Thai doctors have seen success in treating severe cases of the new coronavirus with combination of medications for flu and HIV, with initial results showing vast improvement 48 hours after applying the treatment, they said on Sunday.
The doctors from Rajavithi Hospital in Bangkok said a new approach in coronavirus treatment had improved the condition of several patients under their care, including one 70-year-old Chinese woman from Wuhan who tested positive for the coronavirus for 10 days.
The drug treatment includes a mixture of anti-HIV drugs lopinavir and ritonavir, in combination with flu drug oseltamivir in large doses.
“This is not the cure, but the patient’s condition has vastly improved. From testing positive for 10 days under our care, after applying this combination of medicine the test result became negative within 48 hours,” Dr. Kriangska Atipornwanich, a lung specialist at Rajavithi, told reporters.
“The outlook is good but we still have to do more study to determine that this can be a standard treatment.”
Chinese health officials have already been administering the HIV and flu drugs to fight the coronavirus. The use of the three together in a cocktail seemed to improve the treatment, the Thai doctors said.
Another doctor said that a similar approach in two other patients resulted in one displaying some allergic reaction but the other showed improvement.
“We have been following international practices, but the doctor increased the dosage of one of the drugs,” said Somsak Akkslim, director-general of the Medical Services Department, referring to the flu medicine Oseltamivir.
Thailand has recorded 19 cases of coronavirus. Of the Thai patients, eight have recovered and gone home while 11 are still under treatment in hospitals.
Somsak said the health ministry will meet on Monday to discuss the successful treatment in the case of the 70-year-old but said it is still too soon to say that this approach can be applied to all cases.
“Initially we will apply this approach only to severe cases,” he said.
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What’s alarming pediatricians about surge in children’s respiratory infections, the flu & COVID-19
Oscar G. Gómez-Duarte, M.D., is chief of the division of infectious diseases, department of pediatrics in the Jacobs School of Medicine and Biomedical Sciences at UB, and director of the PediUBatric Infectious Diseases Service at John R. Oishei Children’s Hospital. (University at Buffalo photo)
Tue, Nov 29th 2022 01:10 pm
Oscar G. Gómez-Duarte, Jacobs School’s pediatric infectious diseases division chief, discusses why physicians are so concerned – and how to keep kids healthy
Submitted by the University at Buffalo
The request by children’s hospitals nationwide this month that the federal government declare a formal state of emergency given the surge in respiratory syncytial virus (RSV) and flu cases was no surprise to Oscar G. Gómez-Duarte, M.D.
As chief of the division of infectious diseases, department of pediatrics in the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, and director of the pediatric infectious diseases service at John R. Oishei Children’s Hospital, Gómez has seen firsthand the jump in cases of both RSV and flu, and the resulting increase in hospitalizations of children.
By September, Oishei Children’s Hospital reported having seen more patients admitted to the hospital with RSV than it had seen during the entire 2019-20 respiratory season, along with higher rates of flu infections, some requiring hospitalization.
Gómez says the surge this early in the season is unusual and especially concerning since there are very low vaccination rates for COVID-19 and flu in children. Cases may rise this winter, especially among unvaccinated children in addition to the rise in RSV cases.
How would you characterize this season so far for RSV and flu in kids?
“What’s concerning to us are not only the number of infections, but the severity of these infections leading to a high number of emergency room visits and hospitalizations. The surge in cases is putting pressure on hospitals nationwide. This is a very dramatic increase over what we normally see, especially at this point in the season. This year, we have been seeing significant increases in cases and this is even before the winter season has begun. We saw RSV cases peak over the summer this year and then another peak was reported in October. This RSV infections pattern is quite different from what we normally saw pre-COVID-19 pandemic.”
How do you think COVID-19 has influenced this increase in other respiratory viruses?
“It’s very possible that this jump in respiratory viruses that we are seeing now is related to the dramatic changes in community behavior during the past two years due to the COVID-19 pandemic.
“Those behaviors significantly limited the normal exchange of viruses that people typically have through interactions with each other. That’s especially true of young children, who exchange different viruses with each other at day care, at school and public gatherings. That exposure allows children to develop a natural immunity to common respiratory viruses at a young age.
“During much of the pandemic, that exchange of viruses wasn’t happening, and there was a gap in natural protective immunity. Now that children are again attending day care and school and other gatherings, getting exposed to these viruses that they haven’t been exposed to in the past two years has resulted in a high peak of infections and an overwhelming number of ER visits and hospital admissions. We are seeing increases especially in RSV, and some of these cases are severe.”
What factors make children especially susceptible to developing RSV?
“RSV tends to affect the very young, those under 2 years of age. Infants at the highest risk are those who were born prematurely or who are immune-compromised.”
Is it mostly children with underlying conditions who are being hospitalized with RSV and/or flu?
“We are seeing hospital admissions for RSV and/or flu among previously healthy children with RSV who have no comorbidities; but we are also seeing it in children with underlying conditions, such as asthma, cardiac conditions, neurological disorders, among other chronic conditions.”
Are you seeing cases where a child gets infected with two viruses at once?
“Yes, some children are getting what we call coinfections, where they become infected with more than one virus at a time. In some instances, a child becomes initially infected with flu, begins to recover and subsequently comes down with rhinovirus (a common cold virus), RSV or any other respiratory virus. These coinfections tend to be more severe than when the child just has one infection. Different viruses can attack different receptors and use different mechanisms to damage respiratory cells, and this can worsen the disease and, in some cases, may require that the child be admitted to the intensive care unit for management.”
What kinds of treatments are available for children hospitalized with either RSV or the flu?
“While we do have specific treatments for flu and COVID-19, there is no specific treatment for RSV or other respiratory viruses. The mainstay management of respiratory infections is supportive care, such as hydration, control of fever and supplemental oxygen if needed. When the child’s breathing is very compromised, we will put the child on oxygen and, depending on the severity of the respiratory compromise, they may even require more intense measures such as mechanical ventilation.”
Can children be immunized against RSV?
“Passive immunity in the form of monoclonal antibodies is available for premature infants during RSV season. This FDA-approved monoclonal antibody named palivizumab has the ability to block RSV and decrease the severity of the RSV infections.
“There is no approved active vaccine against RSV in the U.S. for children or adults. There is evidence, however, that pregnant mothers do transmit antibodies against RSV to their babies. It was recently reported that pregnant mothers who received an experimental vaccine against RSV did pass those antibodies onto their babies and these infants were at lower risk of developing RSV infections. These developments are very good news for the future, so that maybe pregnant women who are immunized can pass this protection to their babies.”
How concerned are you that along with RSV and the flu, children may begin to get sick from COVID-19 this winter?
“COVID-19 will stay among us in the same way as RSV, influenza and any other respiratory virus. Accordingly, we expect to continue to have COVID-19 infections in children, along with RSV and the flu. Current variants of the COVID-19 virus are becoming resistant to preventive measures such as monoclonal antibodies, although vaccines remain protective.
“It is concerning that the vaccine coverage for COVID-19 and flu vaccine among children in our community is low. Nationally, only 4% of children younger than 5 and fewer than a third of children ages 5 to 11 have had any COVID vaccine series. There is strong evidence that vaccines prevent infection, prevent hospitalizations, and prevent deaths due to COVID-19.
What should parents watch for?
“The first and most important way to protect children is to make sure they get vaccinated against the diseases where vaccines are available, among them the flu and COVID-19.
“If a child acquires a respiratory infection, the child will likely experience upper respiratory symptoms, such as fever, sore throat, cough and nasal congestion.
“Parents should be vigilant for more concerning symptoms, such as shortness of breath. If a parent notices that the child’s breathing is labored and difficult, this is an emergency situation that requires immediate attention, such as taking the child to the closest emergency room or calling 911.
“Most respiratory infections in children, though, are self-limited, and are not associated with shortness of breath. In most cases, a call to the pediatrician for advice is the best measure to take.”
The views and opinions expressed in this commentary are based on the opinions and/or research of the faculty member(s) or researcher(s) quoted, and do not represent the official positions of the University at Buffalo or Niagara Frontier Publications.
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Got cold or flu symptoms? Guelph’s COVID-19 assessment clinic expands to treat more people
People in Guelph who have cold and flu symptoms will be able to be assessed and treated through an assessment centre set up for COVID-19.
The centre, located at 400 Southgate Drive, has been where people have gone to get tested for COVID-19 for two years. Starting Thursday, it will become the Guelph COVID Cold Flu Care Clinic.
The goal is to help people in the city get care while also “ease the pressure on the emergency department at Guelph General Hospital,” a press release said. The clinic is run by the hospital and the Guelph Family Health Team.
People will be able to make appointments at the clinic seven days a week, although weekend hours will be shorter. People are encouraged to contact their family doctor before booking an appointment at the Guelph COVID Cold Flu Care Clinic.
“People with mild respiratory symptoms are advised to monitor their symptoms, rest, and drink plenty of fluids,” the press release said.
The release also noted “most people in the community with symptoms are not eligible for COVID-19 testing” because they must meet provincial guidelines, which prioritizes people at increased risk of severe outcomes and people who live and work in high-risk settings.
Feel sick? ‘Do not go and join the party’
Marianne Walker is president and CEO of Guelph General Hospital and also the hospital lead for Waterloo Wellington’s COVID-19 response.
She says in Waterloo region, Guelph and Wellington County, hospitals are over capacity with both adult and child patients.
“I think our major issue right now is managing the issues with very sick children and so we are working with Ontario Health to look at taking a provincial approach to that,” Walker said.
To help manage capacity in the health-care system and make sure “not everyone is getting sick at the same time,” Walker says people should listen to public health experts who are recommending people get vaccinated for COVID-19 and get their flu shot, wear masks, avoid large gatherings and stay home if not feeling well.
Walker says that advice is particularly important right now as December is a time when many people might get together with family and friends.
“The big thing too is making sure that if you’re sick, do not go and join the party,” she said.
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