{"id":3353,"date":"2020-04-01T12:12:00","date_gmt":"2020-04-01T17:12:00","guid":{"rendered":"https:\/\/blog.unmc.edu\/infectious-disease\/?p=3353"},"modified":"2026-03-20T10:41:33","modified_gmt":"2026-03-20T15:41:33","slug":"the-weekly-corona-with-dr-raquel-lamarche-2","status":"publish","type":"post","link":"https:\/\/blog.unmc.edu\/infectious-disease\/2020\/04\/01\/the-weekly-corona-with-dr-raquel-lamarche-2\/","title":{"rendered":"The Weekly Corona with Dr. Raquel Lamarche"},"content":{"rendered":"

As our institution, state, country, and the world grapple with the impacts of SARS-CoV-2, causing COVID19, there are lots of ongoing discussions about coronaviruses. <\/em>Dr. Raquel Lamarche is a PGY1 Internal Medicine\/Pediatrics resident at UNMC, who will be summarizing updates about SARS-CoV-2 and hopefully make information easier to digest, with additional outlines of implications for graduate medical education. Last week we started with a primer on Human Coronaviruses (HCoVs). This week we will look at what we know about treatment so far.<\/em><\/p>\n

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“(2003) In the event that SARS CoV re-emerges, we will need clarification of the effectiveness of treatments through controlled trials<\/em>.”\u00a0<\/span>Red Book<\/span><\/a>.\u00a0<\/span><\/p>\n

We have generally treated HCoVs (Human Coronaviruses) with supportive care. Steroids, type-1 interferons, convalescent plasma, ribavirin, and lopinavir\/ritonavir, were all used in the 2002 SARS-CoV-1 outbreak, albeit,\u00a0without controlled data<\/strong>,\u00a0thus NO proof of efficacy<\/strong>. Likewise, throughout this SARS-CoV-2 pandemic, patients from multiple countries have received off-label therapies <\/span>mostly without controls.\u00a0<\/span><\/a><\/p>\n

“(2020) This tragedy of not discovering new therapies during an outbreak cannot be repeated<\/em>,” Dr. Andre Kalil, UNMC Infectious Diseases<\/a>\u00a0<\/span><\/p>\n

I discussed the need for quality evidence with my significant other, an ER-resident in NYC. “People are dying in front of our faces; I would try anything to save their lives<\/em>. You just can’t be a strategic scientist while you are flooded, getting your hands dirty, Raquel<\/em>, ” he said. Those words are enough to send a chill down the spine.\u00a0 Physicians are wired to fight for their patients and may act instinctively when faced with death and uncertainty.\u00a0<\/span><\/p>\n

But the fact remains: NO control groups = NO conclusions about clinical efficacy or safety.<\/span><\/em><\/strong><\/span><\/p>\n

\"Watercolor<\/a>Thankfully, there are some ongoing studies to help make decisions. Here’s what we know about potential treatments for SARS-CoV-2:<\/strong><\/p>\n

Remdesivir<\/strong><\/span><\/h4>\n

MECHANISM<\/p>\n