German doctors on vaccination and treatment of covid – in detail and without embellishment. The most important techniques and drugs in the general instructions they use.
Over the past year and a half, says DW, doctors around the world have made some progress in treating all forms of coronavirus and its strains. However, they remain convinced that vaccines are the most effective method of combating COVID.
Vaccination prevents or alleviates severe illness, so you should not push the situation to the point where intensive therapy is required to treat covid. But so far, unfortunately, universal vaccination is not possible. To date, 5 billion doses of covid vaccine have been used, but primarily in wealthy countries. If we consider that each person needs 2 vaccinations, then this amount is enough for only 1/3 of the world’s population.
Approximately 650,000 people worldwide fall ill with covid every day. About 5% of those infected have a severe illness in which intensive care is used. As of August of this year, almost 10 thousand people in the world die from the effects of covid every day.
When doctors need help
If breathing problems occur, the patient needs urgent medical attention. The decisive factor for hospitalization is rapid breathing and less than 90% of blood oxygen saturation. In this case, the patient is admitted to the intensive care unit, since the lungs can no longer deliver the required amount of oxygen to the blood and hypoxemic respiratory failure occurs. In this case, there is often an acute shortage of air and respiratory failure, fresh air does not reach the depth of the lungs, which lose their ability to supply oxygen, and they refuse.
X-rays can help identify damage to the lungs. At this stage, it is about saving lives. Patients need to receive oxygen artificially so that, even if the lungs are damaged, the blood is enriched with it. Usually a probe or oxygen mask is used for this. In severe cases, a tube is pulled through the mouth or nose to the patient so that he can breathe, which goes to the trachea. With the help of it, oxygen, at a certain pressure, fills the lungs. When the patient lies on their stomach during the procedure, the chances of survival are increased.
Preparations for heavy covid
Heparin is given as maintenance therapy to reduce the risk of thrombosis. The corticosteroid dexamethasone or the glucocorticoid hydrocortisone act as immunomodulators, preventing inflammation. However, this is not a panacea for the treatment of severe forms of the disease. In patients receiving artificial respiration, they reduce mortality by about 3-12%. This is too little, but, doctors say, it is better than nothing. The above drugs are affordable and well tolerated.
To maintain immunity, doctors use the drug tocilizumab together with dexamethasone. It is based on monoclonal antibodies, and in patients receiving artificial oxygen and whose condition worsens, it can help prevent death. In other cases, the drug is not recommended for use.
Monoclonal antibodies in the treatment of coonavirus
Monoclonal antibodies are on the list of encouraging drugs in the treatment of covid, since they act directly on the causative agent of the disease. For example, Donald Trump was treated with REGN-COV2 (manufactured by Regeneron). A substance from a mixture of 2 monoclonal antibodies has received emergency access for use in the United States.
Studies have shown that the use of monoclonal antibodies reduces the risk of developing a severe form of the disease in the case when the symptoms have not yet appeared. If the manifestations of the disease are already present, then they contribute to a faster recovery. However, doctors in Germany do not include the drug on the recommended list.
Bamlanivimab is a drug that acts in a similar manner to REGN-COV2, but is based on a spike protein. German doctors do not recommend it in the treatment of severe forms of the disease due to undesirable side effects, but make an exception for patients at risk. They assume that those who develop antibodies early enough will experience only mild symptoms of the disease, or none at all.
Antibody plasma treatment
The method, which showed great promise, did not justify itself in reality. The idea of a blood transfusion from a recovered person with enough antibodies to boost immunity did not show the benefits of this technique. Neither a decrease in mortality nor an improvement in the condition of patients was observed. In addition, side effects have been reported.
Drugs that have not justified themselves
A number of drugs that raised hopes for their effectiveness in covid did not live up to expectations. This list includes, for example, the antibiotic azithromycin, which is commonly used for bacterial pneumonia. Or the anti-parasite agent ivermectin. Doctors do not recommend vitamin D3 for the treatment of hospitalized patients. Ritonavir and lopinavir, chloroquine and hydroxylchlorochil, the anti-inflammatory drug anakinra were ineffective.
Faster recovery is provided by the use of baricitinib in combination with remdesivir, but these drugs do not affect the prevention of death. In German clinics, remdesivir is not used to treat coronavirus.