welcome to another MedCram COVID-19 update. we are in pandemic Italy has
shot up dramatically to 12,000 cases South Korea is still around 7800 we've
been looking at those two wondering what the difference is between Italy and
South Korea Italy has an excellent healthcare delivery system as does South
Korea many possible explanations for the differences in those two here in the
United States we have a total of 1,300 cases total deaths 38 total recovered 15
serious or critical 10 and that's around 4 cases per million population
number of things have happened politically which you probably already
know about the president has banned lights in from Europe except for Great
Britain the National Basketball Association has essentially canceled the
season at this point Tom Hanks and his wife who are in Australia report that
they are infected with corona virus and there are a number of new cases here and
especially around on the west coast and East Coast in cities our last update we
did talk about zinc and zinc ionophores and the ability of chloroquine to
inhibit RNA dependent RNA polymerase from corona virus essentially we're
looking at chloroquine and its derivatives as an antiviral medication
in prevention and we said that it's potentially possible that the mechanism
that this chloroquine or hydroxychloroquine works through is
through a zinc ionophore mechanism well I wanted to show you this paper that was
published just three days ago and it looked specifically at the in vitro
antiviral activity and optimized dosing regimen for hydroxychloroquine which is
a better tolerated and more available medication and chloroquine for the
treatment of kovat 19 they looked at hydroxychloroquine because it's an
immunomodulator it might be able to attenuate this quote
cytokine storm which is involved with a RDS which we've talked about before I
want to stress that there currently is no evidence to support the use of
hydroxychloroquine own in SARS Cove to infection we don't have any randomized
controlled trials and that's exactly why they are using this medication and
trying to figure out the appropriate dosing before they are able to start a
randomised controlled trial so if you look here
they took cells and they incubated them in this medication and they subjected
them to the actual SARS cuff to virus and they also did it the other direction
they had the virus in the cells and then they treated the
with this hydroxychloroquine in different concentrations they also
looked at chloroquine as well the conclusion of the research was that
hydroxychloroquine was found to be more potent than chloroquine to inhibit SARS
cough - and the key word here is in vitro so here's the data we can see here
chloroquine on the left and hydroxychloroquine here on the right and
as we increase the concentrations of either one whether or not the drug was
there for 24 hours or 48 hours as the concentration of the drug goes up the
percent of inhibition goes up for instance in the hydroxychloroquine we
were able to see these values going up higher therefore inhibiting more virus
and of course if it was there for 48 hours we would have seen it inhibiting
even more than if it was there for only 24 hours letting you believe that the
drug is starting to accumulate more and more in those first 24 to 48 hours you
can also see that given hydroxychloroquine at one micromolar at
48 hours it's able to hit 50% of inhibition whereas over here you need a
much higher concentration to hit 50% of inhibition and that's exactly what these
numbers are so the lower the e number the better and you can see here for
hydroxychloroquine these numbers are smaller than the corresponding
chloroquine numbers down here they have prophylactic treatment which means that
they were incubated with this medication before the virus was given and you can
see here that the numbers are much better for hydroxychloroquine because
the values go up fairly high and they stay up in other words in this case if
you were on hydroxychloroquine for 48 hours prior to infection with the actual
corona virus SARS cough - and it was at this concentration there would be
absolutely no viral replication occurring the way they did this was
using reverse transcriptase PCR they also looked at the dosing and they could
see here how often would they need to actually dose this medication and they
found that if they gave for just four five days it stayed in the system for
quite a long time and the plasma concentration didn't decrease and it was
still affected here we can see blood concentration not dropping too much and
here in the lung concentration where it would be needed the most it hardly
dropped at all it was concentrated in the lungs so even though it was stopped
at day number five it still hung around for an additional at least five days so
the overall study results were that based on these models a loading dose of
400 milligrams twice for the first day and then followed by a maintenance dose
of 200 milligrams given twice daily for four days is recommended for SARS cub to
infection and again I wanted to mention this because we had talked previously
about that so as hospitals across the country start
to see this kind of an infection coming in this may be one type of treatment
that you consider if the mechanism of action for hydroxychloroquine and
chloroquine in vitro in stopping the virus is related at all to the fact that
it's also a zinc ionophore then the question is obvious do other zinc
ionophores do the same thing and here's the zinc ionophore quercetin this
quercetin also do the same thing in terms of increasing zinc intracellular
and blocking viral production well here we have some data that was published and
we'll put a link to this article in the description below and you can see here
clearly that when you add zinc in an increasing concentration zinc does get
inside the cell but when you add quercetin it's going to increase the
amount of zinc inside the cell so the next question is does it actually reduce
virus well again an in vitro study quercetin
as an antiviral agent inhibits influenza A virus entry this study indicates that
quercetin showing inhibitory activity in the early stage of influenza infection
provides a future therapeutic option to develop effective safe and affordable
natural products for the treatment and prophylaxis of influenza infections this
is not kovat 19 this is influenza and here we can see
that at zero quercetin we see a lot of viral particles here that are
illuminated with the fluorescent antibodies and as we increase the dose
of quercetin you can see that the number of particles decreases rapidly until
it's not seen at all as we can see here there is some evidence that quercetin
had already been proven successful at treating Ebola and Zika virus 'as the
question is what's going on with kovat 19 and here we have a story from cbc
which is the news organization of canada spread speeds up montreal researchers
will trial an antiviral treatment for kovat 19 in china these two researchers
here out of Montreal are wanting to tests for setzen in the arena of Cova 19
now this drug is derived from plants and you don't need a prescription for it and
you can actually get this over-the-counter now in a number of
studies that I've seen and researched on the Internet
this medication was tested in Zika and Ebola viruses at a dose of around fifty
to a hundred milligrams per kilogram which would mean that you're talking
about three to seven grams a day of this medication which is just astounding I
don't know if that's the dose that is actually needed but that's what the
studies were showing let's summarize what we found out here for zinc
ionophores and we may come back to this first of all we have no randomized
controlled trials for any of this so we can't say that any of this actually
works but the Chinese have just published a paper a couple days ago
showing that hydroxychloroquine is superior to chloroquine in terms of
potency and their proposed dosing regimen would be 400 milligrams twice a
day for one day and then 200 milligrams orally twice a day for four days Pio
means per ostomy n--'s in the mouth the ID means twice a day in terms of course
seven we don't know it is over-the-counter
we don't know dosing again no randomized controlled trials this is what they're
actually working on trying to do at this point it should be noted and there were
some questions about this if this is a zinc ionna for question is
should you take a zinc supplement I think it's more important that you're
not zinc deficient than it is that you try to boost up your zinc blood levels
because again those are regulated if you have more zinc in your blood then you
should be having your body's gonna regulate that by trying to get it out of
your system and trying to pee it out of course that can be overwhelmed if you
take too much zinc so you don't want to do that either so I think the key here
is don't be zinc deficient so question on zinc supplements thanks for joining
us