COVID-19 Update for 5/14/2020

Hydroxychloroquine

​A retrospective review of 1,438 patients in New York hospitalized for COVID-19 infection found no difference for in-hospital mortality with hydroxychloroquine, azithromycin, or both compared to not receiving either drug.
 
Anakinra

In a 21-day, 45 patient, non-randomized, observational trial, the addition of anakinra to hydroxychloroquine and lopinavir/ritonavir reduced serum C-reactive protein and improved respiratory function in 72% of patients compared to 50% in a historical cohort that had not received anakinra in patients with moderate-to-severe ARDS from COVID-19 that were managed with non-invasive ventilation outside of the ICU. Survival was 90% with anakinra and 50% without the drug at 21 days.
 
Tocilizumab

In a 21 patient, Chinese, uncontrolled retrospective study of patients with severe or critical COVID-19, tocilizumab was added after 7-days of standard treatment. At the time of the study, standard treatment was lopinavir/ritonavir, interferon, ribavirin and glucocorticoids. Fevers and elevated C-reactive protein levels normalized, and levels of IL-6 and other proinflammatory cytokines declined within 24 hours of tocilizumab administration. Within the first 5-days, there was a decrease in the use of supplemental oxygen in 15 patients.
 
Favipiravir

The Russian Direct Investment Fund announced interim results from a 330 patient Russian trial, where 24/40 (60%) of patients treated with favipiravir were negative for COVID-19 within five days compared to 30% in the standard therapy group. The press release did not specify how many patients were in the standard care group, how patients were tested for COVID-19, nor what other therapies are part of standard care for COVID-19 in Russia. The trial is expected to be completed by the end of May 2020.
 
COVID-19 Vaccine

The FDA granted Moderna’s COVID-19 vaccine (mRNA-1273) a Fast Track designation.
 
NIH has formed the Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV) partnership with HHS, FDA, CDC, EMA and AbbVie, Amgen, AstraZeneca, Bristol Myers Squibb, Evotec, GlaxoSmithKline, J&J, KSQ Therapeutics, Eli Lilly, Merck, Novartis, Pfizer, Roche, Sanofi, Takeda and Vir. ACTIV will coordinate and prioritize trials to optimize vaccine and treatment development for COVID-19 through a steering committee of representatives of members.

• In mid-April, there were 657 COVID-19 trials with 304 of the trials being listed as active or recruiting. It is hoped that by coordinating trials, research centers will not be overwhelmed, and patient recruitment will be improved. The steering committee will also prioritize research on the most promising candidates. 
• A description of ACTIV’s strategy to develop successful vaccines is provided by Anthony Fauci, MD, along with other government physicians and academic researchers. The report describes approaches to develop vaccines and scale them up to meet worldwide needs. The benefits and challenges of each type of vaccine is discussed along with the need to have multiple vaccines. 
• The journal Nature provided a graphical description of the different types of methods to create a vaccine that are currently being used to work on a vaccine for COVID-19.