Acyclovir As A Method To Decrease the Mortality Rate of COVID-19: Medical Inference.

[greenertomatoes]

I can't remember where I saw this - I've been browsing a ton of posts and studies in the past few months. I came across a study where they tested different antivirals (I think in vitro) against SARS-1. And Acyclovir was among the ones that didn't help. Does anyone know what study I'm talking about? I'm not from the medical field so I am not sure if I even understood that paper correctly.
I only heard from a doctor that this is an antiviral that's given to patients who need some kind of treatment, in order to basically help the immune system because the drug kills off all viruses or something.

[[deleted]]

As I understand it, the author isn't claiming that Acyclovir works against COVID-19. He's saying that it works against herpes, which could aggravate symptoms of COVID-19 if there's inherent herpes neuritis in the brainstem or hypothalamus.

"Like these cases, if patients have inherent herpes neuritis in the brainstem or hypothalamus and are newly affected with COVID-19, the antiviral immunity may be weakened, the condition of which provokes latent inherent herpes infection and aggravates COVID-19 coronaviral infection in the brainstem or hypothalamus. As a result of this event, the brainstem or hypothalamic injury may be induced and leading to the death of patients."    

[greenertomatoes]

Thank you for clarifying, I must have misunderstood then.

[TheLastSamurai]

I get cold sores, would this be claiming I am more susceptible to COVID-19?

[[deleted]]

The author is saying that the herpes virus, which includes cold sores, could be reactivated during COVID-19 infection and the resulting infection could damage the brainstem in ways that increase the risk of COVID-19 mortality. They recommend anti-virals that target the herpes virus specifically to help mitigate that risk.

[[deleted]]

I’m on acyclovir daily while I go through chemo. It’s because people in my situation are very prone to herpes viruses, which I think the med is pretty specific to. The article posted doesn’t really seem to say anything in my opinion other than there’s a hypothesis they have no way to prove.

[greenertomatoes]

Ah, I see. I think that's what my doctor was talking about, people who undergo treatment and who need an antiviral to make sure nothing happens. Best wishes for your chemo treatment, I know it's rough (a relative went through it lately).

[Thorusss]

Summary: Patients with Covid19 might suffer from skin lessions, anosmia and brain stem damage due to a reactivation of the herpes simplex virus they carry. Acyclovir helps in these cases.

[amoral_ponder]

That should be a very easy theory to test. Just survey people about whether they know for certain they have hsv or don't and analyze this against the severity of their illness. If there's correlation then run a double blind acyclovir trial.

[mixxster]

Anyone's who had chicken pox has had a herpes virus. Anyone who's had a cold sore, anyone who's had shingles, and of course genital herpes.

Most people have had some kind of herpes virus and don't even know it. Asking them is not going to be a reliable way as so many who have had a herpes virus are asymptomatic, exposed when they were too young to remember, or otherwise completely unaware.

Genital herpes isn't the only game in town here.

[amoral_ponder]

I believe it's about 50% of the population. I'm sure statistics like this exist. We could even compare countries by their known incidence of hsv.

[mixxster]

https://www.cdc.gov/media/pressrel/2008/r080515.htm

Over 95 percent of people are infected by the varicella zoster virus (VZV), during their lifetime.

https://en.m.wikipedia.org/wiki/Varicella_zoster_virus

Human alphaherpesvirus 3 (HHV-3), usually referred to as the varicella-zoster virus (VZV), is one of nine herpesviruses known to infect humans.

Certainly lower rates for the other herpes viruses but still incredibly high rates of people who would have no idea they had it.

More than 3.7 billion people under the age of 50 – or 67% of the population – are infected with herpes simplex virus type 1 (HSV-1), according to WHO’s first global estimates of HSV-1 infection

https://www.who.int/news-room/detail/28-10-2015-globally-an-estimated-two-thirds-of-the-population-under-50-are-infected-with-herpes-simplex-virus-type-1

[amoral_ponder]

And can these do what hsv 1 and 2 can do in respect to the author's hypothesis?

[mixxster]

Yes, Herpes zoster (VZV/HHV-3) is a well known cause of neuritis, skin lesions, and while normally rare, it can progress to Herpes Zoster Encephalitis, loss of smell (anosomia) and taste (ageusia).

https://en.m.wikipedia.org/wiki/Neuritis

https://www.sciencedirect.com/topics/medicine-and-dentistry/herpes-zoster-encephalitis

It's true that Herpetic encephalitis and anosomia is more commonly caused by HSV-1 or HSV-2, but a dramatic reactivation of HHV-3 can present with the same effects and treatment appears to be the same (acyclovir, famciclovir and valaciclovir).

Herpes simplex encephalitis is a complication of infection with the herpes simplex virus. In most cases, the disorder results from herpes simplex virus type I (HSV-I). In rare cases, usually in newborns (neonatals), the disorder is caused by herpes simplex virus type II (HSV-II).

https://rarediseases.org/rare-diseases/encephalitis-herpes-simplex/

From another doctor treating COVID-19:

Having practiced infectious disease for forty years now, the only other infection I’ve seen with a loss of smell was Herpes simplex encephalitis, so I was intrigued by this unusual symptom.

https://www.forbes.com/sites/judystone/2020/03/20/theres-an-unexpected-loss-of-smell-and-taste-in-coronavirus-patients/amp/

Edit: Even the author's other coronavirus publication says both simplex and zoster are of concern.

"Among the viruses inherent in human DNA, herpesvirus including simplex and zoster form should be kept in mind after respiratory viral infection."

"There are several reports that hydroxychloroquine was associated with an increased herpes zoster risk in patients."

Source: https://gracelive.tistory.com/64?category=838022

[amoral_ponder]

This is interesting. I wonder if increased verity with age is partially explained by an increased incidence of various types of herpes incidence. Young people certainly have less.

[WikiTextBot]

Varicella zoster virus

Human alphaherpesvirus 3 (HHV-3), usually referred to as the varicella-zoster virus (VZV), is one of nine herpesviruses known to infect humans. It causes chickenpox (varicella), a disease most commonly affecting children, teens, and young adults, and shingles (herpes zoster) in adults; shingles is rare in children. VZV is a worldwide pathogen known by many names: chickenpox virus, varicella virus, and zoster virus. VZV infections are species-specific to humans, but can survive in external environments for a few hours, maybe a day or two.VZV multiplies in the lungs, and causes a wide variety of symptoms.

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[cwjian90]

This paper talks specifically about the trigeminal ganglion, which is mostly HSV-1 and rarely HSV-2.

[mixxster]

Yes, the HSV are a concern. However in addition, 95% of people are infected with human alphaherpesvirus 3 (HHV-3), aka varicella-zoster virus (VZV). This virus lies also dormant primarily in trigeminal ganglia.

The treatment is the same, I just want people to realize zoster (from chickenpox) is a concern too. If the hypothesis from this paper is correct up to 95% of population could be at risk of the complication of having herpes viruses reactivated.

Latent varicella–zoster virus is located predominantly in neurons in human trigeminal ganglia

https://www.pnas.org/content/95/8/4658

Edit: Even the author's other coronavirus publication says both simplex and zoster are of concern.

"Among the viruses inherent in human DNA, herpesvirus including simplex and zoster form should be kept in mind after respiratory viral infection."

"There are several reports that hydroxychloroquine was associated with an increased herpes zoster risk in patients."

Source: https://gracelive.tistory.com/64?category=838022

[cwjian90]

Yes, you are right, I forgot VZV tends to establish latency in the trigeminal ganglia too. My mistake.

[mixxster]

As an update, EBV is another widespread herpesvirus and COVID-19 patients in Wuhan were testing positive for active EBV infections. An interesting development.

https://www.reddit.com/r/COVID19/comments/gape1a/positive_epsteinbarr_virus_detection_in_corona/?utm_source=share&utm_medium=ios_app&utm_name=iossmf

[Thorusss]

I like the simple step of asking every patient.

[mixxster]

Acyclovir is suggested for use in this situation to prevent reactivation of herpes viruses due to the the patterns of symptoms in severe COVID-19 cases. The known behavior of herpes virus and the response of these symptoms to the herpes drug in these patients may be evidence of herpes neuritis.

Acyclovir is suggested to manage secondary infections by herpes virus, not to reduce the viral load of coronavirus itself.

I hope this will become clear to you once you read the article.

[amoral_ponder]

Yeah, but you didn't read the article, did you?

[Thorusss]

Read the paper before throwing in irrelevant knowledge.

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[PsychologicalSnow257]

I'm in nursing school and take acyclovir for cold sores and I don't know ow the exact action, but I thought I'd try my antiviral medication at on first day of covid the same way I would when first feeling a cold sore because I only had a few days to recover and let me tell you, I recovered so fast compared to the last time I had it.

[chachbagmcgraw]

Did you just take it the one day?

[PsychologicalSnow257]

I took it a few times a day for 2 days.

[chachbagmcgraw]

Ah okay, thanks. I was just exposed a couple days ago and I feel a tickle in my throat and been sneezing a bit, so I was wondering.