Thursday, April 2, 2020

A Possible Treatment for COVID-19 and an Approach for Developing Others

SARS-CoV-2, the virus that causes COVID-19 disease is more transmissible, but has a lower mortality rate than its sibling, SARS-CoV, according to a review article published this week in Antimicrobial Agents and Chemotherapy, a journal of the American Society for Microbiology.

As of March 11, more than 120,000 cases of the rapidly spreading COVID-19 have been confirmed worldwide, along with more than 4,000 deaths.

In humans, coronaviruses cause mainly respiratory infections. Individuals with SARS-CoV-2 may remain asymptomatic for 2 to 14 days post-infection and some individuals likely transmit the virus without developing disease symptoms.

SARS-CoV-2 virus illustration
Credit: We Are Covert / Wikimedia Commons

So far, the most promising compound for treating COVID-19 is the antiviral, remdesivir. It is currently in clinical trials for treating Ebola virus infections.

Remdesivir was recently tested in a non-human primate model of MERS-CoV infection. Prophylactic treatment 24 hours prior to inoculation prevented MERS-CoV from causing clinical disease and inhibited viral replication in lung tissues, preventing formation of lung lesions. Initiation of treatment 12 hours after virus inoculation was similarly effective.

Remdesivir has also shown effectiveness against a wide range of coronaviruses. It has already undergone safety testing in clinical trials for Ebola, thereby reducing the time that would be necessary for conducting clinical trials for SARS-CoV-2.

Nonetheless, much work needs to be done to gain a better understanding of the mechanics of SARS-CoV-2. For example, understanding how SARS-CoV-2 interacts with the host ACE2 receptor—by which SARS-CoV-2 gains entry into the host (whether human or animal)—might reveal how this virus overcame the species barrier between animals and humans. This could also lead to design of new antivirals.

Although coronaviruses are common in bats, no direct animal source of the epidemic has been identified to date, according to the report. “It is critical to identify the intermediate species to stop the current spread and to prevent future human SARS-related coronavirus epidemics,” the researchers write.


Contacts and sources:
American Society for Microbiology


Publication: Miguel Angel Martinez. Compounds with therapeutic potential against novel respiratory 2019 coronavirus. Antimicrobial Agents and Chemotherapy, 2020; DOI: 10.1128/AAC.00399-20

Regular Exercise Benefits Immunity – Even in Isolation


New analysis highlights the power of regular, daily exercise on our immune system and the importance of people continuing to work-out even in lockdown.

Being in isolation without access to gyms and sports clubs should not mean people stop exercising, according to a new study from researchers at the University of Bath. Keeping up regular, daily exercise at a time when much of the world is going into isolation will play an important role in helping to maintain a healthy immune system.

The analysis, published in the international journal Exercise Immunology Review, involving leading physiologists Dr James Turner and Dr John Campbell from the University of Bath’s Department for Health, considers the effect of exercise on our immune function.

Credit: John Robert McPherson - / Wikimedia Commons

Over the last four decades, many studies have investigated how exercise affects the immune system. It is widely agreed that regular moderate intensity exercise is beneficial for immunity, but a view held by some is that more arduous exercise can suppress immune function, leading to an ‘open-window’ of heightened infection risk in the hours and days following exercise.

In a benchmark study in 2018, this ‘open window’ hypothesis was challenged by Dr Campbell and Dr Turner. They reported in a review article that the theory was not well supported by scientific evidence, summarizing that there is limited reliable evidence that exercise suppresses immunity, concluding instead that exercise is beneficial for immune function.

They say that, in the short term, exercise can help the immune system find and deal with pathogens, and in the long term, regular exercise slows down changes that happen to the immune system with ageing, therefore reducing the risk of infections.

In a new article, published this month, leading experts, including Dr Turner and Dr Campbell, debated whether the immune system can change in a negative or positive way after exercise, and whether or not athletes get more infections than the general population. The article concludes that infections are more likely to be linked to inadequate diet, psychological stress, insufficient sleep, travel and importantly, pathogen exposure at social gathering events like marathons - rather than the act of exercising itself.

Author Dr James Turner from our Department for Health explains: “Our work has concluded that there is very limited evidence for exercise directly increasing the risk of becoming infected with viruses. In the context of coronavirus and the conditions we find ourselves in today, the most important consideration is reducing your exposure from other people who may be carrying the virus. But people should not overlook the importance of staying fit, active and healthy during this period. Provided it is carried out in isolation - away from others - then regular, daily exercise will help better maintain the way the immune system works – not suppress it.”

Co-author, Dr John Campbell added: “People should not fear that their immune system will be suppressed by exercise placing them at increased risk of Coronavirus. Provided exercise is carried out according to latest government guidance on social distancing, regular exercise will have a tremendously positive effect on our health and wellbeing, both today and for the future.”

Regular moderate intensity aerobic exercise, such as walking, running or cycling is recommended, with the aim of achieving 150 minutes per week. Longer, more vigorous exercise would not be harmful, but if capacity to exercise is restricted due to a health condition or disability, the message is to ‘move more’ and that ‘something is better than nothing’. Resistance exercise has clear benefits for maintaining muscles, which also helps movement.

At this current time in particular, the researchers underline the importance of maintaining good personal hygiene when exercising, including thoroughly washing hands following exercise. To give the body its best chance at fighting off infections, they suggest in addition to doing regular exercise, people need to pay attention to the amount of sleep they get and maintain a healthy diet, that is energy balanced to account for energy that is used during exercise. They hope that this debate article will lead to a wave of new research exploring the beneficial effects of exercise on immune function.




Contacts and sources:
Andy Dunne
University of Bath

Publication: Can Exercise Affect Immune Function to Increase Susceptibility to Infection? Richard J Simpson, John P Campbell, Maree Gleeson, Karsten Kr├╝ger, David C Nieman, David B Pyne, James E Turner, Neil P Walsh. Exerc Immunol Rev, 2020