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Antivirals Effective Against Coronavirus?

Wally

Senior Member
Messages
1,167
3/6/2020 - Dr. Collins (NIH Director) was at the University of Alabama where he discussed Gilead Sciemces anti-viral drug Remdesivir. Discussion of Remdesivir at minute marker 6:48 - 7:50.
Probably the most promising anti-viral for those who are really sick . . . we don’t know if it will work or not . . . give it about a month to see if it works and . . that .we have a specific effective therapeutic.

3/6/2020 - CEO of Gilead Sciences discussing the status of Remdesivir clinical trials (Discussion re Remdesivir at minute marker 5:05 to 9:30).)

3/15/2020 - https://www.dailymail.co.uk/news/ar...elped-SAVE-American-coronavirus-patients.html
[A]n infectious disease specialist at the University of California Davis Medical Center, was part of the team that administered the drug, remdesivir, to a sickly American woman who tested positive for the virus on February 26.

'We thought they were going to pass away,' Thompson told Science magazine Friday about the patient - who was the first known 'community spread' case in the United States.

However, 36 hours after the woman was admitted to hospital, doctors decided to treat her with remdesivir, which is administered by intravenous drip and 'cripples an enzyme named RNA polymerase - used by many viruses to copy themselves. . . .

Similarly, remsdesivir helped 14 Americans who tested positive for coronavirus after they traveled on board the Diamond Princess cruise ship.

Richard Childs, an assistant surgeon general and lung specialist at the National Institutes of Health, told The Wall Street Journal Friday that the patients were treated with the experimental drug in a Japanese hospital.

Childs described the patients as 'critically ill people and their average age is 75'.

'Many of them were probably going to die in a short amount of time, and two weeks later nobody has died and more than half of them have recovered. It's just absolutely amazing,' he remarked. . . .
 

godlovesatrier

Senior Member
Messages
2,590
Location
United Kingdom
Whether it's herbal or pharmaceutical so much of these anti viral drugs is all about timing, start taking it at the wrong time (too late) and it just won't work, not if the virus is aggressive enough to totally overwhelm the natural immune response. I've still got very mild symptoms of something today - I am day 3. I'm a third contact, that is I have a friend I live with who is dealing with coronavirus patients on a daily basis, so if she was sick there's no reason I couldn't have got it from her.

I read another article saying that anti inflamatories allow the virus to spread and do more damage, they are advising paracetamol only. I wonder if this also applies to strong anti inflamatories of the plant based kind?
 

Martin aka paused||M.E.

Senior Member
Messages
2,291
Hi I’m Dr Chen and older than I look
@Chenbariatrics1

*steroids are up in the air. In China usual clinical practice for all ARDS is high dose methylpred. Thus, ALL of their pts have had high dose methylpred. Some question whether this practice increases mortality.

Giving high doses of methylprednisolone makes perfect sense to decrease mortality decreasing the risk of a deadly cytokine storm or a fever that you can't get under control. But of course, you can only do it in quarantine. That's why I cancelled my infusions.
 

godlovesatrier

Senior Member
Messages
2,590
Location
United Kingdom
Stephen Harold Buhner's book Herbal Antivirals has a good section on SARS and coronaviruses. I've cross referenced the cytokines and they all seem to be the same as covid19. He makes a few recommendations for the plant based medicines, which I know nobody is interested in but it's the science that people might want to read. Page no 932. He discusses the cytokines involved and the reason why it effects the old more than the young:

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1584290724130.png
 
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Wally

Senior Member
Messages
1,167
Does anyone have any information about the third trial of Vitamin C that is suppose to be taking place in China? The only information that I have been able to locate online is reference to there being a third trial, but I have not been able to locate any specific criteria for the trial. I know that the first trial will involve ICU patients in serious or critical condition diagnosed with SARI and they will be given 12 grams of IV Vitamin C twice a day for 7 days. See, https://clinicaltrials.gov/ct2/show/NCT04264533

The second clinical trial is mentioned in the article quoted below* as using 6 to 12 grams of IV Vitamin C per day for moderate or severe patients. No other information is given in this article about how the participants will be selected. I am assuming that since it may involve the same group of researchers that the study might include hospitalized moderate or severe patients not in the ICU, but my search query for another Vitamin C clinical trial in China came up with no results. Just wanted to see if anyone else might have found information about these two other trials that I have not.

Also, I am not sure if this information has been posted about where the raw product and manufacture of Vitamin C (and other supplements) is being produced, but I thought it was interesting to note as it follows with the other concerns raised about prescription drug manufacturers primarily being based in China and India.
See, 1) https://www.nutraingredients-asia.c...y-defends-standards-against-marketing-claims# and
2) https://www.statnews.com/2020/02/14/coronavirus-outbreak-exposes-weak-link-us-drug-supply-chain/ and
3) https://www.npr.org/sections/health...us-is-affecting-the-u-s-pharmaceutical-supply
(This issue is not a new one, but perhaps the magnitude of the COVID-19 pandemic will cause larger countries (like the U.S.) to again re-think their dependency on the outsourcing of the production of drugs and supplements to one or two other countries.. See, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3278171/ )

*https://www.globalresearch.ca/three...ch-studies-approved-treating-covid-19/5705405
Intravenous vitamin C is already being employed in China against COVID-19 coronavirus. I am receiving regular updates because I am part of the Medical and Scientific Advisory Board to the International Intravenous Vitamin C China Epidemic Medical Support Team. Its director is Richard Z. Cheng, MD, PhD; associate director is Hong Zhang, PhD.
Among other team members are Qi Chen, PhD (Associate Professor, Kansas University Medical School); Jeanne Drisko, MD (Professor, University of Kansas Medical School);
Thomas E. Levy, MD, JD; and Atsuo Yanagisawa, MD, PhD. (Professor, Kyorin University, Tokyo). To read the treatment protocol information in English: click this (Protocol in Chinese is here).

. . .
A second clinical trial of intravenous vitamin C was announced in China on Feb. 13th. In this second study, says Dr. Cheng,

“They plan to give 6,000 mg/day and 12,000 mg/day per day for moderate and severe cases. We are also communicating with other hospitals about starting more intravenous vitamin C clinical studies. We would like to see oral vitamin C included in these studies, as the oral forms can be applied to more patients and at home.” Additional information here.
And on Feb 21, 2020, announcement has been made of a third research trial now approved for intravenous vitamin C for COVID-19.
 

pamojja

Senior Member
Messages
2,443
Location
Austria
Giving high doses of methylprednisolone makes perfect sense to decrease mortality decreasing the risk of a deadly cytokine storm or a fever that you can't get under control.

According to the 'Expert consensus on comprehensive treatment`' out of Shanghai, a city very successful as it seems now, it it is cautioned against: whole treatment section added in below quote, the whole of it attached as pdf.

Treatment plan

(A) antiviral treatment

You can try hydroxychloroquine sulfate or chloroquine phosphate, or Abidol for oral
administration, interferon nebulization and inhalation, interferon κ is preferred, and interferon α
recommended by the national scheme can also be applied. It is not recommended to use 3 or
more antivirals at the same time. The viral nucleic acid should be stopped in time after it becomes
negative. The efficacy of all antiviral drugs remains to be evaluated in further clinical studies.
For patients with severe and critical viral nucleic acid positives, recovery patients can be tested for
recovery plasma. For detailed operation and management of adverse reactions, please refer to the
"Clinical Treatment Program for Recovery of New Coronary Pneumonia Patients During Recovery
Period" (trial version 1). Infusion within 14 days of the onset may be more effective. If the viral
nucleic acid is continuously detected at the later stage of the disease, the recovery period of
plasma treatment can also be tried.

(Two) treatment of light and ordinary patients

Supportive treatment needs to be strengthened to ensure sufficient heat; pay attention to water
and electrolyte balance to maintain internal environment stability; closely monitor patient vital
signs and finger oxygen saturation. Give effective oxygen therapy in time. Antibacterials and
glucocorticoids are not used in principle. The patient's condition needs to be closely monitored. If
the disease progresses significantly and there is a risk of turning into severe, it is recommended to
take comprehensive measures to prevent the disease from progressing to severe. Low-dose shortcourse
glucocorticoids can be used with caution (see the application section of glucocorticoids for
specific protocols). ). Heparin anticoagulation and high-dose vitamin C are recommended. Lowmolecular-
weight heparin 1 to 2 per day, continued until the patient's D-dimer level returned to
normal. Once fibrinogen degradation product (FDP) ≥10 μg / mL and / or D-dimer ≥5 μg / mL,
switch to unfractionated heparin. Vitamin C is administered at a dose of 50 to 100 mg / kg per day,
and the continuous use time is aimed at a significant improvement in the oxygenation index. If
lung lesions progress, it is recommended to apply a large-dose broad-spectrum protease inhibitor,
ulinastatin, at 600 to 1 million units / day until the pulmonary imaging examination improves. In
the event of a "cytokine storm", intermittent short veno-venuous hemofiltration (ISVVH) is
recommended.

(III) Organ function supportive treatment for severe and critically ill patients

1. Protection and maintenance of circulatory function: implement the principle of early active
controlled fluid replacement. It is recommended to evaluate the effective volume and initiate fluid
therapy as soon as possible after admission. Severe patients can choose intravenous or
transcolonic fluid resuscitation depending on the conditions. The preferred supplement is lactated
Ringer's solution. Regarding vasoactive drugs, noradrenaline and dopamine are recommended to
maintain vascular tone and increase cardiac output. For patients with shock, norepinephrine is the
first choice. It is recommended to start low-dose vasoactive drugs at the same time as fluid
resuscitation to maintain circulation stability and avoid excessive fluid infusion. Cardioprotective
drugs are recommended for severe and critically ill patients, and sedative drugs that inhibit the
heart are avoided as much as possible. For patients with sinus bradycardia, isoprenaline can be
used. For patients with sinus rhythm, a heart rate of <50 beats / min and hemodynamic instability,
intravenous pumping of low-dose isoproterenol or dopamine is recommended to maintain the
heart rate at about 80 beats / min.

2. Reduce pulmonary interstitial inflammation: 2019-nCoV leads to severe pulmonary interstitial
lesions that can cause pulmonary function deterioration. It is recommended to use a large dose of
a broad-spectrum protease inhibitor ulinastatin.

3. Protection of renal function: Reasonable anticoagulant therapy and appropriate fluid therapy
are recommended as soon as possible. See chapter "Cytokine storm" for prevention, protection
and maintenance of circulatory function.

4. Protection of intestinal function: Prebiotics can be used to improve the intestinal microecology
of patients. Use raw rhubarb (15-20 g plus 150 ml warm boiling water) or Dachengqi decoction for
oral administration or enema.

5. Nutritional support: parenteral nutrition is preferred, via nasal feeding or via jejunum. The
whole protein nutrient preparation is preferred, and the energy is 25 to 35 kcal / kg (1 kcal = 4.184
kJ) per day.

6. Prevention and treatment of cytokine storm: It is recommended to use large doses of vitamin C
and unfractionated heparin. Large doses of vitamin C are injected intravenously at a dose of 100 to
200 mg / kg per day. The duration of continuous use is to significantly improve the oxygenation
index. The use of large Dose of the broad-spectrum protease inhibitor ulinastatin, given 1.6 million
units, once every 8 h, under mechanical ventilation, when the oxygenation index> 300 mmHg can
be reduced to 1 million units / d. Anticoagulation can be taken The treatment protects endothelial
cells and reduces the release of cytokines. When FDP ≥ 10 μg / mL and / or D-dimer ≥ 5 μg / mL,
heparin (3-15 IU / kg per hour) is given anticoagulation. Heparin is used for the first time. The
patient's coagulation function and platelets must be re-examined 4 h later. ISVVH is used for 6 to
10 h every day.

7. Sedation and artificial hibernation: Patients undergoing mechanical ventilation or receiving
ECMO need to be sedated on the basis of analgesia. For patients with severe man-machine
confrontation during the establishment of artificial airways, short-term application of low-dose
muscle relaxants is recommended. Hibernation therapy is recommended for severe patients with
oxygenation index <200 mmHg. Artificial hibernation therapy can reduce the body's metabolism
and oxygen consumption, and at the same time dilate the pulmonary blood vessels to significantly
improve oxygenation. It is recommended to use continuous intravenous bolus medication, and the
patient's blood pressure should be closely monitored. Use opioids and dexmedetomidine with
caution. Because severely ill patients often have elevated IL-6 levels, which can easily lead to
bloating, opioids should be avoided; 2019-nCoV can still inhibit sinus node function and cause
sinus bradycardia, so it should be used with caution on the heart. Inhibitory sedatives. In order to
prevent the occurrence and exacerbation of lung infections, and to avoid prolonged excessive
sedation, try to withdraw muscle relaxants as soon as possible. It is recommended to monitor the
depth of sedation closely.

8. Oxygen therapy and respiratory support:
① nasal cannula or mask oxygen therapy, SaO2 ≤93% under resting air condition, or SaO2 <90%
after activity, or oxygenation index (PaO2 / FiO2) 200-300 mmHg; With or without respiratory
distress; continuous oxygen therapy is recommended.
② High flow oxygen through the nose High-flow nasal cannula oxygen therapy (HFNC), receiving
nasal cannula or mask oxygen therapy for 1 to 2 hours, oxygenation fails to meet the treatment
requirements, and there is no improvement in respiratory distress; Increased distress; or
oxygenation index of 150-200 mmHg; HFNC is recommended.
③ Noninvasive positive pressure ventilation (NPPV), receiving 1 to 2 h of HFNC oxygenation does
not achieve the treatment effect, and there is no improvement in respiratory distress; or
hypoxemia and / or exacerbation of respiratory distress during treatment; or When the
oxygenation index is 150 ~ 200 mmHg; NPPV can be selected.
④ Invasive mechanical ventilation, HFNC or NPPV treatment does not meet the treatment
requirements for 1 to 2 hours of oxygenation, and respiratory distress does not improve; or
hypoxemia and / or exacerbation of respiratory distress during treatment; or oxygenation index
<150 mmHg; invasive ventilation should be considered. Protective ventilation strategies with a
small tidal volume (4-8 mL / kg ideal body mass) as the core are preferred.

9. Implementation of ECMO: Those who meet one of the following conditions may consider
implementing ECMO.
① PaO2 / FiO2 <50 mmHg for more than 1 h;
② PaO2 / FiO2 <80 mmHg for more than 2 h;
③ Arterial blood pH <7.25 with PaCO2> 60 mmHg for more than 6 h. #
ECMO mode is preferred for intravenous-venous ECMO.

(4) Special problems and treatment in treatment
1. Application of glucocorticoids: Use glucocorticoids with caution. Imaging showed significant
progress in pneumonia. Patients with SaO2 ≤ 93% or shortness of breath (respiratory frequency ≥
30 breaths / min) or oxygenation index ≤ 300 mmHg in the state of no oxygen inhalation.
Glucocorticoids can be added at the risk of intubation. Patients are advised to withdraw promptly
from glucocorticoid use when intubation or ECMO support can maintain effective blood oxygen
concentrations. For non-severe patients using methylprednisolone, the recommended dose is
controlled at 20 to 40 mg / d, severe patients are controlled at 40 to 80 mg / d, and the course of
treatment is generally 3 to 6 days. Can be increased or decreased according to the body weight.

2. Use of immunoregulatory drugs: Subcutaneous injection of thymosin 2 to 3 times per week has
certain effects on improving patients' immune function, preventing the disease from becoming
worse, and shortening the time of detoxification. Due to the lack of specific antibodies, high-dose
intravenous immunoglobulin therapy is currently not supported. However, some patients have low
levels of lymphocytes and the risk of co-infection with other viruses. Human immunoglobulin can
be infused intravenously at 10 g / d for 3 to 5 days.

3. Accurate diagnosis and treatment of combined bacterial and fungal infections: clinical
microbiological monitoring of all severe and critically ill patients. The sputum and urine of the
patients are kept daily for culture, and the patients with high fever should be cultured in time. All
patients with suspected sepsis who have indwelling vascular catheters should be sent for
peripheral venous blood culture and catheter blood culture at the same time. All patients with
suspected sepsis may consider collecting peripheral blood for molecular diagnostic tests for
etiology, including PCR-based molecular biology testing and next-generation sequencing.
Elevated procalcitonin levels have implications for the diagnosis of sepsis / septic shock. When
patients with new type of coronavirus pneumonia get worse, there is an increase in the level of
CRP, which is not specific for the diagnosis of sepsis caused by bacterial and fungal infections.
Critically ill patients with open airways are often prone to bacterial and fungal infections at a later
stage. If sepsis occurs, empirical anti-infective treatment should be given as soon as possible. For
patients with septic shock, empirical antibacterial drugs can be used in combination before
obtaining an etiological diagnosis, while covering the most common Enterobacteriaceae,
Staphylococcus and Enterococcus infections. Patients with infection after hospitalization can
choose β-lactamase inhibitor complex. If the treatment effect is not good, or the patient has
severe septic shock, it can be replaced with carbapenem drugs. If considering enterococci and
staphylococcal infections, glycopeptide drugs (vancomycin) can be added for empirical treatment.
Daptomycin can be used for bloodstream infections, and linezolid can be used for lung infections.
Attention should be paid to catheter-related infections in critically ill patients, and treatment
should be empirically covered with methicillin-resistant staphylococci. Glycopeptide drugs
(vancomycin) can be used for empirical treatment. Candida infection is also more common in
critically ill patients. Candida should be covered empirically when necessary. Echinocin drugs can
be added. With the length of hospitalization of critically ill patients, drug-resistant infections have
gradually increased. At this time, the use of antibacterial drugs must be adjusted according to drug
sensitivity tests.

4. Nosocomial infection prevention and control:
① In accordance with the Basic System for Infection Prevention and Control of Medical
Institutions (Trial) of the National Health and Health Commission in 2019, actively implement
evidence-based infection prevention and control clustering intervention strategies to effectively
prevent ventilator-related pneumonia and Multidrug-resistant bacteria and fungal infections such
as catheter-related bloodstream infections, catheter-related urinary tract infections, carbapenemresistant
gram-negative bacilli.
② Strictly follow the National Health and Health Commission's "Technical Guide for the
Prevention and Control of New Coronavirus Infection in Medical Institutions (First Edition)",
"Guidelines for the Use of Common Medical Protective Products in the Prevention and Control of
Pneumonia of New Coronavirus Infection (Trial)" and "New Coronary Pneumonia" During the
epidemic period, the technical guidelines for protection of medical personnel (trial
implementation), strengthened process management, correctly selected and used personal
protective equipment such as masks, gowns, protective clothing, eye masks, protective masks,
gloves, and strict implementation of various disinfection and isolation measures. Minimize the risk
of nosocomial infections and prevent 2019-nCoV infections in hospitals by medical staff.

5. Treatment of infants and young children: Only mild symptomatic oral treatment is needed for
mild children. In addition to symptomatic oral administration for children with common type,
treatment with syndrome differentiation can be considered. If combined with bacterial infection,
antibacterial drugs can be added. Severely ill children are mainly symptomatic and supportive
treatment. Ribavirin injection was given antiviral therapy empirically at 15 mg / kg (2 times / day).
The course of treatment did not exceed 5 days.

(V) Treatment plan of integrated traditional Chinese and western medicine
The combination of traditional Chinese and western medicine for the treatment of new
coronavirus pneumonia can improve the synergistic effect. For adult patients, the condition can be
improved through TCM syndrome differentiation. For light patients, those with a syndrome of
wind-heat type are given the traditional Chinese medicine Yinqiaosan plus and minus treatment;
those with gastrointestinal symptoms and those with damp-wetting and yang-type syndrome are
given the addition and subtraction of Zhipu Xialing Decoction and Sanren Decoction. For ordinary
patients, those with syndromes of hot and evil stagnation of lungs can be treated with Chinese
medicine Ma Xing Shi Gan Decoction; those with syndromes of dampness and stagnation of lungs
can be treated with traditional Chinese medicine Da Yuan Yin, Gan Lu Fang Dan, etc., which can be
controlled to some extent Progression of the disease, reducing the occurrence of common to
severe; for anorexia, nausea, bloating, fatigue, anxiety and insomnia, the addition and subtraction
of Chinese medicine Xiao Chai Hu Tang can significantly improve symptoms. For severe patients, if
the fever persists, or even the high fever, bloating, and dry stools are closed, and those who are
heat-tolerant and the lungs are closed, give the Chinese medicine Dachengqi Decoction enema to
relieve fever or reduce fever, or use Chinese medicine. The treatment of Baihu Decoction,
Shengjiang San and Xuanbai Chengqi Decoction were added and subtracted to cut off the condition
and reduce the occurrence of heavy to critical illness. Children with light patients, when the
disease belongs to the defender, can be added or subtracted from Yinqiaosan or Xiangsusan.
Ordinary children, those with damp heat and closed lungs, are given Ma Xing Shi Gan Decoction
and Sanren Decoction; those with moderate scorching dampness and heat such as bloating and
vomiting with abdominal distension can be added or subtracted without changing Jinzhengqi San.
For severe patients with epidemic and closed lung (currently rare in the country), please refer to
adult Xuanbai Chengqi Decoction and Manna Disinfection Danjiao; if the poison is hot, the gas
can't pass, and the medicines are not good, the Rhubarb Decoction is given to enema for
emergency.

Translated with google translate, the whole document with precise description of diagnosis and progression as attachment.
 

Attachments

  • Expert consensus on comprehensive treatment.pdf
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tdog333

Senior Member
Messages
171
How do we sanitize mail and packages? I've heard the virus can live on surfaces for 3-9 days.

So far I've just unboxed packages on the counter, washed the bottle (inside contents) off with soap, then throw the package away and wipe the counter.

Not sure what to do about paper mail, any ideas?
 

Hip

Senior Member
Messages
18,000
I am using a 70% isopropyl alcohol 30% water solution in a spray bottle to disinfect mail as well as plastic or cardboard packaged food items bought at the supermarket. 70% ethanol + 30% water is just as good, if not better. You can buy ethanol as surgical spirit, or methylated spirits. Alcohol evaporates quite quickly from paper or cardboard.

Alcohol solution is one of the disinfectants shown effective for coronavirus in a recent study.

The study said household bleach diluted down 50:1 with water also works (household bleach is normally 5% sodium hypochlorite, and in the study they used 0.1% sodium hypochlorite). Though be careful if spraying bleach, as bleach vapor is not good for the lungs.


A recent study found that the SARS-CoV-2 coronavirus could survive 24 hours on cardboard, and 3 days on plastic and steel surfaces.
 

Martin aka paused||M.E.

Senior Member
Messages
2,291
According to the 'Expert consensus on comprehensive treatment`' out of Shanghai, a city very successful as it seems now, it it is cautioned against: whole treatment section added in below quote, the whole of it attached as pdf.



Translated with google translate, the whole document with precise description of diagnosis and progression as attachment.
Thank you! Better not to get it!
 

Wally

Senior Member
Messages
1,167
New video from Dr. John Campbell provides information about potential complications that could arise if anti-inflammatory drugs are used to treat symptoms (like fever) that are associated with this illness. Since most people have O.T.C. anti-inflammatory drugs in their medicine cabinet, it may be important to investigate with your health care provider, if the recommendation to avoid self-treating symptoms with these types of O.T.C. drugs should be folllowed.

3/16/20
 

Wally

Senior Member
Messages
1,167
Information from the Linus Pauling Institute at Oregon State University re possible drug interactions with Vitamin C and laboratory tests that may be effected by supplemental use of Vitamin C.
See, https://lpi.oregonstate.edu/mic/vitamins/vitamin-C
Drug interactions

Overall, evidence suggesting specific drugs can lower blood vitamin C concentrations in humans is limited. Dihydropyridine calcium channel blockers (e.g., nicardipine, nifedipine) can inhibit vitamin C uptake by intestinal cells in vitro. However, a reduction in blood vitamin C concentrations with these drugs has not been reported in humans (200). Aspirin can impair vitamin C status if taken frequently (201).

Conversely, there are case reports suggesting that supplemental vitamin C may lower blood concentrations of some medications, such as fluphenazine (the antipsychotic drug, Prolixin) and indinavir (the antiretroviral drug, Crixivan) (200). There is some evidence, though controversial, that vitamin C interacts with anticoagulant medications like warfarin (Coumadin). Large doses of vitamin C may block the action of warfarin and thus lower its effectiveness. Individuals on anticoagulants should limit their vitamin C intake to <1 g/day and have their prothrombin time monitored by the clinician following their anticoagulant therapy (200). In addition, vitamin C may bind aluminum in the gut and increase the absorption of aluminum-containing compounds (e.g., aluminum-containing antacids, aluminum-containing phosphate binders). People with impaired kidney function may be at risk for aluminum toxicity when supplemental vitamin C is taken at the same time as these compounds (200, 201). Finally, supplemental vitamin C may increase blood estrogen concentrations in women using oral contraceptives or hormone replacement therapy (200).

The potential effect of antioxidants during chemotherapy is not well understood, yet only likely to be an issue if a specific chemotherapeutic agent acts through an oxidative mechanism, which is uncommon (171). It is not clear whether vitamin C given parenterally could diminish or increase the efficacy of chemotherapy drugs — in particular, akylating agents (e.g., cyclophosphamide, busulfan), antitumor antibiotics (e.g., doxorubicin, bleomycin), and arsenic trioxide. Patients are advised to discuss with their oncologist before using vitamin C supplements (200, 201).

Because high doses of vitamin C have also been found to interfere with the interpretation of certain laboratory tests (e.g., serum bilirubin, serum creatinine, and the stool guaiac assay for occult blood), it is important to inform one's health care provider of any recent supplement use.
———————

Additional info. about possible drug interactions with Vitamin C.. See, https://www.pharmacytimes.com/publi...urge-patients-to-use-supplements-with-caution.

2019-11-26 13:00:04
Yvette C. Terrie, BSPharm, RPh

During cold and influenza season, many consumers elect to use various nutritional supplements marketed for immune health and support. Immune-boosting supplements may contain 1 or more of vitamins A, C, D, and E, along with trace elements of selenium and zinc. Some also contain echinacea, ginger, and other herbal ingredients for immune enhancement.
. . .
In some cases, drug-supplement interactions can be of clinical importance but often go unrecognized by many consumers and health care professionals, according to the Handbook of Drug–Nutrient Interactions.2 As a result, a drug-supplement interaction may be a contributing factor in adverse drug effects, an increased risk of toxicities, or ineffective therapy.2 This is particularly critical in certain patient populations (see table 1).2,3
. . .


1584391412959.png

. . .
—————-

https://res.mdpi.com/d_attachment/p...036/article_deploy/pharmaceutics-10-00036.pdf. (Note - Paper is 45 pages long, Vitamin C info. is on pages 6-8, 22-23.)

Evidence of Drug–Nutrient Interactions with Chronic Use of Commonly Prescribed Medications: An Update
. . .
Abstract: The long-term use of prescription and over-the-counter drugs can induce subclinical and clinically relevant micronutrient deficiencies, which may develop gradually over months or even years. Given the large number of medications currently available, the number of research studies examining potential drug–nutrient interactions is quite limited. A comprehensive, updated review of the potential drug–nutrient interactions with chronic use of the most often prescribed medications for commonly diagnosed conditions among the general U.S. adult population is presented. For the majority of the interactions described in this paper, more high-quality intervention trials are needed to better understand their clinical importance and potential consequences. A number of these studies have identified potential risk factors that may make certain populations more susceptible, but guidelines on how to best manage and/or prevent drug-induced nutrient inadequacies are lacking. Although widespread supplementation is not currently recommended, it is important to ensure at-risk patients reach their recommended intakes for vitamins and minerals. In conjunction with an overall healthy diet, appropriate dietary supplementation may be a practical and efficacious way to maintain or improve micronutrient status in patients at risk of deficiencies, such as those taking medications known to compromise nutritional status. The summary evidence presented in this review will help inform future research efforts and, ultimately, guide recommendations for patient care.
 
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Wally

Senior Member
Messages
1,167
Another video by Dr. Campbell regarding how viruses (and bacteria) are impacted by fever. This video goes along with his video linked above at post/reply #210.

Reducing Fever: Good or Bad?
 

Wally

Senior Member
Messages
1,167
More discussion on whether or not anti-inflammatory drugs should be used as a first line treatment for fever or aches/pains resulting from COVID-19 (novel coronavirus).

https://www.cnn.com/2020/03/16/heal...ench-health-minister-scn-intl-scli/index.html

CNN)France's health ministry has suggested that popular anti-inflammatory painkillers such as ibuprofen could worsen the effects of the coronavirus, raising questions over which over-the-counter drugs people should be taking to treat the symptoms of the disease.

Health Minister Olivier Veran, who has also worked as a neurologist, tweeted on Saturday that "taking anti-inflammatory drugs (ibuprofen, cortisone...) could be an aggravating factor of the infection. If you have a fever, take paracetamol. If you are already on anti-inflammatory drugs or in doubt, ask your doctor for advice."

His suggestion was criticized by some health experts, who cited the lack of publicly available evidence suggesting a link between ibuprofen and adverse effects of the coronavirus. There is currently no published scientific evidence that the virus is worsened by ibuprofen.

Nonetheless, Veran's recommendation came on the same day that the French government reported that "grave adverse effects" linked to the use of non-steroidal anti-inflammatory drugs (NSAID) -- the family of drugs that includes ibuprofen -- have "been identified with patients affected by Covid-19, in potential or confirmed cases."
"We repeat that the treatment of a fever or of pain linked to Covid-19 or to any other respiratory viral disease should be paracetamol," the ministry's new guidelinesadded. Paracetamol is typically known in the US as acetaminophen.

Veran's tweet was widely shared, particularly in France, and the advice has raised questions over the impact of ibuprofen to treat the virus. CNN has contacted the French health ministry for comment.

"Deeply concerned about this bold statement," Muge Cevik, a researcher at the University of St Andrews Infection and Global Health Division, said on Twitter. "There's no scientific evidence I am aware of that ibuprofen [causes worse] outcomes in #COVID19."

"I don't think we've had any firm evidence to suggest that [ibuprofen aggravating Covid-19] is a concern at this point," said Dr. Yvonne Maldonado, professor of pediatrics and infectious disease epidemiologist at Stanford University in California.

But other experts suggested that Veran's advice is in line with some countries' general guidance on anti-inflammatory painkillers such as ibuprofen, even if their specific connection to the coronavirus is not clear.

"There is a good reason to avoid ibuprofen as it may exacerbate acute kidney injury brought on by any severe illness, including severe Covid-19 disease. There isn't yet any widely accepted additional reason to avoid it for Covid-19," Rupert Beale, a group leader in Cell Biology of Infection at the UK's Francis Crick Institute, told the UK's Science Media Centre.

NSAIDs might affect how Covid-19 binds to human cells, according to Dr. Yogen Kanthi, assistant professor of cardiology at the University of Michigan, who studies inflammation.

"There is data from basic science studies that have shown that Covid-19 itself binds to a protein at the surface of cells called ACE2," he said. "There is a hypothetical risk that giving NSAIDs like ibuprofen could increase levels of ACE2 shown in animal models, but not in patients." . . .

There may be a risk in over-suppressing the immune response necessary to fight off the infection, according to Maldonado, "But I don't think there's any evidence so far to suggest that." . . .
 

Cipher

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Glucosamine might have antiviral effects against COVID-19 and other RNA-viruses:

MAVS O-GlcNAcylation Is Essential for Host Antiviral Immunity against Lethal RNA Viruses

Abstract

It is known that lethal viruses profoundly manipulate host metabolism, but how the metabolism alternation affects the immediate host antiviral immunity remains elusive. Here, we report that the O-GlcNAcylation of mitochondrial antiviral-signaling protein (MAVS), a key mediator of interferon signaling, is a critical regulation to activate the host innate immunity against RNA viruses. We show that O-GlcNAcylation depletion in myeloid cells renders the host more susceptible to virus infection both in vitro and in vivo. Mechanistically, we demonstrate that MAVS O-GlcNAcylation is required for virus-induced MAVS K63-linked ubiquitination, thereby facilitating IRF3 activation and IFNβ production. We further demonstrate that D-glucosamine, a commonly used dietary supplement, effectively protects mice against a range of lethal RNA viruses, including human influenza virus. Our study highlights a critical role of O-GlcNAcylation in regulating host antiviral immunity and validates D-glucosamine as a potential therapeutic for virus infections.

We reported that GlcN effectively protects mice against the lethality of a range of RNA viruses, including influenza virus, coxsackie virus, VSV, etc. In particular, GlcN shows a promising effect toward drug-resistant influenza strains. The protective effects were not observed in either Ogt-deficient mice or IFNR−/− mice, confirming that the antiviral effect of GlcN is via O-GlcNAcylation and IFN signaling.
In conclusion, we demonstrated O-GlcNAcylation is critical for MAVS-mediated host antiviral immunity and validated GlcN as a potential broad-spectrum antiviral therapeutic.

Quote from another paper discussing the study above:
This striking new finding points to the possibility that high-dose glucosamine supplementation might aid prevention and control of RNA virus infections. Whereas the hexosamine biosynthesis pathway is capable of generating UDP-N-acetylglucosamine in the absence of exogenous glucosamine, glucosamine administration can further enhance the intracellular pool of this compound, thereby boosting the extent of O-GlcNacylation evoked by viral infection.30 The dietary dose employed in this study is quite high in the context of previous clinical experience – 2.5% of a human diet providing 400 g dry weight daily would correspond to 10 g glucosamine – but an intake of 3 g daily would be practical and is within the range of previous clinical experience.31 Rather high intakes may be required for significant clinical benefit, inasmuch as this compound is rather inefficiently absorbed after oral administration.32

Tagging @Hip as I know you use N-acetyl-glucosamine. The study in question used D-Glucosamine hydrochloride, I don't know how they compare. According to examine.com, glucosamine sulfate gives higher plasma levels than glucosamine hydrochloride:
Excretion rates (urinary) between HCl and sulfate are similar[31] despite sulfate being noted to reach 6-fold higher levels in plasma than HCl following oral administration.[8]

Glucosamine sulfate salts are the best way to supplement glucosamine, with glucosamine sulfate as a close second. Glucosamine hydrochloride is ineffective. N-Acetylglucosamine is not glucosamine and should be considered a different supplement.
 
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Hip

Senior Member
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It's hard to pin down what N-acetyl-glucosamine might do for viral infections. One study found NAG inhibits the antiviral Th1 response, and inhibits Th17 as well. So that suggest it might weaken antiviral immunity. But another study found Th17 cells contribute to coxsackievirus B replication, so reducing Th17 might be antiviral.
 
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Two academic medical centers here in the Netherlands are starting a trial with a tuberculosis vaccin (BCG). 500 of their employees will be given the vaccin on a daily basis and there is also a placebo group of 500 people. The vaccin doesn’t directly destroys or protect against coronavirus , but should give a boost to the immuun system so that the progession of the symptoms is milder. Article is in Dutch unfortunately but I guess international media will pick up the story soon.

https://www.nu.nl/coronavirus/60383...-tbc-vaccin-als-bescherming-tegen-corona.html
 

Wally

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https://techcrunch.com/2020/03/18/j...rus-treatment-in-chinese-clinical-trials/amp/
Japanese flu drug appears ‘effective’ in coronavirus treatment in Chinese clinical trials

Based on results of clinical trials conducted with affected patients in both Wuhan and Shenzhen by Chinese medical authorities, Japanese-made flu drug favipiravir (also known as Avigan) has been shown to be effective in both reducing the duration of the COVID-19 virus in patients and to have improved the lung conditions of those who received treatment with the drug.

The trials involved 340 patients in total, and since the drug has already been developed and approved for use in treating flu, it has a “high degree of safety,” according to China science and technology ministry official Zhang Xinmin, who spoke to reporters on Wednesday according to The Guardian. The tests showed a reduction in the period during which patients tested positive for the new coronavirus from 11 days down to just four, and showed improvements in the lung condition of around 91 percent of patients treated with favipiravir, compared to just 62 percent for those without among the trial participants.


The Chinese studies are not the only attempt to test the efficacy of the drug in COVID-19 treatment – Japanese doctors are bonding their own studies. A Japanese health ministry source told Japanese newspaper the Manichi Shimbun that the drug so far has been given to around 70 to 80 people, but that early results suggest it isn’t effective in treating those with more severe symptoms where the virus has already multiplied to a much greater extent. . . .

Still a treatment that is effective in reducing the duration of the presence of the virus even in milder cases, and in lessening the impacts in moderate symptomatic patients, would be a huge benefit to the ongoing fight against the coronavirus. . . ,
 

Pyrrhus

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Glucosamine might have antiviral effects against COVID-19 and other RNA-viruses:
MAVS O-GlcNAcylation Is Essential for Host Antiviral Immunity against Lethal RNA Viruses

That is a fascinating paper- thank you for sharing. There are a number of dsRNA sensors in the cell, and enteroviruses appear to have ways of compromising all of them, except for MAVS. Therefore MAVS is crucial for an enterovirus-infected cell to initiate the interferon response. I had no idea that MAVS required N-acetyl-glucosamine for its function.
 
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