My Covid-19 Story - Possible Treatment? - Blog 33

Disclaimer: This blog post does not constitute, or replace any medical advice. If you have an emergency or a serious medical question, please contact a medical professional or call 911 immediately. The information below is simply my own personal research and observations, please discuss with your medical provider any treatments that you are considering.

My Covid-19 story starts back at the end of June beginning of July 2020. I was home working on case studies online due to the school pulling us from clinical rotations because of Covid-19. While at home awaiting to restart clinical rotations, I was awoken in the middle of the night with a fever of 101.7. I felt horrible the next day, my fever continue along with body chills, aches and malaise. I lost my taste and smell, wasn’t hungry or thirsty, and had a constant pressure headache. I barely had enough energy to get up out of bed, I felt drained. I was barely eating and drinking, honestly, I was feeling hopeless. I was taking Tylenol round the clock to help control the fevers, but as the medicine wore off, my fever would spike again. I was quarantining myself at home and was on the brink of driving myself to the hospital on day 3 of the illness. My despair led me to do what I do best, read, research and learn. I googled and read on everything that was being done with treating Covid-19 back in July of 2020. I came across some information about Valacyclovir (Valtrex), an antiviral drug that is currently prescribed for cold sores, genital herpes, shingles, and chickenpox. It’s a relatively cheap, effective and a safe medication that has been around for years, approved by the FDA in the late 90’s.

I was feeling horrible already, the information I was reading sounded interesting and promising. I figured I had nothing to loose if I tried the antiviral medication. I took 2 grams of Valacyclovir at 1 pm on day 4 of my symptoms, what happened next was almost short of a miracle. Later on that same evening, I started feeling better. I felt like I had my energy again, my fever was not spiking anymore, I was hungry, and my body aches were almost completely gone. I still had no taste or smell, but the way I was feeling overall was a night and day difference compared to just a few hours before the medicine. I continued the Valacyclovir 2 gram dose at 1 am, 12 hours after the first dose. The following day I took 1 gram every 12 hours, I took the 12 hour dose for the next 7 days. I improved significantly with every ticking hour after the first dose of Valacyclovir, what happened?

The following week after my symptoms first started a friend wanted to visit for the weekend. I was worried that the virus was still lingering in my home, I suggested that she start Valacyclovir 1gm BID prophylactically while she was visiting the weekend. She visited over the weekend, and went home on Sunday evening. That very next Tuesday my friend found out that her roommate was feeling under the weather. Her roommate went ahead and tested herself, she tested positive for Covid-19. I immediately suggested that my friend continue the Valacyclovir dose prophylactically, 1gm BID. Her roommate was very sick for several days, my friend never got Covid-19, yes even while living under the same roof in a small apartment.

Fast forward to September 2021, just a few days ago, my good friend was feeling sick and tested positive for Covid-19. I suggested that he start Valacyclovir after having symptoms and a fever that wasn’t going away, he took his first dose before bed at 8pm. I texted him the next morning to see how he was feeling, his reply “Feeling great, thanks. Just a lil bit of post nasal drip causing slight cough but no fever or headache. No Tylenol since yesterday am”. The following day my father starts feeling sick and under the weather with a fever, malaise, and muscle aches. He tested positive Covid-19, I was very concerned due to him being 73 years old. I had him start Valacyclovir that very same day, his first dose was right before bed. The very next day, no more fevers and was feeling better, he has not had a fever ever since he started Valacyclovir. So let’s address the elephant in the room………

Correlation does not imply causation but what happened in the scenarios above?

The questions below are just some of the questions that I have been trying to figure out. I self tasked myself with trying to answer the questions because it’s the reason why I went into medicine in the first place. I am a lifelong learner and I want to improve the lives and health of anyone that I come in contact with.

1. What does the medication Valacyclovir a nucleoside analogue DNA polymerase inhibitor used for the Herpes Virus & the Varicella Zoster Virus do to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)?

2. Does Valacyclovir a nucleoside analogue DNA polymerase inhibitor effect or inhibit viral replication in Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) ?

3. Are patients currently taking Valacyclovir prophylactically for HSV contracting Covid-19? If they do contract the virus, are they having mild, moderate or severe symptoms while on the medication?

4. Does the medication Valacyclovir a DNA polymerase inhibitor also weaken or inhibit viral replication in a RNA virus?

5. Does Valacyclovir a medication for HSV also penetrate infected Covid-19 cells?

6. Does the PK value of the medicinal chemical compound found in Valacyclovir cause a decrease in the acidification of the cells cytoplasm, which in turn decreases or inhibits viral replication?

7. Can we conduct a retrospective study on patients with known HSV with proper treatment and Covid-19?

What we do know so far…

Herpesvirus

• Enveloped, Icosahedral Capsid symmetry

• Double Stranded Linear DNA structure

• Virion Size 100^2 nm

Coronavirus

• Enveloped, Helical Capsid symmetry

• Single Stranded Linear RNA structure

• Non-segmented negative polarity

• Virion Size 100 nm

What is Valacyclovir?

• Antiviral drug, Initially approved by the FDA in 1995

• It can treat herpes virus infections, including shingles, cold sores, genital herpes and chickenpox

• Does not cure herpes, but may prevent herpes sores or blisters

• Valacyclovir an inactive Pro drug converted to the active drug Acyclovir after first pass metabolism

What cells does Valacyclovir target?

• Infected HSV cells

What does Valacyclovir do once you take it?

• Once inside the infected cells the viral thymidine kinase (V-TK) goes to work

• This viral enzyme converts acyclovir into 502 acyclovir monophosphate, a nucleotide analogue. The monophosphate is further converted into 503 diphosphate by cellular guanylate kinase and into triphosphate by a number of cellular enzymes.

• Acyclovir triphosphate inhibits replication of herpes viral DNA

What is the enzyme DNA polymerase?

• Viral enzyme needed by the herpes viruses to copy it’s genetic material and spread to other cells

• When Valacyclovir blocks the enzyme DNA polymerase, the virus isn’t able to multiply

• The result is an infection that’s less severe, and helps the immune system have an easier time controlling the illness.

How does Valacyclovir inhibit replication of herpes viral DNA?

1. Competitive inhibition of viral DNA polymerase

2. Incorporation and termination of the growing viral DNA chain

3. Inactivation of the viral DNA polymerase

How long does Valacyclovir stay in your system?

• It achieves peak serum concentration in 1 to 3 hours

• Valacyclovir stays in your system for approximately 22 to 25 hours

• FDA reports it is detectable in urine for up to 96 hours (4 days) after the last dose

Valacyclovir side effects?

• Headache, Dizziness, Tired feeling, Depression, Nausea, Vomiting, Stomach pain, Joint pain

Where can I get more information on Valacylovir?

• Drugs.com, Valacyclovir

Below are some studies that I have been reading over trying to make sense of my hypothesis, feel free to look at the information for yourself ;

• ACYCLOVIR for SARS-CoV-2: An Old Drug with a New Therapeutic Purpose-An Observational Study

• Understanding the pharmacokinetics of prodrug and metabolite

• VALTREX® (valacyclovir hydrochloride) Caplets Initial U.S. Approval: 1995

• An orally bioavailable broad-spectrum antiviral inhibits SARS-CoV-2 in human airway epithelial cell cultures and multiple coronaviruses in mice

• Use of Acyclovir, Valacyclovir, and Famciclovir in the First Trimester of Pregnancy and the Risk of Birth Defects

• Targeting endosomal acidification by chloroquine analogs as a promising strategy for the treatment of emerging viral diseases

• Impact of acyclovir use on survival of patients with ventilator-associated pneumonia and high load herpes simplex virus replication

• Omeprazole Increases the Efficacy of Acyclovir Against Herpes Simplex Virus Type 1 and 2

• Inhibitors of endosomal acidification suppress SARS-CoV-2 replication and relieve viral pneumonia in hACE2 transgenic mice

• A review: Mechanism of action of antiviral drugs

• Chapter 64 Antiviral therapy of HSV-1 and -2

• SARS-CoV-2 Cell Entry Is Blocked by a Clinically Proven Protease Inhibitor

• Remdesivir is a direct-acting antiviral that inhibits RNA-dependent RNA polymerase from severe acute respiratory syndrome coronavirus 2 with high potency

• High-Dose, Short-Duration, Early Valacyclovir Therapy for Episodic Treatment of Cold Sores: Results of Two Randomized, Placebo-Controlled, Multicenter Studies

• Antivirals Against Coronaviruses: Candidate Drugs for SARS-CoV-2 Treatment?

• Acyclovir for SARS-CoV-2: An Old Drug with a New Purpose

• Inhibition of SARS Coronavirus Infection In Vitro with Clinically Approved Antiviral Drugs

• Promising Acyclovir and its derivatives to inhibit the protease of SARS-CoV-2: Molecular Docking and Molecular Dynamics simulations

• Acyclovir as a Potential Adjuvant Therapy in COVID-19 Treatment Regimens

• Detection of significant antiviral drug effects on COVID-19 with reasonable sample sizes in randomized controlled trials: A modeling study

• Evaluation of safety and efficacy of prolonged suppressive therapy of genital herpes with valacyclovir

If you are automatically going to dismiss the possibility, that’s a you problem, my infatuation with medicine and science revolves around the simple fact, we are barely scratching the surface. I will be adding any new information that I may come across to this blog post in real time, also if you have been on Valacyclovir before and/or during Covid-19, I would like to hear from you. What has your experience been while taking Valacyclovir for HSV during the Covid-19 pandemic? I want to hear the good, bad or indifferent, also please share this post with your friends and family in order to collect more data, Thank you!

Coming together is a beginning, staying together is progress, and working together is success

Henry Ford

Head Up, Eyes Forward!