COVID-19 FAQs for the Community

COVID-19 FAQ for the Community

From the Offices of the Executive Vice Presidents for Research

Updated August 26, 2020, 2:00PM CST

Vanderbilt University Medical Center (VUMC) continues to closely follow the COVID-19 outbreak. These FAQs contain information about COVID-19 to answer questions we have received from the community. This webpage will continue to be updated frequently as new information is received and responses are subject to change. Additional information for VUMC patients is available at: https://www.vumc.org/coronavirus/information-vumc-employees-and-patient

Treatment

Current research suggests that hydroxychloroquine may not be safe or effective for treating patients with COVID-19. Some data has suggested possible significant risks associated with this drug (as of July 31, 2020).  The FDA published a caution on using hydroxychloroquine on COVID-19 outside of the hospital setting due to the risk of heart rhythm problems (source). The WHO has stopped the hydroxychloroquine arm of their COVID-19 randomized control trial because interim results were not promising in reducing mortality (source). The best way to learn how to treat COVID-19 is to conduct randomized controlled clinical trials, but many hydroxychloroquine studies have been stopped early due to safety concerns. You can search for more in-progress clinical trials at trialstoday.org.

Researchers recently showed that ivermectin, a drug used to treat parasitic infections, reduced the growth of SARS-CoV-2 in the laboratory setting. Ivermectin is currently being studied in humans for treating COVID-19, but the results are not yet known (as of July 31, 2020). Many of these studies are looking at ivermectin as a complementary drug used with other treatments. It is not known whether it is safe or helpful for this disease.  Sometimes new treatment ideas turn out to help, and sometimes they are actually proven to be harmful.  The best way to learn how to treat COVID-19 is to conduct randomized controlled clinical trials. You can search for in-progress clinical trials at trialstoday.org. 

Valacyclovir, an antiviral drug, has not yet been studied in humans for treating COVID-19 (as of July 31, 2020). It is not known whether it is safe or helpful for this disease.  Sometimes new treatment ideas turn out to help, and sometimes they are actually proven to be harmful.  The best way to learn how to treat COVID-19 is to conduct randomized controlled clinical trials. You can search for in-progress clinical trials at trialstoday.org. 

Favipiravir, an antiviral drug used for influenza in Japan, is currently being studied in humans for treating COVID-19 in over 30 clinical trials (as of July 31, 2020). It is not known whether it is safe or helpful for this disease.  A small, nonrandomized study showed that favipiravir may help remove the airway of the coronavirus (source), but large studies have not been published yet. Sometimes new treatment ideas turn out to help, and sometimes they are actually proven to be harmful.  The best way to learn how to treat COVID-19 is to conduct randomized controlled clinical trials. You can search for in-progress clinical trials at trialstoday.org.

There is not much information about the safety and effectiveness of using glutathione for treating patients with COVID-19 (as of July 31, 2020). Much larger studies are needed to tell us whether glutathione is safe or helpful for this disease.  Sometimes new treatment ideas turn out to help, and sometimes they are actually proven to be harmful.  The best way to learn how to treat COVID-19 is to conduct randomized controlled clinical trials. You can search for in-progress clinical trials at trialstoday.org.

There is very limited information about the safety and effectiveness of using arbidol/umifenovir, a drug used in China and Russia for the flu, for treating patients with COVID-19 (as of August 7, 2020) (source 1, 2).  It is not known whether it is safe or helpful for this disease.  Sometimes new treatment ideas turn out to help, and sometimes they are actually proven to be harmful.  The best way to learn how to treat COVID-19 is to conduct randomized controlled clinical trials. Trials for arbidol are in progress but the results are not known yet. You can search for in-progress clinical trials at trialstoday.org. 

There is very limited information about the safety and effectiveness of montelukast, a medication used in asthma, for treating COVID-19 (as of August 7, 2020) (sources 1, 2). It is not known whether it is safe or helpful for this disease.  Sometimes new treatment ideas turn out to help, and sometimes they are actually proven to be harmful.  The best way to learn how to treat COVID-19 is to conduct randomized controlled clinical trials. You can search for in-progress clinical trials at trialstoday.org. 

Dietary supplementation of zinc has not been linked to preventing COVID (as of August 7, 2020) (source). There is very limited information about the safety and effectiveness of using zinc for treating patients with COVID-19 (source). In the past, there have been several human trials assessing the ability of zinc lozenges to reduce symptom duration during a cold infection, but these have produced mixed results and have not included COVID-19. Sometimes new treatment ideas turn out to help, and sometimes they are actually proven to be harmful. The best way to learn how to treat COVID-19 is to conduct randomized controlled clinical trials. Trials with zinc, mostly in addition with other potential treatments, and COVID are in progress but the results are not known yet. You can search for in-progress clinical trials at trialstoday.org. 

Vitamin C has an important role in healthy immune function, and low levels in the body can increase one’s susceptibility to infections. Over past decades, there have been several human trials assessing the ability of vitamin C supplementation to reduce symptom duration and severity during a cold infection, but these have produced mixed results. However, there is very limited information about the safety and effectiveness of using vitamin C for treating or preventing COVID-19 (as of August 7, 2020). The best way to learn how to treat COVID-19 is to conduct randomized controlled clinical trials. Trials for Vitamin C are in progress but the results are not known yet (source). You can search for in-progress clinical trials at trialstoday.org. 

There is evidence that vitamin D may enhance immune functions in human cells and reduce the spread of some viruses in the laboratory setting.  However, there is very limited information about the safety and effectiveness of using vitamin D for treating or preventing COVID-19 (as of August 7, 2020)(source). If your healthcare professional finds that you have a Vitamin D deficiency, it should be treated regardless of COVID-19. The best way to learn how to treat COVID-19 is to conduct randomized controlled clinical trials. You can search for in-progress clinical trials at trialstoday.org.

There are very limited data about copper supplements building immunity and even less information about the safety and effectiveness of copper supplements for fighting COVID-19 (as of August 12, 2020). There are some studies looking at the potential role of copper as part of a combination of treatments for COVID-19 but the results are not known yet. There is some data on the COVID-19 virus not surviving for more than 4 hours on a copper surface in a lab setting, but this is different from taking copper supplements. Sometimes new treatment ideas turn out to help, and sometimes they are actually proven to be harmful.  The best way to learn how to treat COVID-19 is to conduct randomized controlled clinical trials. You can search for in-progress clinical trials at trialstoday.org. 

In May, the World Health Organization released a statement warning the community to be cautious about promoting unproven claims that nicotine, and especially smoking, could help treat COVID-19. It is well known that smoking has many negative impacts on respiratory and overall health. There is limited evidence about nicotine, outside of smoking, as a treatment for COVID-19 (as of August 12, 2020). Sometimes new treatment ideas turn out to help, and sometimes they are actually proven to be harmful. The best way to learn how to treat COVID-19 is to conduct randomized controlled clinical trials. You can search for in-progress clinical trials at trialstoday.org.

There are no published studies on the effectiveness of nicotinamide, or any dietary sources of nicotinamide, in protecting against COVID-19 (as of August 12, 2020). It is not known whether nicotinamide is safe or helpful for this disease. Additionally, soy products are not an especially rich source of nicotinamide. A randomized controlled clinical trial on the effect of nicotinamide riboside on COVID-19 outcomes among the elderly is underway in Denmark. You can search for in-progress clinical trials at trialstoday.org.

There are no published studies that say RhoGAM, sometimes referred to as Rho(D) Immune Globulin, is safe or effective to treat COVID-19 (as of August 12, 2020). The only approved use of RhoGAM is for prevention of a condition called “Rh immunization” which happens when someone with Rh-negative blood develops antibodies after exposure to Rh-positive blood, such as during a delivery. You can search for in-progress clinical trials for COVID-19 and other conditions at trialstoday.org

Ambroxol is used in other countries for breaking up phlegm in respiratory diseases. There are no studies that say Ambroxol is safe or effective to treat COVID-19 or to reduce the respiratory symptoms of COVID-19 (as of August 12, 2020). The best way to learn how to treat COVID-19 is to conduct randomized controlled clinical trials. You can search for in-progress clinical trials at trialstoday.org

Nobivac 1-cv is a vaccine approved for treating canine coronavirus which affects dogs, not humans. This vaccine does not prevent COVID-19, which is caused by a different coronavirus called SARS-CoV-2019. There are other vaccine options currently being studied for COVID-19. You can search for in-progress clinical trials at trialstoday.org.

Itolizumab, a treatment approved in India for psoriasis, was part of one study in humans for treating COVID-19 (source), but no results have been published (as of August 4, 2020). It is not known whether it is safe or helpful for this disease. The best way to learn how to treat COVID-19 is to conduct randomized controlled clinical trials. You can search for in-progress clinical trials at trialstoday.org.

Some studies have shown that selenium deficiency may be associated with COVID-19 risk (source 1, 2). There is a hypothesis that selenium supplements might help with COVID-19 (source 1, 2), but it has not yet been studied in in humans for treating COVID-19 (as of August 5, 2020). It is not known whether it is safe or helpful for this disease. The best way to learn how to treat COVID-19 is to conduct randomized controlled clinical trials. You can search for in-progress clinical trials at trialstoday.org.

Some scientists believe that ozone therapy can be used as an add-on treatment for COVID-19 or to help prevent organ damage due to COVID-19 infection. However, there is currently no definitive scientific evidence. A clinical trial is underway in Italy to study whether oxygen-ozone therapy plus probiotic supplementation is effective in slowing the progression of COVID-19. An observational trial of individuals who have already undergone ozone therapy is being conducted in Turkey to investigate whether this therapy can prevent COVID-19. You can also search for in-progress clinical trials at trialstoday.org.

Prevention

The United States Environmental Protection Agency has a searchable listing of approved products that have activity against the virus that causes COVID-19 infections.

Witch hazel is not recommended as a disinfectant against coronavirus.  The United States Environmental Protection Agency has a searchable listing of approved products that have activity against the virus that causes COVID-19 infections.

The CDC recommends frequent handwashing with soap and water for at least 20 seconds for the prevention of COVID-19.  When handwashing is not possible, the CDC recommends using a hand sanitizer with at least 60% alcohol. The United States Food and Drug Administration has a list of frequently asked questions about hand sanitizers and COVID-19.

The CDC recommends frequent handwashing with soap and water for at least 20 seconds for the prevention of COVID-19.  When handwashing is not possible, the CDC recommends using a hand sanitizer with at least 60% alcohol. The United States Food and Drug Administration has a list of frequently asked questions about hand sanitizers and COVID-19.

The active ingredient in hand sanitizers that the CDC recommends recommended for use against COVID-19 is alcohol. When handwashing is not possible, the CDC recommends using a hand sanitizer with at least 60% alcohol. Aloe vera is included in some hand sanitizers to help reduce the skin irritation that alcohol can cause for some people.

There are no studies that say drinking aloe vera juice is safe or effective in preventing COVID-19. There are no registered clinical trials looking at aloe vera juice and COVID-19 (as of August 17, 2020). The best way to learn how to treat COVID-19 is to conduct randomized controlled clinical trials. You can search for in-progress clinical trials at trialstoday.org

There is no scientific reason to believe that drinking cold water will make a COVID-19 infection worse. It is good practice when sick with any type of respiratory illness to stay well hydrated.

The CDC recommends that surfaces be cleaned with soap and water or another detergent, and then disinfected with a household disinfectant. The EPA has a list of products recommended for SARS-CoV-2019. However, people primarily get COVID-19 by close contact through respiratory droplets, not from contaminated surfaces. 

In studies, the coronavirus that causes COVID-19 appears to become undetectable on copper surfaces faster than other surfaces. To clean surfaces, though, it is still recommended to use soap and water or an EPA-recommended disinfectant. To kill the virus on your hands, use soap and water or an alcohol-based sanitizer.

There are different kinds of UV rays. There is evidence that UVC rays can kill viruses, possibly including the virus that causes COVID-19, but the sun’s UVC rays are blocked by the earth’s atmosphere. The sun’s UVA and UVB rays do reach us, but there is inconclusive evidence about their ability to kill the virus on different kinds of surfaces. All UV rays have the potential to damage cells. This damage could possibly hurt a virus, but it can also cause skin damage and skin cancer in humans. Sunblock agents help protect our skin against this kind of damage. UV light is not recommended for use in killing the virus on human skin.

The United States Environmental Protection Agency has a searchable list of approved products that have activity against the virus that causes COVID-19 infections. Borax is not on this list (as of August 25, 2020).

There is no evidence that using a saline nasal spray can protect against COVID-19 infection. However, several studies are in progress to test whether certain other types of nasal sprays (for example, those containing iodine or nitric oxide) can be effective in treating or preventing COVID-19. The best way to learn how to treat COVID-19 is to conduct randomized controlled clinical trials. You can search for in-progress clinical trials at trialstoday.org.

Glycol ether is not on the Environmental Protection Agency’s (EPA) list of disinfectants for use against the COVID-19 virus. A disinfectant on that EPA list is recommended. The CDC suggests using those disinfectants and making sure to follow the manufacturer’s instructions.

There is no evidence suggesting that products like VapoRub can prevent COVID-19 infection. The ingredients in VapoRub – camphor, eucalyptus oil, and menthol – do have antibacterial properties, and can sometimes soothe symptoms from respiratory ailments when applied to the chest or throat or used in a vaporizer. However, VapoRub should not be used in or near the nostrils because inhalation of its petroleum base can cause dangerous vapors to collect in the lungs, resulting in a pneumonia-type illness and lung damage. Camphor can also be toxic if absorbed through the lining inside the nose or accidentally swallowed.  

Other Questions

Neither, but they are all related. An antigen is part of a virus that your immune system uses to recognize it as a foreign substance – this signals your body to start making antibodies to fight the virus. Antigens and antibodies are being studied for use in tests and treatments for COVID-19. You can search for in-progress clinical trials at trialstoday.org. 

We do not know how long antibodies to the virus that causes COVID-19 last in the body, and we do not know how much protection they may give people against getting COVID again (source). Antibodies are also just one part of our immune system’s defense against a virus, including the SARS-CoV-2 virus that causes COVID-19.   Scientists will learn more about antibodies and other parts of the immune system as more people recover from COVID-19.

You should talk to your medical providers about any procedures that are not urgently needed. [source: CDC] They will help decide if there are more benefits of you receiving care than there are risks of you being exposed to the coronavirus. If you must visit in-person, you should follow recommended precautions such as wearing a mask, good hand hygiene, avoiding touching your face, and staying at least 6 feet away from others.

This likely depends on the type of exercise and the nature of the location. The CDC recommends not wearing a mask during high intensity activities, like running, if it causes breathing difficulty. Sweat can also make the mask become wet, making it even more difficult to breathe through and could promote the growth of bacteria. If unable to wear a cloth face covering, consider conducting the activity in a location with better ventilation (for instance, outdoors versus indoors) and where you can maintain physical distance from others. Gyms and other fitness sites may have their own additional requirements for mask usage. You can see more of the CDC’s considerations for wearing cloth face coverings here.

COVID-19 swab testing has not been shown to cause major injury to the nose or sinuses. When COVID-19 testing began, it was believed that nasal swabs needed to be inserted 3-5 inches into the nose to reach the back of the nasal cavity. This can be very uncomfortable, causing a small proportion of people to gag, cough, bleed from the nose, or even faint. However, newer tests use a type of swab that is much shorter in length but just as effective. The test you receive may depend on the availability of these different swabs.

N95 respirator masks can protect the wearer from respiratory droplets, including those that contain viruses like SARS-CoV-2. There is evidence that the virus that causes COVID-19 is primarily spread through large respiratory droplets, and a close fitting surgical mask can also offer protection against those. It’s critical they are “fit-tested” to ensure that it fits tightly around the nose and mouth for maximum effectiveness. Given the limited worldwide supply of both N95 and surgical masks, they are recommended only for health care professionals at greatest risk of exposure through direct COVID-19 patient care. N95 masks are not recommended for the general public, in part because they can be more difficult to breathe through. Instead, the general public is encouraged to wear reuseable cloth masks to limit the spread of the virus. You can read more about the FDA’s recommendations for personal protective equipment here.

The CDC recommends wearing a cloth face mask as barrier to prevent respiratory droplets from traveling into the air when you speak, cough, or sneeze. Studies have found that masks made of multiple layers of a tight weave fabric are more effective at blocking small particles, like those the size of virus particles. A study completed at Duke University compared droplet transmission through 14 different mask types and found the least transmission for fitted N95 and surgical masks as well as cotton-polypropylene-cotton, 2-layer polypropylene, and 2-layer cotton pleated masks, while knitted masks, bandanas, and fleece neck gaiters had higher levels of droplet transmission. All mask types reduced the droplet transmission compared to no mask at all, with the exception of the gaiter type neck fleece which appeared to cause the largest droplets to disperse into a multitude of smaller droplets. Since those smaller droplets can remain airborne longer, the fleece neck gaiter type of masks should be avoided. Masks with exhalation valves should also be avoided because they release unfiltered air and don’t protect others if you’re contagious. Masks should cover both the nose and mouth and can be secured with ties or ear loops.  They should fit snugly but comfortably, without gaps on the sides or below. You can read more about the CDC’s recommendations for cloth face coverings here.