Skip to main content
Move the World.
Coronavirus treatment update

Lead Image © James Thew / Adobe Stock

Since January, hundreds of scientific teams and biotech companies have been developing and testing treatments for COVID-19.

Already, clinical trials have found several drugs that appear to help, lowering the risk of death, shortening hospital stays, or reducing the severity of the disease. But other once-promising COVID-19 treatments have fallen flat when tested on patients in controlled studies.

Here's our latest, evidence-based coronavirus treatment update, including the options that appear to work, those that don't, and the ones researchers still aren't sure about.

Stuff that (Probably) Works

Dexamethasone

In June, researchers involved in the United Kingdom's huge RECOVERY trial reported that dexamethasone (a cheap, readily available steroid) reduced death rates in ventilated patients by nearly one-third, from 40% to 28% — making it the first proven, life-saving coronavirus treatment.

The steroid had no benefit for patients with milder cases of COVID-19, but the researchers advised using dexamethasone to treat more severe cases.

The drug probably works by tamping down the immune system's overreaction (called a cytokine storm), which kills many patients with severe COVID-19. But for patients with less advanced cases, there would be no benefit (and possibly some harm) from reducing their immune response, so the steroid should be used as a last resort.

A month later, the researchers published their peer-reviewed study on dexamethasone in the New England Journal of Medicine, which confirmed their early data. On September 2, a meta-analysis of clinical studies undertaken by the WHO and published in JAMA found an association between dexamethasone and lower mortality rates in patients with severe cases of COVID-19.

Remdesivir

Researchers began testing the antiviral drug remdesivir on COVID-19 patients in February, encouraged by the drug's efficacy against other coronaviruses in animal testing.

In April, several groups reported that patients given the drug showed signs of improvement and quicker recovery times.

On May 1, the FDA issued the drug's maker — Gilead Sciences — an emergency use authorization for remdesivir as a potential coronavirus treatment. It followed that up on October 22 by making remdesivir its first approved treatment for COVID-19 (specifically, for hospitalized patients at least 12 years old).

Still, some studies — including a large WHO trial — have found no benefit of remdesivir for advanced cases of COVID-19. Because antiviral drugs work by slowing down the replication of the virus, they are more effective when given early on, before the body is overwhelmed with viruses.

As it stands, though, remdesivir is one of the most promising COVID-19 treatments available.

Bamlanivimab and Etesevimab

Canadian biotech firm AbCellera and U.S.-based pharmaceutical company Eli Lilly have used a blood sample from a single coronavirus survivor to develop bamlanivimab (LY-CoV555) and etesevimab (LY-CoV016), two drugs that contains a coronavirus antibody designed to prevent the virus from infecting cells.

On October 7, Eli Lilly reported that, in a study involving more than 250 non-hospitalized COVID-19 patients, participants given both bamlanivimab and etesevimab were significantly less likely to be hospitalized and had significantly lower viral levels in their nasal swabs after 11 days than patients given a placebo.

The NIH tested bamlanivimab in people with mild-to-moderate cases of COVID-19 in a Phase 2 and 3 trial (ACTIV-2) and a combination of it and remdesivir on hospitalized patients in a Phase 3 trial (ACTIV-3). It halted the testing in the ACTIV-3 trial on October 26 after determining the drug combination had no impact on patients. The ACTIV-2 trial is ongoing.

On November 9, the FDA granted bamlanivimab an emergency use authorization as a treatment for high-risk COVID-19 patients ages 12 and up with mild-to-moderate cases.

Two weeks prior, Eli Lilly said it anticipated being able to manufacture one million doses of bamlanivimab and 50,000 doses of the combination therapy (bamlanivimab and etesevimab) before the end of 2020, noting that the first 100,000 of those doses could be ready to ship within days of securing FDA authorization.

Casirivimab and Imdevimab

Bamlanivimab and etesevimab isn't the only COVID-19 antibody combo treatment under development — biotechnology firm Regeneron has created its own antibody cocktail: casirivimab and imdevimab (formerly known as REGN-COV2).

On November 21, the treatment received an EUA from the FDA, and doctors are now free to prescribe the combination of drugs to patients at least 12 years old with mild to moderate COVID-19.

On September 29, the company reported the results of a trial involving 275 non-hospitalized COVID-19 patients.

Compared to patients given a placebo, those in the active group had a quicker decrease in viral load and a faster alleviation of symptoms. The drug also had a particularly significant impact on patients whose own bodies failed to generate a strong antibody response to the coronavirus.

This suggests that the treatment "could provide a therapeutic substitute for the naturally-occurring immune response," according to Regeneron President George D. Yancopoulos.

Too Soon to Say

Convalescent Plasma Therapy

On August 23, the FDA issued a controversial emergency use authorization for transfusions of blood plasma from coronavirus survivors — also known as convalescent plasma therapy — as a COVID-19 treatment, noting that 70,000 American patients had already received it.

The path to this began in April, when two studies in China found that patients with severe cases of COVID-19 benefited from convalescent plasma therapy. The theory behind the treatment is that survivors' blood plasma has antibodies, which can help neutralize the virus in patients with active infections.

Since then, the preliminary results from studies has been mixed.

One study involving more than 35,000 patients reported that giving patients convalescent plasma within three days of diagnosis produced a statistically significant decrease in mortality compared to those given it four or more days after. However, that study has yet to be peer reviewed.

A smaller peer-reviewed study published in October 12, meanwhile, found that convalescent plasma had no effect on patients' likelihood of getting worse or dying.

However, 80% of the patients in that study already had their own coronavirus antibodies by the time they received the plasma, potentially rendering the treatment moot.

Famotidine

One of the most unlikely potential COVID-19 treatments has been famotidine, the active ingredient in the over-the-counter heartburn drug Pepcid.

Early in the pandemic, reports began circulating in China that patients who took famotidine had better outcomes. Despite only anecdotal evidence, several groups launched clinical trials to test the drug.

So far, it seems famotidine doesn't directly target the coronavirus, but it does appear to be connected to better patient outcomes.

More research is needed, though, before famotidine can be confirmed as an effective coronavirus treatment.

Favipiravir

Developed by Fujifilm Toyama Chemical in 2014 as a flu treatment, favipiravir has gotten new life as a promising coronavirus treatment.

In March, Chinese officials reported that the drug was "clearly effective" in two clinical trials involving 320 COVID-19 patients — in one of the trials, it cut the average recovery time from 11 days to just four.

Several nations, including Russia, China, and India, have since approved the drug's use as a COVID-19 treatment. It has yet to receive approval in the U.S., though, but as recently as August, new trials were still getting underway stateside.

Tocilizumab

As recently as mid-July, the rheumatoid arthritis medication tocilizumab (brand name Actemra) was looking like one of the more promising COVID-19 treatments — a retrospective study found that it appeared to decrease ventilated patients' risk of death from COVID-19 by 45%.

But just two weeks later, drugmaker Roche announced the disappointing results of a late-stage clinical trial of tocilizumab, reporting that it failed to beat a placebo at improving hospitalized patients' clinical status or reducing their chances of dying.

Tocilizumab did, however, appear to reduce the amount of time COVID-19 patients spent in the hospital — from an average of 28 days down to 20.

On October 20, JAMA Internal Medicine published three studies in which researchers gave the drug to COVID-19 patients with pneumonia. The first found that it may reduce mortality somewhat, the second that it had no benefit on disease progression, and the third that it might reduce a patient's risk of death or needing ventilation.

All three noted that more research is needed, but other trials of the arthritis drug are ongoing, so there is a chance it could still emerge as a useful coronavirus treatment.

Interferons

Interferons are immune proteins that help fight infections by interfering with a virus’s ability to replicate. Studies have shown that they could be useful as a COVID-19 treatment — but the timing of the delivery is key.

If given soon after a patient contracts COVID-19, they appear capable of providing an immune boost that can speed up recovery.

But because one of the hallmarks of COVID-19 is its ability to cause a harmful overreaction of the immune system — a cytokine storm — a late delivery of interferons could make an illness worse.

Several studies of interferons are still ongoing — including one testing its ability to boost the benefits of remdesivir — so we’ll likely learn more about their utility as a COVID-19 treatment in the near future.

Very Doubtful

Chloroquine / Hydroxychloroquine

In lab studies, the malaria drug chloroquine showed promise in preventing and treating SARS infections, making it a solid candidate as a novel coronavirus treatment.

In March, the FDA granted chloroquine and its alternative formulation, hydroxychloroquine, emergency use authorizations, clearing doctors to prescribe both as COVID-19 treatments, often combined with zinc or the antibiotic azithromycin.

However, the drugs failed to live up to their promise during rigorous clinical testing, and the FDA revoked the authorizations on June 18.

Multiple studies around chloroquine have been corrected, withdrawn, criticized, or retracted, including two papers in the Lancet and NEJM that claimed the drug increased the risk of dying for COVID-19 patients.

Lopinavir and Ritonavir

In January, China began recommending that doctors treat COVID-19 patients with the HIV drugs lopinavir and ritonavir. By March, several research groups were testing the drug combination's efficacy in clinical trials.

Early reports from those trials were disappointing, though, and the ones that trickled in over the next few months were no better. In July, the WHO announced it was officially discontinuing the lopinavir/ritonavir arm of its massive SOLIDARITY trial.

We'd love to hear from you! If you know about a coronavirus treatment update we missed or if you have a tip for a future Freethink story, please email us at [email protected].

Up Next

If you want to understand a problem, talk to the people working on solutions. Join us as we meet the people and explore the ideas on the frontlines of an unprecedented global response.

Coronavirus
Updated Coronavirus Vaccine List: Where We Stand Today
Coronavirus Vaccine List
Coronavirus
Updated Coronavirus Vaccine List: Where We Stand Today
A regularly updated coronavirus vaccine list highlighting the candidates closest to receiving approval from regulators.

A regularly updated coronavirus vaccine list highlighting the candidates closest to receiving approval from regulators.

Coronavirus
Robots Are Running COVID-19 Drug Development
COVID-19 Drug Development
Coronavirus
Robots Are Running COVID-19 Drug Development
IBM’s new online platform, RoboRXN, combines artificial intelligence, cloud computing, and robotics to automate the COVID-19 drug development process.

IBM’s new online platform, RoboRXN, combines artificial intelligence, cloud computing, and robotics to automate the COVID-19 drug development process.

Coronavirus
“Antibody Inhaler” Could Rapidly Treat—and Prevent—COVID-19
antibody inhaler
Coronavirus
“Antibody Inhaler” Could Rapidly Treat—and Prevent—COVID-19
Scientists have discovered a new antibody therapy that can be inhaled to provide treatment and temporary immunity to the coronavirus.
By Sarah Wells

Scientists have discovered a new antibody therapy that can be inhaled to provide treatment and temporary immunity to the coronavirus.

Coronavirus
How To Stop COVID-19's Killer Cytokine Storm
cytokine storm
Coronavirus
How To Stop COVID-19's Killer Cytokine Storm
COVID-19 can cause a potentially lethal cytokine storm, a runaway immune system response. Researchers are studying drugs they hope can calm the storm.

COVID-19 can cause a potentially lethal cytokine storm, a runaway immune system response. Researchers are studying drugs they hope can calm the storm.

Public Health
Doctors Use AI to Test New Coronavirus Treatments on Patients
Coronavirus Treatments
Public Health
Doctors Use AI to Test New Coronavirus Treatments on Patients
The University of Pittsburgh Medical Center launched a new trial that uses artificial intelligence to test promising coronavirus treatments as quickly as possible.

The University of Pittsburgh Medical Center launched a new trial that uses artificial intelligence to test promising coronavirus treatments as quickly as possible.

Coronavirus
Immune Proteins Show Promise as COVID-19 Treatment
COVID-19 Treatment
Coronavirus
Immune Proteins Show Promise as COVID-19 Treatment
Immune proteins called interferons appear useful as a COVID-19 treatment if given to patients before an infection becomes severe.

Immune proteins called interferons appear useful as a COVID-19 treatment if given to patients before an infection becomes severe.

Public Health
Plasma from Coronavirus Survivors Helps Sick Patients Recover
Plasma from Coronavirus Survivors
Public Health
Plasma from Coronavirus Survivors Helps Sick Patients Recover
Two studies in China found that plasma from coronavirus survivors helps patients with severe cases of COVID-19 recover within days of treatment.

Two studies in China found that plasma from coronavirus survivors helps patients with severe cases of COVID-19 recover within days of treatment.

Public Health
A List of the Coronavirus Symptoms, and When to See a Doctor
what are the coronavirus symptoms
Public Health
A List of the Coronavirus Symptoms, and When to See a Doctor
Here is the latest information on coronavirus symptoms and how to distinguish COVID-19 from allergies, the flu, or a common cold.

Here is the latest information on coronavirus symptoms and how to distinguish COVID-19 from allergies, the flu, or a common cold.

Robotics
Spain Will Use Robots to Increase Coronavirus Testing
Coronavirus Testing
Robotics
Spain Will Use Robots to Increase Coronavirus Testing
Spain is buying a fleet of robots to increase coronavirus testing from 20,000 COVID-19 tests daily to 80,000, according to officials.

Spain is buying a fleet of robots to increase coronavirus testing from 20,000 COVID-19 tests daily to 80,000, according to officials.