very cheap and long-known drugs help save the lungs with coronavirus

Cloving hospital on the basis of the Medical Scientific and Educational Center (ISSC) Moscow State University named after M.V.Lomonosov took the first patients on April 21 and completed his work on June 13. It turned out that it was possible to achieve the best treatment results for COVID-19 in Moscow. Over the entire period, 4 patients died, and among severe patients who got mechanical ventilation, the mortality rate was less than 14% (for comparison, the average for the city and the world was up to 70 – 80%). Eighteen doctors out of 220 employees of the hospital were infected with coronavirus, there were no deaths among the medical staff.

What approaches were used at the University Hospital of Moscow State University to achieve such results? We continue the conversation with the head. Department of Therapy, Faculty of Fundamental Medicine, Moscow State University, Head of the Department of Age-Associated Diseases, Medical Scientific and Educational Center, Doctor of Medical Sciences, Cardiologist Yana Orlova.

MEDICINE FOR COUGH FOR 80 RUBLES

– Most of those who are ill or are afraid to get sick are worried about fibrotic changes in their lungs. They say that you have developed special therapy that can reduce the risk of developing fibrosis. Is it possible?!

– Yes, we launched an appropriate clinical study. There are no final results yet, but we have developed clinical practice.

“What did you do to save the lungs?”

– We used a combination of bromhexine and spironolactone (both are long-known very cheap drugs. – Ed.). Bromhexine is an expectorant that has been prescribed to patients with pneumonia and cough for many years. At the same time, experimental data showed that this drug can block a specific enzyme and impede the penetration of coronavirus into cells. True, it was on this effect that we counted to a lesser extent in inpatients, since such an effect is important mainly in the early stages of the disease. But the expectorant effect of bromhexine really helps patients with COVID. I heard that our colleagues in Peter launched a study of bromhexine for prophylactic purposes. We will wait for the results.

Coronavirus infected 18 doctors from 220 employees of the hospital, there were no deaths among the medical staffPhoto: Ivan MAKEEV

FIBROSIS OBSTACLE

– The second drug – spironolactone – is traditionally widely used in cardiology for the treatment of heart failure, severe hypertension. It has a small diuretic, magnesium and potassium-preserving effect, continues Yana. Orlova. – It has several mechanisms through which it can be useful in coronavirus infection.

Firstly, a mechanism that prevents the development of fibrosis in general in the body. There are works that, in particular, show that spironolactone reduces fibrosis in the heart. At the same time, it is known that the tendency to fibrosis is not local, but systemic – where there is more inflammation, there will certainly be fibrosis. And we see, of course, fibrotic changes in the “covide” in our patients. Therefore, we prescribed spironolactone as a drug for the prevention of this process.

Secondly, this drug blocks sex hormone receptors, in particular testosterone. Some published studies suggest that “high-testosterone” men suffer from “covid” more often and develop more severe fibrotic changes. Therefore, blocking these receptors for several weeks during COVID treatment may be useful in reducing the severity of complications. We are not talking about a longer intake, since male patients are unlikely to agree with a decrease in testosterone levels in the long term.

And perhaps the most important point. In almost all of our patients, we observed hypokalemia (a decrease in potassium levels. – Ed.). With coronavirus infection, potassium is intensely excreted from the body, and scientific articles even suggest that hypokalemia serves as the trigger for a cytokine storm. So spironolactone has a real chance to reduce the risk of this dangerous complication. But the main thing, in my opinion, is that lowering the level of potassium in the body is extremely harmful to the heart and triggers life-threatening rhythm disturbances, increasing the risk of sudden death. We, like all others, replenished potassium with droppers, but it was more effective to retain it in the body with the help of spironolactone.


Men certainly get worse than women;  the elderly are heavier than the young;  overweight people are heavier than patients without excess weight Photo: Ivan MAKEEV

Men certainly get worse than women; the elderly are heavier than the young; overweight people are heavier than overweight patientsPhoto: Ivan MAKEEV

WHEN PRESCRIBED PATIENTS

– Yana Arturovna, how many patients did you have on average?

– About 10 – 14 days. But someone and 50 days.

– Have you noticed signs by which it can be assumed that the disease in the person brought is likely to go the hard way?

– Such studies were carried out in the world, our clinical practice confirmed them. Men certainly get worse than women; the elderly are heavier than the young; overweight people are heavier than overweight patients. Men with a classic male type of baldness, a lot of facial hair, we can say brutal men get sick harder.

– Under what conditions did you discharge patients?

– We acted as close as possible to the recommendations Ministry of Health: so that the temperature for three days was not higher than 37.5 degrees; so that C-reactive protein (an indicator of inflammation) is lower than 10 mg / l, and saturation, that is, the level of oxygen in the blood, is higher than 96%.

“HEAD OF EPIDEMIOLOGY DEPARTMENT OF ITSELF WORKED AT SANPROPUSNIK”

– How often do you get sick doctors and nurses?

– In the first month no one got sick at all. We have a very powerful epidemiological service. The head of the sanitary-epidemiological department, a senior researcher, correctly organized the whole process, and for the first two weeks she personally worked in the sanitary inspection room at the exit from the “red zone” and helped doctors and nurses who were exhausted after the shift safely remove protective clothing.

Then both people’s fatigue and viral load accumulated. By the middle of the second month, sick people began to appear. There were no seriously ill patients. We treated part of the staff in our observation, part of it was treated at home. In total, 18 people were infected from the medical staff (less than 10%).

– Doctors take something for prevention? Vitamins C, D, Zinc?

– I saw the recommendations of American nutritionists, they speak out positively about taking zinc, melatonin and vitamin C. There were somewhat conflicting data on vitamin D. But we did not give any such recommendations to our employees. We have all the prevention was associated with minimizing contacts and other measures of epidemiological safety.

Physicians are the heroes of our time.“If you think that you are special and that a pandemic will not affect you, you are deeply mistaken,” listen to what the doctors who are fighting with coronavirus say

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How the government wants to help small traders

For several years now, the town centers of certain municipalities have displayed a succession of “lease to sell” or “to rent” signs on deserted shop windows. Neither a metropolis nor a village, the medium-sized cities of France suffer from the disappearance of small businesses. And those who had resisted the establishment of peripheral shopping centers have now been hit hard by the coronavirus epidemic and containment.

Buy back commercial premises

According to The echoes, the government is therefore working on a new form of aid: the repurchase of premises which would then be rented to traders at low prices. Caisse des Dépôts is currently discussing with local communities to set up this system, and create property companies that would buy the walls.

→ DEBATE. Will the Internet supplant traditional commerce?

The details still remain to be worked out: will it be empty premises or takeovers of goodwill? How long will the floor rent price be guaranteed? Will counterparts be asked of traders? The government must specify this new form of assistance in the coming weeks, and the fourth version of the budget, scheduled for the fall, will act the measure.

Solidarity fund, deferral of charges and partial unemployment

Meanwhile, traders can already take advantage of other mechanisms unlocked during the coronavirus epidemic to avoid bankruptcies and layoffs. A solidarity fund makes it possible to benefit from direct aid, subject to conditions. Charges (rent, water, gas, electricity) can be deferred, and the government has called on landlords to completely cancel rents for containment periods for small stores, even if nothing requires them. Social and tax contributions can also be spread over time.

→ ANALYSIS. Businesses push for rent cancellation

Like large businesses, traders can apply for a government-guaranteed loan, regardless of their size and structure. But these loans go through banks and many small shops claim to have no response to their requests. Finally, the partial unemployment scheme made it possible for the State to pay part of the wages of stationary workers. Already made less generous on June 1, this mechanism will be reduced a second time on October 1.

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Twitter founder donates $ 10 million to help US prisoners

Twitter founder and CEO Jack Dorsey donates $ 10 million to the non-profit Reform Alliance. According to Mr. Dorsey, this money will be directed for the purchase of medical masks and other equipment necessary to combat the spread of COVID-19. All items will be sent to prisons and prisons in all 50 US states.

The Reform Alliance was created by American rappers Jay-Z and Meek Mill and is trying to get US laws changed to reduce the number of prisoners. Since the outbreak of the COVID-19 epidemic, NCOs have stated that it is necessary to release older people, patients, and prisoners who are not dangerous to society from places of deprivation of liberty, since prisons, according to the Reform Alliance, can become centers of the spread of coronavirus, and prisoners will not have the opportunity to avoid infection . The organization also asks to cancel the terms of imprisonment for those who received them for technical misconduct such as fines not paid on time.

Kirill Sarkhanyants