Since December 2019, a new infection caused by a previously unknown coronavirus now known as Covid-19 has appeared in Wuhan, a city of 11 million people in central China.
Most of the earliest cases were related to exhibits at a seafood and live animal market in Wuhan. As of February 20, 2020, the Chinese authorities and the John Hopkins University site, which allows the epidemic to be monitored in real time, reported 75,778 cases, 2,130 deaths and the spread of the virus in 29 countries including France (12 cases). , Hong Kong, Macao, Taiwan, Thailand, Japan, South Korea, United States, Vietnam, Singapore, Nepal, Australia, Canada, etc.
The pathogen was quickly identified on 01/10/2020 as a new coronavirus (Covid-19), closely related to the CoV of Severe Acute Respiratory Syndrome (SARS-CoV). The new virus shares a genome sequence analogy of 80% and 96.3% genomic similarity to the BatCoV RaTG13 sequence from the bat. What makes it a circulating virus and not the fruit of a recent recombination, a fortiori of laboratory, as one hears it in the flow of fake news associated with the epidemic.
No specific treatment currently
Currently, there is no specific treatment against coronaviruses and therefore against this new virus. Covid-19 belongs to the beta-coronavirus family which also contains the SARS CoV (2002-2003) and the Middle East respiratory syndrome CoV (MERS-CoV, 2012). Firms around the world are urgently trying to identify effective antiviral agents to fight the disease. Either by taking up molecules active against other viruses – HCV, HIV, H1N1 virus, CMV, Ebola virus, etc. – or by screening the viral cultures of Covid-19, all the molecules they have. This is how AZT, the first antiretroviral drug used to treat HIV infection, was discovered, as well as non-nucleoside reverse transcriptase inhibitors. Some research also uses an immunotherapeutic approach: monoclonal antibodies or immunoglobulins from cured patients. Even traditional medicine is part of certain Chinese tests.
38 scheduled tests
On the very official NIH site in the United States, there are as of 20/02/2020 no less than 38 trials scheduled, or in progress, on the Covid-19 (see table 1).
Several drugs, such as ribavirin and interferons, active against the hepatitis C virus, but also lopinavir-ritonavir (Kaletra®) or darunavir (Prezista®), drugs against HIV, or even the booster present in the Genvoya® (cobicistat), are on the list of molecules under study in vivo. Protocols with Kaletra® had already been launched in the case of MERS-Cov in 2016, such as the MIRACLE trial, in Saudi Arabia, with results which, if they had held a miracle, would have already been published … L effectiveness of other FDA-approved drugs has also been evaluated in several studies in vitro ribavirin, penciclovir, nitazoxanide, nafamostat, chloroquine and two well-known broad-spectrum antiviral drugs, oseltamivir (for flu), remdesivir for ebola, and favipiravir (T-705), are all tested against a clinical isolate of Covid-19 in vitro. Standard tests have been performed to measure the effects of these compounds on cytotoxicity, viral yield and infection rates of the virus which was first called 2019-nCoV. Remdesivir appears to be recognized as a promising antiviral drug against a wide range of RNA virus infections (including SARS / MERS-CoV5) in cultured cells, mice and non-human primate models. It is currently under clinical development for the treatment of Ebola virus infection.
However, there is nothing to write that anti-HIV molecules are in a good place for anti-coronavirus therapeutic research. A comparative study carried out by TP Sheahan on in vitro models of MERS-CoV has shown that “remdesivir (RDV) and interferon beta (IFNb) have superior antiviral activity than lopinavir (LPV) and ritonavir (RTV) in vitro. In mice, prophylactic and therapeutic RDVs improve lung function, and reduce pulmonary viral load and severe lung disease. On the other hand, prophylactic LPV / RTV-IFNb slightly reduces viral loads without impacting the other parameters of the disease. Therapeutic LPV / RTV-IFNb improves lung function but does not reduce virus replication or severe pulmonary pathology” (figure 1).
What largely temper the questioning, on social networks, of some people living with HIV and treated or on PrEP who want to know if they are protected from coronavirus. For the time being, certainly not.
To know more
Bibliography
Paraskevis D, Kostaki EG, Magiorkinis G, Panayiotakopoulos G, Sourvinos G, Tsiodras S. Full-genome evolutionary analysis of the novel coronavirus (2019-nCoV) rejects the hypothesis of emergence as a result of a recent recombination event. Infect Genet Evol. 2020 Jan 29; 79: 104212. doi: 10.1016 / j.meegid.2020.104212
Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, Ren R, Leung KSM, Lau EHY, Wong JY, Xing X, Xiang N, Wu Y, Li C, Chen Q, Li D, Liu T , Zhao J, Li M, Tu W, Chen C, Jin L, Yang R, Wang Q, Zhou S, Wang R, Liu H, Luo Y, Liu Y, Shao G, Li H, Tao Z, Yang Y, Deng Z, Liu B, Ma Z, Zhang Y, Shi G, Lam TTY, Wu JTK, Gao GF, Cowling BJ, Yang B, Leung GM, Feng Z. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N Engl J Med. 2020 Jan 29. doi: 10.1056 / NEJMoa2001316
Sheahan TP, Sims AC, Leist SR, Schäfer A, Won J, Brown AJ, Montgomery SA, Hogg A, Babusis D, Clarke MO, Spahn JE, Bauer L, Sellers S, Porter D, Feng JY, Cihlar T, Jordan R , Denison MR, Baric RS. Comparative therapeutic efficacy of remdesivir and combination lopinavir, ritonavir, and interferon beta against MERS-CoV. Nat Commun. 2020 Jan 10; 11 (1): 222. doi: 10.1038 / s41467-019-13940-6.
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