There is no cure for the coronavirus. But there are drugs that can help with symptoms at home and ones that, in a hospital environment, may – or may not – improve the chances of a person who is seriously ill.

The state-of-the-art of COVID-19 pharmacology seems to change by the day.

Medical experts around the world are sharing as much information as quickly as they can as researchers race to find therapies to quell the coronavirus pandemic.

“It’s kind of nuts. In the last four months, there have been more than 2,000 publications for COVID-19-related therapies, descriptions of the disease – it’s just an insane amount of data to keep up with, and unfortunately none of it is of the highest quality,” said Matthew Miller, who has a doctorate in pharmacy and is a clinical specialist in infectious diseases at UCHealth University of Colorado Hospital and the University of Colorado Skaggs School of Pharmacy, both at the Anschutz Medical Campus.

Miller shared with UCHealth Today his state of knowledge as of the afternoon of March 23. He considered drugs for the specific coronavirus, which causes COVID-19, SARS-CoV-2, on two fronts: medications that a person who has contracted the virus can take at home to ease symptoms, and ones that hospital providers are using for those admitted for serious cases.

Try this at home

Roughly 80% of coronavirus cases do not require hospitalization. Information about testing for COVID-19 at UCHealth may be found here. Most cases, identified via a test or not, can be cared for just as well at home, test or not. You treat the symptoms as you would that of a bad flu – adding a major focus on hand hygiene and household disinfection to prevent the coronavirus from spreading to others in the household, Miller says.

• Hydrate with water or other clear fluids (the caffeine in coffee, cola, and many teas is a mild diuretic, diminishing the hydrating effect). “People with high fevers can lose more fluids,” Miller said.
• Pain relievers and fever reducers – including NSAIDs such as ibuprofen – should be fine. A March 11 article in the British medical journal The Lancet raised temporary alarm about the hypothetical possibility of ibuprofen/NSAIDs being a hindrance to COVID-19 treatment. That has since been contradicted by World Health Organization and the Food and Drug Administration. With the exception of patients with conditions that would preclude ibuprofen and other NSAIDs anyway (kidney conditions, high blood pressure, and others), “There’s no specific reason to avoid NSAIDs,” Miller said.
• Lozenges, cough drops, and over-the-counter medicines such as dextromethorphan (Robitussin and others) and guaifenesin (Mucinex and others) can help with the cough that often comes with COVID-19. Dextromethorphan could be the choice for the dry cough that COVID-19 is best known for; guaifenesin that for wetter coughs. Some formulations include both. Again, the idea is to improve symptoms – neither will address the underlying virus.
• Sinus congestion and runny nose isn’t a typical symptom, but over-the-counter decongestants can help here.
• Zinc lozenges may help (or may not) reduce viral replication in the nose and throat, but their effectiveness with SARS-CoV-2 remains unproven.
• Those taking ACE inhibitors or ARBs for cardiovascular issues should continue to do so, Miller says, citing a March 17 American College of Cardiology statement that reads, in part, “The continued highest standard of care for cardiovascular disease patients diagnosed with COVID-19 is top priority, but there are no experimental or clinical data demonstrating beneficial or adverse outcomes among COVID-19 patients using ACE-I or ARB medications.” The statement does add the caveat that the recommendation could change with a better understanding of COVID-19 on these patients.

Miller says that a community pharmacist can help recommend specific products for specific patients. He urges those with symptoms to send a proxy for onsite inquiries, though. People who have any symptoms of illness – such as a fever, cough or shortness of breath, should stay home and isolate themselves so they don’t infect anyone else since COVID-19 is proving to be extremely contagious.