Treating COVID-19 Patients with a Pill

Dr. Neha Narula with Stanford Health Care talks about a clinical trial that's looking at a possible new oral treatment from Pfizer

Video Transcript

MICHELLE GRIEGO: Pfizer is testing a new pill that could help treat patients with COVID-19. We asked Dr. Neha Narula with Stanford Health Care about that trial and some of the other latest coronavirus headlines.

NEHA NARULA: Yes, indeed. So Pfizer recently announced that they have begun the early stages of a clinical trial looking at this new antiviral, and the name is PF-07321332. And it's known as a protease inhibitor, which is to be taken at the first sign of a COVID infection. Now the way this medication works is that it binds to and blocks a viral enzyme called protease that is responsible for viral replication within our cells.

And so while this particular antiviral is new, we've actually had very effective and therapeutic medications, antivirals in particular, that have been used and that are currently being used against viruses like HIV and hepatitis C. And they're very effective, and they work in similar mechanisms. So it's definitely getting a lot of buzz as a possible treatment for those who do end up contracting COVID.

And this comes at a very important time, because we are now seeing this third surge in Europe. We're now seeing rising numbers of variants. And so while vaccines are still the most effective way to prevent COVID, along with our social distancing, hand washing, in order to tackle this pandemic successfully, not only are we going to need preventative strategies, but also effective therapeutics. And so this particular medication, we are eagerly anticipating the results of the clinical trials, because an effective treatment will help us put this pandemic behind us, help prevent severe COVID infections, help prevent severe complications. And so super excited to hear more about this.

- In our last segment, we had talked about the AstraZeneca vaccine and the possible link to blood clotting, the rare instances of blood clotting. Do we know any more about that now?

NEHA NARULA: So yes, as you've mentioned, several countries in Europe, we talked about this last week, paused their vaccine rollouts. And a number, it's now around 30 reported blood clots following AstraZeneca vaccine being administered across Europe, and mostly in women under the age of 55. Now we don't have conclusive data on causation, but there were two groups, one in Norway and one in Germany, that independently examined patients within their own respective countries and found that these clots are possibly due to the vaccine triggering an autoimmune response that is overactivating cells in our body called platelets.

Now platelets are important. They do help us-- you know, whenever we get a cut or a scrape, they help prevent us from bleeding out. They create clots so that we don't bleed out. But what we're seeing is that these vaccines may be triggering a response within our body that's overactivating these cells, creating unnecessary clots.

And so we have to remember these-- these research studies are not yet published or peer reviewed. And so we will have to continue to follow up on these studies. But if there is some basis, if there's some truth to their findings, the good news is that we can identify these particular adverse effects and treat them very effectively. And so, as you mentioned, this is a very rare complication.

We have to remember that it is about 30 patients in millions. So it is-- it's super rare. It's a very small percentage. And in-- in the millions of people that have suffered from severe complications, hospitalizations, and death, we are seeing that this small percentage does not allow us to say this is super risky to take this vaccine. In fact, the WHO and the European Medicines Agency have both stated that the benefits of this particular vaccine tremendously outweigh the risks.

- And speaking of vaccines and safety, is it safe for pregnant women to get vaccinated?

NEHA NARULA: Yes, so exciting research was actually just published this past week in the "American Journal of Obstetrics and Gynecology." And they were-- this particular group of women was studied in big centers like MGH, Mass General, Brigham and Women's Hospital, MIT, Harvard. And what they looked at was the antibody response in 130 women, of which 84 were pregnant, 31 were lactating, and they compared them to nonpregnant vaccinated individuals.

And what they found was that the vaccines elicited equivalent antibody levels in both groups. Additionally, some more information that was found were that these mothers were actually passing these antibodies onto their newborns. So sufficient antibody levels were found in breast milk and placenta. And this is a fantastic finding, because the first few months is such a vulnerable time period for newborns, and so having this extra protection through the antibodies being passed on from their mothers is just a relief to know, because they will have some protection against COVID.

Additionally, there were no more side effects in this particular group of women than the general public. So it's a very inspiring and positive study, mostly because, you know, initial clinical trials, pregnant women are not included. And we know that pregnancy is an increased risk for severe COVID infections, complications, and adverse outcomes such as preterm birth. So overall, very, very exciting. And I think it reassures us as a medical community that we can effectively offer these vaccines to our pregnant patients.

- So we were talking about long haulers, and we know that some people really suffer some effects long after contracting COVID. And there's a new study that's taking a closer look at that. Do we know any more what that study shows?

NEHA NARULA: Yeah, so when the pandemic started, as a medical community, we were expecting some long-term consequences of COVID, just given the number of ICU stays, hospitalizations, and the severe complications we were seeing. What we didn't expect were to have long-term consequences in patients in mild-to-moderate infections that were being seen on an outpatient setting. And so symptoms like fatigue, body aches, brain fog, chest pains, they were being reported anecdotally or through grassroots efforts.

And recent research is now estimating that about 10% to 30% of infected COVID patients will suffer from these prolonged symptoms, or what we're calling long COVID. And now with more than 30 million cases, just taking that-- that lower end of that range, you're still looking at millions of people being affected by these long COVID symptoms. And this is where Dr. Mehta and Dr. Lau from Johns Hopkins have come to organize and actually recently launched the largest study looking at this particular group of patients that are long hauler patients.

And the study is called COVID Long Study. And they're hoping to recruit about 25,000 patients. At this point, we know they've had about a quarter of patients-- a quarter of that number register already. They're continuing to kind of gather that information about their demographics, their health history, their initial COVID symptoms, their long hauler symptoms.

And they're going to be analyzing that to better understand this disease, and not only just what they've experienced, but also the trajectory going forward. And so we don't have any data as of now. But we're hoping to learn so much from-- from this large study that's going to be coming out of Johns Hopkins. So more to come on that.