esterase to some degree.
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In short, this combination of drugs act inside and outside the infected cells. One inhibits the virus from assembling itself inside the cell (lopinavir), and the other works outside the cell to inhibit newly formed viruses from breaking free and spreading (oseltamivir).I do not see these drugs as a long-term solution, but rather as a possible treatment method for people who are already infected until a proper vaccine is developed and distributed to provide large-scale resistance against this virus (or until containment efforts control the spread of this virus to the point where it effectively "dies off", like what happened with SARS).
gwdope on February 2nd, 2020 at 20:07 UTC »
Who manufactures those drugs? Asking for a portfolio.
autotldr on February 2nd, 2020 at 20:01 UTC »
This is the best tl;dr I could make, original reduced by 77%. (I'm a bot)
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