NEW DELHI: As the number of coronavirus patients in India is surging, those developing serious complications are being given a combination of anti-HIV, anti-malaria drugs and Tamiflu-an antiviral drug while most patients are just being managed with antipyretics, this newspaper has learnt. So far, at least 6 patients — in Jaipur, Gurugram and Delhi — who have developed severe pneumonia and other complications due to the infection have been given the repurposed drugs and at least two of them are still not out of danger, sources said.
A doctor treating some of these patients in the capital said while the Central Drug Standards Control Organisation had approved Lopinavir and Ritonavir, a fixed dose combination used in HIV patients, for corona cases, the clinicians are also resorting to other drugs that have shown some degree of efficacy against the virus elsewhere. “Many doctors are watching for signs of deterioration in patients and then using multiple drugs hoping at least one works,” said a senior doctor.
Dr Dhruva Chaudhry, president of the Indian Society for Critically Care Medicine, who is working with the government on treatment guidance for clinicians, said anti-retroviral drugs are showing some efficacy against the infection too, but there is no largescale study or randomised control trial to show in what percentage of complicated cases do they work.
In severe cases, COVID-19 can be complicated by acute respiratory disease syndrome, sepsis and septic shock, multiorgan failure, including acute kidney injury and cardiac injury. Older age and co-morbid disease have been reported as risk factors for death.
“It is the latter category of people that we are worried about because mild cases can just be monitored and treated with paracetamol,” said Dr Chaudhry. The ICMR, in its guidelines on clinical management of coronavirus patients, has said anti-retroviral drug therapy be started in patients when organ dysfunction sets in. But won’t that be too late? “Nobody knows answer to that, but the side effects of anti-HIV drugs are major and therefore it can’t be used indiscriminately,” said a doctor adding that a more targeted drug was the only hope.