A case study on off‐label medications vs alternative medicines in Patients with mild to moderate symptoms of COVID‐19

Abstract

BackgroundThe emergence of SARS‐CoV‐2/2019 novel coronavirus (COVID‐19) first appeared in the US in March 2019. There were no current guidelines or clear direction on the use of antivirals or other agents on treating Covid‐19 for this new virus, and escalating death rates in the underserved community became disturbing. The early studies consisted of studying Chloroquine (CQ) or Hydroxychloroquine (HCQ) with or without Azithromycin (AZ), Lopinavir/Ritonavir (LV/RV) and other HIV Protease Inhibitors; Remdesivir (RDV) looked promising; however, it was still in clinical trial phases. COVID‐19 causes individuals to suffer from respiratory distress, organ failure, hypotension, lactic acidosis, oliguria, and other acute blood disorders due to various pathogens and conditions. This massive infection triggers an immune response which vasoactivates chemicals, such as cytokines, dilate the blood vessels and increase capillary permeability, causing vascular fluid to shift to the interstitium. The immune system extends signaling molecules (cytokines) that recruit immune cells to the infection site as part of an inflammatory response. In a desperate attempt to save lives, Valtrex (VX) was used to treat COVID‐19 as an off‐label use to stop viral replication, stop inflammation, and promote recovery time for patients sent home with viral pneumonia due to COVID 19 that were Short of breath and who were symptomatic. VX is not without bothersome side‐effects: it must be used with caution in persons with kidney disease and in people 60 years and older. To treat the pneumonia with a combination approach, amoxicillin (AMX) with clavulanate(CLV) was used twice a day for five days. In addition, Diflucan 150 mg was used to halt the overproduction of yeast caused by using antibiotics.MethodsMEDLINE, PubMed, and print repositories on trials: for CQ HCQ with or without AZ, LV/RV, Protease Inhibitors, and RDV in COVID‐19 or SARS‐CoV‐2 infection, until May 2020. The patients were given consent for off‐label use of the treatment. The patients involved in the study were between the ages of 25 to 49. They had documented positive test results for SARS‐CoV‐2 infection. Radiologic studies were done as well as a complete blood count and a chemistry level.ResultsThere were ten people treated with VX, AMX, and Diflucan((DFN). All the participants recovered. One participant had to receive supplemental oxygen and saline nebulizer treatments at home for one due to shortness of breath a month. The comparison group used high doses of probiotics 100 billion cells and ginger shots twice a day. The people who used VX, AMX, and DFN reported recovery from the symptoms of fever, coughing, and SOB in 24‐48 hours. However, the patients that used the alternative medications reported symptom improvement around day 5 ‐7. In conclusion, there is an insufficient confirmation regarding the clinical effectiveness and safety of VX in patients with COVID‐19. Its use should be considered preliminary, requiring ethical approval and clinical trial oversight. VX can potentially be used in patients with mild to moderate symptoms of Covid‐19 that are sent home and asked to self‐quarantine who are symptomatic but requires additional study.