Promising Progress on Covid-19 Medical Research

The progress of research on medicine to treat COVID-19 offers new hope. However, clinical test results must be investigated carefully and require further study.

Kompas/AGUS SUSANTO

A medical worker views the results of a polymerase chain reaction (PCR) test on Tuesday (16/6/2020) at a Biosafety Level 2 (BSL-2) mobile lab at Moh. Ridwan Meuraksa hospital in East Jakarta. The mobile lab is equipped with swab testing facilities that meet the standards of the World Health Organization (WHO), and was developed by the Covid-19 Research and Innovation Consortium of the Research and Technology Ministry (BRIN) to increase Indonesia’s testing capacity.

JAKARTA, KOMPAS – A number of studies finding that certain drugs are effective in the treatment of COVID-19 give new hope. However, these must be addressed with caution. The use of the drugs must follow the doctors’ guidance, and the new medications require further study to establish their side effects.

"We are continuously discussing COVID-19 drugs and examining research as well as a statement from the FDA [US Food and Drug Administration] regarding hydroxychloroquine. That includes discussing the findings of the methasone," said Indonesian Pulmonary Doctors Association (PDPUI) chairman Agus Dwi Susanto on Wednesday (17/06/2020) in Jakarta.

Government spokesperson for COVID-19 affairs Achmad Yurianto said on June 17 that 1,031 new cases of COVID-19 had been discovered. This brought the total number of COVID-19 cases in Indonesia to 41,431. Of this number, 16,243 patients recovered, and 2,276 patients died.

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To overcome COVID-19, researchers from several countries have conducted clinical trials on a number of drugs. A recent research initiative called Recovery (Randomized Evaluation of COVID-19 Therapy), led by researchers from the University of Oxford in England, found that dexamethasone reduces the risk of patient death.

According to Agus, studies are now being carried out to ensure the effectiveness and efficacy of dexamethasone for COVID-19 therapy. "Next week, we will have the results of our evaluation," he said.

Kompas/Hendra A Setyawan

A technician monitors a machine as it extracts compounds from the leaves of the ketepeng badak (ringworm bush; Cassia alata) and the benalu (a type of mistletoe; Dendrophthoe sp.) on 6 May 2020 (6/5/2020) at the Traditional Medicine Quality Production Laboratory (CPOTD) of the Research Center for Chemistry, located at the Indonesian Institute of Sciences (LIPI) Science and Technology Park (Puspitek) in South Tangerang, Banten. The lab is developing a candidate treatment for Covid-19 from the herbal compounds

In accordance with the COVID-19 management protocol issued by the PDPUI together with a number of other professional medical organizations, chloroquine, or hydroxychloroquine, has been used as a drug for COVID-19 patients in Indonesia. However, the FDA has revoked the authorization of the emergency use of hydroxychloroquine and chloroquine in COVID-19 therapy because it increases the risk of heart problems.

According to Agus, the use of drugs to treat COVID-19 must be constantly updated on the basis of the latest scientific data. Caution must be applied to any claims that there are effective drugs, including those released by Surabaya-based Airlangga University and Oxford University.

He advised Indonesians not to react too credulously to the discovery of new drugs, including dexamethasone. Their use must be in accordance with medical recommendations because they can cause significant side effects.

Giving hope

The findings regarding the effectiveness of dexamethasone in COVID-19 therapy were released by the Recovery team on Tuesday (16/6). The test, which began in March, involved 2,100 COVID-19 patients who were administered with dexamethasone at a dose of 6 milligrams per day for 10 days. Their condition was then compared to 4,300 patients who received standard COVID-19 care.

The study found that this drug reduced the risk of death of COVID-19 patients who were in the critical phase. Dexamethasone reduced the risk of death from 40 percent to 28 percent for patients on ventilators. For patients who need oxygen but who are not on a ventilator, this drug reduces the risk of death from 25 percent to 20 percent. However, this drug does not affect patients with mild symptoms.

Also read : Winning Against Covid-19

KOMPAS/TOTOK WIJAYANTO

A researcher performs a test on 11 March 2020 at the Indonesia Original Modern Medicines (OMAI) research center at the Dexa Laboratories of Biomolecular Sciences (DLBS), located at the Cikarang industrial estate in Bekasi, West Java. The Dexa Group and OMAI have been conducting research on the potential development of locally produced medicinal compounds since 2005 towards pharmaceutical independence.

The head of the research team, an infectious disease specialist at Oxford University, Peter Horby, said the drug significantly reduced mortality. The British government is preparing to use it.

The World Health Organization (WHO) welcomed the results of early clinical tests using dexamethasone, which saved the lives of patients in critical condition because of COVID-19. "This is good news and I congratulate the British government, Oxford University and the many hospitals and patients in the UK that contributed to this scientific breakthrough," said WHO director general Tedros Adhanom Ghebreyesus.

Dexamethasone is a steroid that has been in use since the 1960s to reduce inflammation in a variety of conditions, including certain inflammation disorders and cancers. This drug has been listed on the WHO Essential Drug Model since 1977 and is now unpatented and available at affordable prices in many countries.

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However, the WHO is still waiting for a complete analysis of the data to increase medical understanding of the treatment. Tedros promised to renew the WHO\'s clinical guidelines, including how and when the drug should be used to treat COVID-19.

A number of studies, such as a publication by Lei Zha of Liverpool University and a team in The Medical Journal of Australia on April 13, have used corticosteroids to treat COVID-19 patients. However, no correlation was found between the therapy and patient outcomes.

The WHO is testing a number of drugs for COVID-19 in 35 countries. There are four drugs, or combinations of drugs, that are being tested clinically, namely remdesivir, a combination of HIV drugs lopinavir and ritonavir, lopinavir and ritonavir plus beta interferon and the antimalarial drug chloroquine. All of these drugs have been shown to be effective against the SARS-CoV-2 virus, which causes COVID-19, in laboratory and animal testing.