Hong Kong public hospitals to revise Covid-19 treatment guidelines, highlight effective drugs behind low mortality rates

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Hong Kong’s public hospitals will revise clinical treatment guidelines for Covid-19 patients to better highlight the effectiveness of an antiviral drug that has helped achieve one of the lowest coronavirus death rates in the world.

Dr Owen Tsang Tak-yin, medical director of the Hospital Authority’s infectious disease centre at Princess Margaret Hospital, made the revelation at a media briefing on Thursday as the city’s third wave of infections showed signs of easing, with health officials reporting 21 new cases, taking the local tally to 4,755, with 81 related deaths.

Hong Kong to push ahead with easing social-distancing rules, confirms 21 new cases

“The third wave has been very rapid and fierce,” Tsang said. “But despite that, we have one of the lowest mortality rates worldwide, at about 1.6 per cent.”

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One factor that helped suppress the death rate was effective treatment, which centred on a cocktail therapy involving antiviral drug Interferon; Kaletra, a drug originally used for HIV/Aids, and Ribavirin, which was also used for hepatitis C, according to Tsang.

Ribavirin, which was used for hepatitis C treatment. Photo: Handout
Ribavirin, which was used for hepatitis C treatment. Photo: Handout

The treatment guidelines, which were last updated in June, would be revised “very soon”, Tsang said, and would highlight Interferon as the major medication for Covid-19, combined with Ribavirin. But Kaletra may lead to some side effects and has proved to be unsuitable for some patients, causing liver problems in such cases.

Kaletra, a drug originally used for HIV/Aids. Photo: Handout
Kaletra, a drug originally used for HIV/Aids. Photo: Handout

Another antiviral drug, Remdesivir, was found to be most effective among patients in severe condition requiring oxygen support, but less effective in those who are critically ill and requiring intubation, while Hydroxychloroquine and Chloroquine have been ruled out as overseas research have shown their ineffectiveness.

Dexamethasone, a type of steroid used to treat patients with the severe acute respiratory syndrome. Photo: AFP
Dexamethasone, a type of steroid used to treat patients with the severe acute respiratory syndrome. Photo: AFP

Tsang said Dexamethasone, a type of steroid used to treat patients with the severe acute respiratory syndrome, had been effective in seriously ill Covid-19 sufferers, as the drug could alleviate inflammation of major organs, a condition from the coronavirus that had led to multiple complications.

One factor that helped suppress Hong Kong’s Covid-19 death rate was treatment centred on a cocktail therapy involving antiviral drug Interferon. Photo: National Museum of American History
One factor that helped suppress Hong Kong’s Covid-19 death rate was treatment centred on a cocktail therapy involving antiviral drug Interferon. Photo: National Museum of American History

Reflecting on the local third wave, the veteran doctor said the patients’ median age had risen from 32 during the previous wave in March, to 48. Since the pandemic began, he said, some 95 per cent of Covid-19 patients who died had suffered from chronic illnesses like high blood pressure and diabetes, while the death rate among the elderly could be as high as 29.6 per cent for those over 90, and 23.6 per cent among those aged between 80 and 89.

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