Drug Combinations May Be Our Best Hope For Treating Covid-19

Drug combinations may be what helps us bridge the gap to an effective vaccine.

Photo by Anna Shvets from Pexels

Drug Combinations Are Common in Viral Diseases

It is not uncommon to see viruses, particularly those for which there is not an effective vaccine, being treated with more than one drug. HIV is one example where patients are often on a cocktail of drugs, each targeted at one of the ways that HIV attacks the body. Again, this shows that there is neither a single effective drug therapy for HIV, nor an effective vaccine against HIV. It also highlights the complexity of HIV. The many steps involved in an HIV infection offer many targets for drug therapies.

Outside of social distancing, mask wearing and other public health measures, effective drug combinations may be the only weapon we have in the fight against this virus.

Covid-19, though not quite as complex as a virus like HIV, does have several demonstrated potential drug targets in its life cycle. This opens up the possibility that drug combinations may be a good option for treatment.

Drug Targets For SARS-CoV-2

The life cycle of SARS-CoV-2, the causative virus in Covid-19, can be broken down into a few phases. The first phase is binding and entry into the cell. This mechanism is well understood, involving the binding of the viral spike protein to the human ACE2 receptor, with the help of the human protease TMPRSS2. This mechanism allows the viral body to fuse with the human cell membrane and ultimately enter the cell.

Image: Ambrish Saxena, J Biosci, (2020)45:87 Source: doi: 10.1007/s12038–020–00067-w
Remdesivir molecular structure. Source: https://commons.wikimedia.org/wiki/File:Remdesivir.svg

Drug Combinations in Covid-19

We have seen a number of drug combinations come and go over the past many months. Perhaps the most memorable was the combination of the antimalarial hydroxychloroquine with the antibiotic azithromycin. This combination gained immediate attention as one of the first potential therapies in early 2020, but ultimately failed to produce any measurable effect against SARS-CoV-2.

Medical student, molecular biologist and educator. I write about science and medicine.

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