THE “VIRUS FROM WUHAN” OR THE “WUHAN VIRUS”

 

 

Six men entered an abandoned copper mine to clear bat excreta in provide of Yunnan in China sometime in 2012. All six soon became sick with pneumonia and 3 died. Bloods were sent to rule out dengue, Japanese encephalitis, Nipah virus, hepatitis B, hepatitis C and HIV, all turned out negative. It was decided to check for coronavirus antibodies too; this turned out to be positive. Chinese virologists could soon isolate a new coronavirus and named this “RaCoVBT4991.”

 

By 2018 a new biosafety level 4 lab was ready in the city of Wuhan. Extensive research in bat coronavirus started in this lab. Research in increasing the capacity of coronavirus to latch on to human cells were performed routinely and numerous papers demonstrating “gain of function” were published in leading scientific journals like Science and Nature.

 

Some of these papers were co authored by American scientists. It was also well known that the US government gave grants for such research in the hundreds of millions of Dollars. Dr.Anthony Fauci was not only aware of these grants but actually facilitated them.

VOLUME 21 | NUMBER 12 | DECEMBER 2015 nature medicine

The “gain of function” technique means the combination of bits of genes of different coronaviruses in order to make the recombined new virus more aggressive and infectious. The coronavirus is able to enter human cells by the spikes covering it. These spikes home on to receptor molecules called ACE2. The ACE2 receptors are present in the throat, respiratory passages, heart, kidney, blood vessels, intestine ,liver and also the brain.

 

22 JUNE 2012 VOL 336 SCIENCE www.sciencemag.org

 

Almost all experiments on coronaviruses therefore entailed making the spikes on the virus become more capable of penetrating human ACE2 receptors. One study published explained how a part of the spike making gene in a bat coronavirus was combined with a mouse coronavirus gene, and this new creation had much greater capacity to engage with human ACE 2 receptors, apart from making mice very ill.

 

The other technique that makes a virus more pathogenic is termed “passaging.” A Dutch team were pioneers in “passaging.” These scientists had the dubious distinction of taking the H5N1 (avian flu) virus and infection a series of 10 ferrets. The procedure required a ferret to be infected by H5N1, then the virus was retrieved from the first ferret and injected into a second ferret and then once again the virus was isolated to be injected into the third ferret, and so on. It was documented that by the time the 10th ferret was infected the H5N1 virus had mutated enough to infect another ferret through air ! The scientists in Amsterdam had made the H5N1 virus airborne.

 

The H5N1 virus has a case fatality rate of almost 70%. Luckily it is not airborne and is as yet not a human pathogen. It infects humans in close and prolonged contact with chicken. The scientific world was more than a bit alarmed when they learnt that by infecting 10 ferrets one after the other one could convert the H5N1 virus into an airborne one. The ramifications were scary; the Americans suspended all such experiments on enhancing viruses within their shores from 2014 to 2017. During this period they financially supported Chinese scientists to continue with the techniques of making viruses more lethal, under the pretext of making new therapeutics and vaccines.

 

Interestingly when the Covid-19 Pandemic broke out, the new coronavirus for some very strange reasons was named “SARS-CoV-2” after the coronavirus that caused severe acute respiratory syndrome or SARS in 2012. This now seems very odd because genomic similarity between SARS-2 and SARS-1 is a mere 79%. But similarity of genome with the 2013 Yunnan virus is a whopping 96.2%!

 

Intriguingly albeit the Chinese scientists mentioned the RaCovBT4991 in their paper on bat coronaviruses, they conveniently never informed the world of its lethality. Remember 3 of 6 people infected had died in 2013 after being infected by the bat coronavirus. Also somewhere down the line the Chinese renamed RaCovBt4991 to RaTG13. We will hence focus our attention on RaTg13.

 

A paper was published 4 days ago in Nature by a group from the UK that compared infectivity of so called SARS-CoV-2 with RaTg13. The researchers concluded that the virus causing the current havoc across the planet is 1000 times more capable of latching on to human ACE 2. The chances of a virus with 96.2% genomic similarity to mutate within only 8 years to the new coronavirus are extremely remote. Such a mutation would normally take more than 5 to 7 decades at least. There is therefore human hand at play here, which has made the spikes of the Pandemic virus ferociously aggressive and infective.

 

I would be inclined to rename SARS-CoV-2 to something else only based upon its genetic characteristics.

 

Lancet Psychiatry 2020
PublishedOnline
June 25, 2020 https://doi.org/10.1016/ S2215-0366(20)30287-X

 

Also SARS (caused SARS-CoV-1) presents with fever , body aches and pneumonia. The clinical presentation was restricted to thesis features. The 2019 coronavirus, however, manages to attack multiple other organs. For instance the brain can be affected without pneumonia. Patients may have stroke or even severe psychiatric changes. Inflammation of the brain can be confirmed by a brain MRI or presence of the virus in the CSF. A paper including 150 such patients has already been published.

 

Almost a third of serious patients admitted in intensive care have been found to have cardiac abnormalities. These patients have raised troponin levels, and impaired heart function. There may be patients who have acute myocarditis (inflammation) without any fever or pneumonia. Myocarditis has been confirmed by heart MRI. Causation of myocarditis is confirmed by ruling the role of other viruses such as HIV, Hep B,Hep C, cardiotropic virus and Lyme disease. Covid-19 was confirmed by the PCR test.

 

Lancet 2020; 395: e116

 

Patients may suffer heart attack directly by the new corona virus which destabilises the plaque in the coronary artery or indirectly by increasing work load of the heart , and also by making the blood more coagulable. These changes may be sen in absence of pneumonia; hence an astute clinician will always be on the look out for the new coronavirus when confronted with a heart attack, irregular rhythm, or heart failure.

 

 

Almost 35% patients admitted in New York hospitals had acute kidney injury and 14% needed dialysis. This virus can directly attack kidneys or compromise blood vessels supplying them.

 

Autopsies have confirmed the presence of a diffuse vasculitis or inflammation of medium and small sized blood vessels. Endotheliitis has been seen in vessels of almost organs. Infallmation of blood vessels leads to small and big blood clots that amplify the disease and worsen prognosis. Empirical low molecular weight heparin is advised but effectiveness is unknown.

The new coronavirus can directly destroy pancreas cells that produce insulin and also indirectly by interleukin 6 (IL6) , which is a pro inflammatory protein. This results in raised blood sugar demanding more insulin in patients with diabetes. Blood sugar can also be found increased in patients with previously normal blood sugars.

 

 

 

Anti-diabetes treatment should ideally be insulin , because almost all other drugs may impair other organs. Sulfonylureas for example may affect cardiac function, while SGLT2 inhibitors may play havoc with kidneys or create ketosis.

 

The reason I have enumerated the different organs affected by Covid 19 is to make clear that this disease is clinically far removed from SARS. There is little clinical resemblance to SARS and therefore the current given name of the new coronavirus is quite illogical to say the least.

 

It should be emphasised that multisytem involvement is seen in the minority of patients admitted in intensive care. The majority of patients have mild or no symptoms. Also fatality rate in India is amazingly lows compared to Western nations; new cases per day in Delhi have been steadily falling since June 23rd from 4000 a day to 1250 2 days ago.

 

The new virus bears little genomic resemblance to SARS, and also has distinct clinical characteristics. It therefore should be renamed. This may not be politically correct but we do have the “Delhi belly”or the travellers’ diarrhoea. The WHO has or will be dispatching a fact finding mission of an epidemiologist and an animal health expert to confirm whether this new virus originated from an animal. Curiously, the Wuhan Institute of Virology will not be investigated.

 

The new coronavirus should not be called SARS-CVoV-2. A much more appropriate name would be the “Yunnan Virus” or the “Wuhan Virus.”

COVID 19:THE INDIAN (ICMR) VACCINE TO BE LAUNCHED BY 15th AUGUST 2020

https://youtu.be/lhJfX-o5itI

 

 

The ministry of health and the Indian Council of Medical Research have despatched an astounding letter to “Dear colleagues” to “envisage ” public health use of the Indian vaccine no later than 15th August 2020, “after completion of all clinical trials.” The letter goes on to warn the recipients that “non-compliance will be viewed very seriously.” Obviously all science has been thrown to the winds on demanding a vaccine for public health use latest by 15th August 2020. The tenor of the letter is more in the realm of extortion than scientific communication.

A vaccine like any new drug mandates 3 phases of clinical trials ; phase 1 to assess safety, phase 2 to check efficacy and then a phase 3 trial in tens of thousands of participants to check for both safety and efficacy. The 3 phases just CANNOT be done in 5-6 weeks.

The health secretary could be pardoned because he obviously has no idea of vaccines or clinical trials, but for the director general of the Indian Council of Medical Research to pen such a letter is laughable.

References:-

1)ChAdOx1 nCoV-19 vaccination prevents SARS-CoV-2 pneumonia in rhesus macaques bioRxiv preprint doi: https://doi.org/10.1101/2020.05.13.09….

2)Safety, tolerability, and immunogenicity of a recombinant adenovirus type-5 vectored COVID-19 vaccine:a dose-escalation, open-label, non-randomised, rst-in-human trial. Lancet 2020; 395: 1845–54

3)Trial of Moderna Covid-19 vaccine delayed, investigators say, but July start still possible By Damian Garde @damiangarde. STAT, July 2, 2020

4)Doubts over Oxford vaccine as it fails to stop coronavirus in animal trials. The Telegraph 18 May 2020.

 

 

COVID 19 :WAS THE VIRUS LEAKED FROM WUHAN INSTITUTE OF VIROLOGY?

 

 

Tweaking or tinkering with the beta coronavirus is not very difficult. Numerous papers published in peer reviewed scientific journals have reported the techniques of “passaging” and “gain of function.” These techniques can make the bat coronavirus more infective and also more lethal. The Wuhan Institute of Virology is the leading centre for research to increase capability of bat coronaviruses to infect humans. The Americans have pumped in more than $ 7 million into the Wuhan Institute of Virology. No wonder no investigation will ever confirm whether SARS-CoV-2 is “accidental” , “natural” or “deliberate.” Experiments enhancing lethality of viruses MUST STOP immediately.

References:-

1:COVID-19 in children and adolescents in Europe: a multinational, multicentre cohort study Lancet Child Adolesc Health 2020 Published Online June 25, 2020 https://doi.org/10.1016/ S2352-4642(20)30177-2

 

2:Childhood Multisystem Inflammatory Syndrome — A New Challenge in the Pandemic This editorial was published on June 29, 2020, at NEJM.org.

3:Multisystem Inflammatory Syndrome in U.S. Children and Adolescents This article was published on June 29, 2020, at NEJM.org. DOI: 10.1056/NEJMoa2021680

4:Multisystem Inflammatory Syndrome in Children in New York State This article was published on June 29, 2020, at NEJM.org. DOI: 10.1056/NEJMoa2021756

5:Airborne Transmission of Influenza A/H5N1 Virus Between Ferrets 22 JUNE 2012 VOL 336 SCIENCE www.sciencemag.org

6:A SARS-like cluster of circulating bat coronaviruses shows potential for human emergence Vineet D Menachery1, Boyd L Yount Jr1, Kari Debbink1,2, Sudhakar Agnihothram3, Lisa E Gralinski1, Jessica A Plante1, Rachel L Graham1, Trevor Scobey1, Xing-Yi Ge4, Eric F Donaldson1, Scott H Randell5,6, Antonio Lanzavecchia7, Wayne A Marasco8,9, Zhengli-Li Shi4 & Ralph S Baric1,2 VOLUME 21 | NUMBER 12 | DECEMBER 2015 nature medicine

7:A pneumonia outbreak associated with a new coronavirus of probable bat origin 270 | Nature | Vol579 | 12March2020

8:The Re-Emergence of H1N1 Influenza Virus in 1977: A Cautionary Tale for Estimating Divergence Times Using Biologically Unrealistic Sampling Dates PLoS ONE | www.plosone.org 1 June 2010 | Volume 5 | Issue 6 | e11184

9:Coexistence of multiple coronaviruses in several bat colonies in an abandoned mineshaft Xing-Yi Ge1#, Ning Wang1#, Wei Zhang1, Ben Hu1, Bei Li1, Yun-Zhi Zhang2,3, Ji-Hua Zhou2, Chu-Ming Luo1, Xing-Lou Yang1, Li-Jun Wu1, Bo Wang1, Yun Zhang4, Zong-Xiao Li4, Zheng-Li Shi1* VIROLOGICA SINICA 2016, 31 (1): 31–40 DOI: 10.1007/s12250-016-3713-9

10:The possible origins of 2019-nCoV coronavirus Preprint · February 2020 DOI: 10.13140/RG.2.2.21799.29601

11:Dr. Fauci Backed Controversial Wuhan Lab with U.S. Dollars for Risky Coronavirus Research BY FRED GUTERL ON 4/28/20 AT 2:57 PM EDT; NEWSWEEK

12:CORONAVIRUS Cryo-EM structure of the 2019-nCoV spike in the prefusion conformation Wrapp et al., Science 367, 1260–1263 (2020) 13 March 2020 1 of 4

13:Functional assessment of cell entry and receptor usage for SARS-CoV-2 and other lineage B betacoronaviruses NAtuRe MiCRoBioLogy | VOL 5 | MARcH 2020 | 562–569 | www.nature.com/naturemicrobiology

 

 

COVID 19: IS TIME TO THINK OF REOPENING SCHOOLS ?

 

 

 

The RT-PCR test is not a foolproof test; therefore the CDC, FDA , and local certified labs add the caveat that a positive test does not exclude infection by another virus or bacteria, also a positive test does not confirm cause of symptoms or disease is SARS-CoV-2. Life must go on, especially in India where mortality by Covid-19 is remarkably low, despite millions being infected. The doomsayers conveniently forget to mention the low death rate in Indians. It is high time serious thought was given to opening of schools , or else a generation of children will have their future seriously dented. Schools are opening up in many countries of the world. There is ample data that children are infected significantly less than adults, if infected they shrugged off the virus admirably well, very few succumb to the disease. Schools are a vital part of a child’s growth, educationally, socially and emotionally. Friendships are made for life and a child gets to realise her or his trajectory in life. Disruption of schools will particularly affect millions of poor children who seem to have no one to speak on their behalf. Online teaching is no match for the classroom, and poor children have no access to the internet.

 

References:-

 

1:Protecting the psychological health of children through effective communication about COVID-19 Lancet Child Adolesc Health 2020 Published Online March 31, 2020 https://doi.org/10.1016/ S2352-4642(20)30097-3

2:Mental health considerations for children quarantined because of COVID-19 Lancet Child Adolesc Health 2020 Published Online March 27, 2020 https://doi.org/10.1016/ S2352-4642(20)30096-1

 

3:Kawasaki-like multisystem in ammatory syndrome in children during the covid-19 pandemic in Paris, France: prospective observational study : BMJ2020;369:m2094 http://dx.doi.org/10.1136 bmj.m2094

4:Research Shows Students Falling Months Behind During Virus Disruptions Published June 5, 2020 Updated June 6, 2020, The New York Times.

5:Changes in contact patterns shape the dynamics of the COVID-19 outbreak in China Cite as: J. Zhang et al., Science 10.1126/science.abb8001 (2020).

6:Short Communication: Submitted to Osong Public Health and Research Perspectives Coronavirus disease-19: The First 7,755 Cases in the Republic of Korea medRxiv preprint doi: https://doi.org/10.1101/2020.03.15.20….

7:Covid-19 outbreak in Vo, Italy medRxiv preprint doi: https://doi.org/10.1101/2020.04.17.20….

8:Age specificity of cases and attack rate of novel coronavirus disease (COVID-19) medRxiv preprint doi: https://doi.org/10.1101/2020.03.09.20….

9:Lockdown is not egalitarian: the costs fall on the global poor June 19, 2020 https://doi.org/10.1016/ S0140-6736(20)31422-7 www.thelancet.com

10:Epidemiology and transmission of COVID-19 in 391 cases and 1286 of their close contacts in Shenzhen, China: a retrospective cohort study.

11:Lancet Infect Dis 2020 Published Online April 27, 2020 https://doi.org/10.1016/ S1473-3099(20)30287-5

 

12:School Children Don’t Spread Coronavirus, French Study Shows By Marthe Fourcade June 23, 2020, 6:41 PM GMT+5:30; Bloomberg

13:Determining the optimal strategy for reopening schools, work and society in the UK: balancing earlier opening and the impact of test and trace strategies with the risk of occurrence of a secondary COVID-19 pandemic wave medRxiv preprint doi: https://doi.org/10.1101/2020.06.01.20….

14:Dong Y MX, Hu Y, et al. Epidemiology of COVID-19 among children in China. Pediatrics. 2020.

15:Lu X, Zhang L, Du H, Zhang J, Li YY, Qu J, et al. SARS-CoV-2 Infection in Children. N Engl J Med. 2020.

16:Cai J, Xu J, Lin D, Yang Z, Xu L, Qu Z, et al. A Case Series of children with 2019 novel coronavirus infection: clinical and epidemiological features. Clin Infect Dis. 2020.

17:COVID-19 in children and adolescents in Europe: a multinational, multicentre cohort study Lancet Child Adolesc Health 2020 Published Online June 25, 2020 https://doi.org/10.1016/ S2352-4642(20)30177-2

 

Lockdown, Shutdown, Breakdown: India’s COVID Policy Must Be Driven By Data, Not Fear

A lockdown cannot be imposed on a whim or gut feeling. Crucially, it should never be imposed to garner approval ratings. There has to be a science behind it; the decision must be evidence based, not a reflection of a house constructed from sand. The lockdown in India, now all set to enter its fourth stage, is laughable. It was imposed from March 25. As per the WHO, there had been a total of 434 cases till that day, with a cumulative 9 deaths. Italy had 63,927 cases with 6077 deaths, and the US had 42,164 cases and 571 deaths.

THE PERILS OF MATHEMATICAL MODELS SHOULD HAVE BEEN OBVIOUS.



 

Finally both The Times of India (18th June 2020) and The Indian Express (19th June 2020) have cited an editorial published by the Indian Journal of Medical Research that all mathematical models on the Covid-19 pandemic were incorrect, and worse carry a “strong element of bias.”

 

Sadly the edit does not provide any further elaboration on this “bias”. It was expected that the authors dived deep into their “bias” hypothesis. Especially because of the fact that the numbers sprayed by the doomsayers have just not materialised. The exaggeration was so obvious that it took ones breath away. Data from all over the world kept pouring in that mortality in Covid-19 ranged around 1-2 infected per thousand, at times even less than this. But the doom sayers persisted with their doom and gloom predictions as recently as this week.

 

Astonishingly the doomsayers have been provided platforms by the media all these months. The predictions made for terrifying headlines. The protocol in the media was rapidly established, the bigger the numbers for people infected , the greater would be force the force behind the news stories published and interviews recorded.

 

Editors scrambled without exception to provide more and more sensational headlines. No one questioned the source of these deeply flawed models. Neither has this editorial. The authors of the editorial need to answer as to why they presume there was a strong bias by the modellers ? What is a weak “bias?” What were the forces behind the “bias?” Does it really matter whether the modellers were from the university of Kurukshetra or the University of Washington? Was there any influence of these modellers with “bias” on the ICMR?

 

Who funds these newly established non governmental centres for disease control in India? These are some hard questions that need to be checked. Did the media inadvertently provide publicity to these modellers? Or were they hand in glove? Did the editors not realise that despite large-scale infectivity the death rate of the SARS-CoV-2 was very low amongst Indians. As opposed to death rate in Western countries of 3 figures per million, the Indian death rate has been a single digit per million of the population.

 

As of today there have been 12,605 deaths in India at a rate of 9 per million. A remarkably low number but true. There is always the probability that a considerable number of these deaths may be with Covid-19 virus as a bystander, rather than because of it. The modellers however has predicted lakhs of deaths.

 

Unfortunately these modellers were taken at face value, and not unlike the rest of the world, the government was compelled to over react. Who wants lakhs of deaths on their watch? Certainly no sane or responsible government. The English government responded to the Imperial college “document” as did we to our own brilliant modellers. The repercussions will be felt far and wide and sadly for a long time.

 

It is so obvious that lakhs of business lie ruined, lakhs of people were forced to literally walk thousands of kilometres back to their villages. Hundreds succumbed in the ordeal. Little girls walked bare feet hundreds of kilometres to drop dead due to exhaustion and starvation. Many got ploughed down by vehicles as they trudged home in utter despair. The harrowing list of miseries is endless.

 

But despite the clearly visible and palpable sufferings of lakhs of people the media refused to suspend sensationalism around Covid-19. The interviews kept coming, guests repeated ad nauseam that millions would be infected by SARS-CoV-2. That millions would get infected is so obvious that repeating this fact again and again is downright stupid or deliberate scare mongering.

 

The number of infected people infected so far are 381,485. Any public health student will know that in reality at least 10 times this number are actually infected. There is considerable serological data from across the globe ascertaining to the fact that at least 10 times more people are infected that those detected by a positive RT-PCR test. We therefore have at least 3.8 million people infected.

 

3.8 or 4 million people infected seems like a huge number till we bear in mind that we have 1,350 million people in our country. This implies that only 0.296% of our population has been infected by Covid-19. The mainstream and alternate media however keeps drumming the “millions” number.

 

When you keep repeating the “millions’ figure, knowing very well that as the denominator expands the mortality rate gets lowered there is a strong chance that some agenda is at play. Sensationalism for 4 weeks my be considered an inadvertent error, but to keep flogging a weakening horse over months becomes more than suspicious.

 

Why an online so called alternative media magazine priding itself on objectivity repeatedly invite doomsayers for interviews is downright baffling if not suspicious. There is neither science nor any substance in the interviews.

 

I have been repeatedly (in my blogs, videos and interviews ) underscoring the low mortality rate in Covid-19 patients. This was not based on astrology but on painstaking evidence gathered from peer reviewed medical literature. Above all there was absolutely no agenda. It certainly was not for applause or being in the spot light. The panic was becoming both visible and palpable, the ramifications of the fear will cast a large shadow for years to come.

 

According to the Swiss Policy Research the overall lethality of Covid-19 is about 0.1% as per the latest immunological and serological studies. Thus in the range of a strong seasonal flu.

 

The overall mortality in in the range of a strong flu season in countries like the UDS,UK, and also Sweden ( without a lockdown). In country like Germany, Austria and Switzerland overall mortality is in the range of a mild flu season.

 

Upto 80% of test positive cases remain without symptoms. Even among 70-79 year old, about 60% remain symptom free. Almost 95% patients develop moderate symptoms.

 

Importantly 60% of people may have cellular background immunity to Covid-19 due to previous common colds (coronavirus infection).

 

The average age of people dying is 80 years and 96% of these have  chronic illnesses.

 

When people sit down to write about these times centuries from now, they surely will notice that more people died of fear of this virus than by the virus itself.

 

A lot of this fear has been fuelled by the modellers and the media. Mercifully  some in the  print media have finally realised that the mathematical models presented all these months are manifestly incorrect.

COVID-19 ; TOCILIZUMAB ; THEODORE ROOSEVELT AIRCRAFT CARRIER

 

https://youtu.be/5ZYmDgAu5Zg

 

Antivirals can definitely play a role in management of Covid-19 patients. The only 2 drugs with randomised trials so far are Interferon and Remdesivir. Interferon should be given before 7 days of symptom onset. The very few patients that do not recover may need tocilizumab which acts against interleukin-6 receptors.Only one injection may be needed. The aircraft carrier Theodore Roosevelt has demonstrated that 60% of infected patients remain asymptomatic, 60% develop antibodies and above all only 1 sailor succumbed out of the 1100 infected.

Hence case fatality rate is less than 0.1% in young and fit sailors. Triple combination of interferon beta-1b, lopinavir–ritonavir, and ribavirin in the treatment of patients admitted to hospital with COVID-19: an open-label, randomised, phase 2 trial

Published Online The Lancet; May 8, 2020 https://doi.org/10.1016/ S0140-6736(20)31042-4

 

Remdesivir for the Treatment of Covid-19 — Preliminary Report

J.H. Beigel, K.M. Tomashek, L.E. Dodd, A.K. Mehta, B.S. Zingman, A.C. Kalil, E. Hohmann, H.Y. Chu, A. Luetkemeyer, S. Kline, D. Lopez de Castilla, R.W. Finberg, K. Dierberg, V. Tapson, L. Hsieh, T.F. Patterson, R. Paredes, D.A. Sweeney, W.R. Short, G. Touloumi, D.C. Lye, N. Ohmagari, M. Oh, G.M. Ruiz-Palacios, T. Benfield, G. Fätkenheuer, M.G. Kortepeter, R.L. Atmar, C.B. Creech, J. Lundgren, A.G. Babiker, S. Pett, J.D. Neaton, T.H. Burgess, T. Bonnett, M. Green, M. Makowski, A. Osinusi, S. Nayak, and H.C. Lane, for the ACTT-1 Study Group Members* This article was published on May 22, 2020, at NEJM.org.

Remdesivir for 5 or 10 Days in Patients with Severe Covid-19

Jason D. Goldman, M.D., M.P.H., David C.B. Lye, M.B., B.S., David S. Hui, M.D., Kristen M. Marks, M.D., Raffaele Bruno, M.D., Rocio Montejano, M.D., Christoph D. Spinner, M.D., Massimo Galli, M.D., Mi-Young Ahn, M.D., Ronald G. Nahass, M.D., Yao-Shen Chen, M.D., Devi SenGupta, M.D., Robert H. Hyland, D.Phil., Anu O. Osinusi, M.D., Huyen Cao, M.D., Christiana Blair, M.S., Xuelian Wei, Ph.D., Anuj Gaggar, M.D., Ph.D., Diana M. Brainard, M.D., William J. Towner, M.D., Jose Muñoz, M.D., Kathleen M. Mullane, D.O., Pharm.D., Francisco M. Marty, M.D.,Karen T. Tashima, M.D., George Diaz, M.D., and Aruna Subramanian, M.D., for the GS-US-540-5773 Investigators*

This article was published on May 27, 2020, at NEJM.org. DOI: 10.1056/NEJMoa2015301

medRxiv preprint doi: https://doi.org/10.1101/2020.05.29.20117358.this version posted June 3, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license . Tocilizumab for COVID-19 Tocilizumab for treatment of mechanically ventilated patients with COVID-19 Emily C Somers, PhD ScM1,2,3*, Gregory A Eschenauer, PharmD4*, Jonathan P Troost, PhD5, Jonathan L Golob, MD PhD1, Tejal N Gandhi, MD1, Lu Wang, PhD6, Nina Zhou, MS6, Lindsay A Petty, MD1, Ji Hoon Baang, MD1, Nicholas O Dillman, PharmD7, David Frame, PharmD4, Kevin S Gregg, MD1, Dan R Kaul, MD1, Jerod Nagel, PharmD7, Twisha S Patel, PharmD7, Shiwei Zhou, MD1, Adam S Lauring, MD PhD1, David A Hanauer, MD MS8, Emily Martin, PhD9, Pratima Sharma, MD MS1, Christopher M Fung, MD10, Jason M Pogue, PharmD4

Effective treatment of severe COVID-19 patients with tocilizumab

Xiaoling Xua,1,2, Mingfeng Hanb,1, Tiantian Lia, Wei Sunb, Dongsheng Wanga, Binqing Fuc,d, Yonggang Zhouc,d, Xiaohu Zhengc,d, Yun Yange, Xiuyong Lif, Xiaohua Zhangb, Aijun Pane, and Haiming Weic,d,2

www.pnas.org/cgi/doi/10.1073/pnas.2005615117

 

Pilot prospective open, single-arm multicentre study on off-label use of tocilizumab in severe patients with COVID-19

S. Sciascia1,2, F. Aprà2, A. Baffa1,2, S. Baldovino1,2, D. Boaro2, R. Boero2, S. Bonora2, A. Calcagno2, I. Cecchi1,2, G. Cinnirella2, M. Converso2, M. Cozzi1,2, P. Crosasso2, F. De Iaco2, G. Di Perri2, M. Eandi3, R. Fenoglio1,2, M. Giusti2, D. Imperiale2, G. Imperiale2, S. Livigni2, E. Manno2,