One of the examples, widely disseminated in the media in recent weeks, is the medication CIGB-258, with verified results in clinical trials suggesting that it could have a positive impact in treating COVID-19 patients at a certain stage of the disease.

To share experience gained thus far in Cuba with the use of this product and the properties, that supported its incorporation in the fight against the new coronavirus, Dr. Gillian Martínez Donato, CIGB researcher and manager of this scientific project, answered the following questions for Granma.

-What is the CIGB-258?

It is an immunomodulatory peptide, derived from the cellular stress response protein, known as HSP60. The molecule was designed using bioinformatic tools and is obtained by chemical synthesis.

It has functions associated with regulation of the immune system. This protein increases its presence during viral infections and inflammatory processes. Peptides (protein fragments of low molecular weight) derived from HSP60 can constitute a danger signal for the immune system and induce a response to eliminate pathogens.

Other peptides from HSP60 have an immunoregulatory function and, once the pathogens are eliminated, these peptides contribute to regulating the extent of the inflammatory response. CIGB-258 was designed to essentially activate the mechanisms that control and reduce inflammatory processes.

This peptide has been shown to be safe with evidence of efficacy in Phase I clinical study in patients with rheumatoid arthritis, by reducing the clinical activity associated with that condition, including synovitis and edema in patients’ hands.

This evidence is associated with reduced inflammation, caused by the immune system in this type of illness. It was also corroborated that, in these patients, the concentrations of inflammatory cytokines (molecules produced by the immune system) decreased. A Phase II clinical study is currently underway in 187 patients with rheumatoid arthritis, and the results will be available by the end of 2020.

-Why was the use of CIGB-258 with COVID-19 considered?

SARS-COV-2 infection has spread rapidly throughout the world. While 80% of those infected experience mild flu-like symptoms or no symptoms at all, 20% may evolve to serious or critical condition.

Statistics show that, on average, 80% of critical patients die and the fundamental cause is acute respiratory distress. This respiratory distress is caused by an exaggerated inflammatory reaction by the immune system to infection with the virus. The scientific literature calls this type of reaction a “cytosine storm”, since these molecules, secreted by cells of the immune system, abruptly increase in number.

Such a pattern of hyper-response can trigger cardiovascular collapse, multiple organ failure and death in patients with COVID-19.

Taking into account CIGB-258’s mechanism of action, linked to the regulation of inflammation, and results in clinical studies which demonstrated the safety and evidence of reduction of joint and systemic inflammation, the CIGB submitted to the State Center for the Control of Medicines, Equipment and Medical Devices (Cecmed), a request for its use in confirmed COVID-19 patients in serious and critical condition.

This request was approved, and thus its use in our country began.

-What results have been achieved with this medication?

As of May 5th, a total of 31 patients had received therapy with this peptide, 12 began therapy in serious condition and 19 critical. The survival rate for patients in serious condition treated with CIGB-258 was 92% and 73% for patients in critical condition. Overall, the survival rate for patients in these two categories was 81%.

These results are really very encouraging, especially because international reports have reported that the survival rate of COVID-19 patients in critical condition does not exceed 30%. We continue to accumulate evidence to draw conclusions about the effectiveness of CIGB-258 in treating COVID-19.

(Source: Granma)

As part of this meticulous work, Prime Minister Manuel Marrero Cruz commented that some 230 government measures have been adopted, and implementation is moving forward as projected.

He stated that, given the advance of the pandemic globally, and in line with Cuba’s prevention and control plan, the decision was made to request the withdrawal of all foreign vessels from our territorial waters.

He noted that, as the Revolution has taught us, if any situation arises regarding the health of crew members or passengers, technical problems, or fuel supplies, our government will, of course, respond as needed.

The current context also demands the suspension of arrivals to the country of all passenger aircraft, regularly scheduled or charter flights, he stated, since this poses an additional risk for our people.

In this case and as previously announced, exceptions will always be made, for our international brigades, the delivery of donations from another government, an emergency that requires facilitating airport services, or the arrival of needed supplies and merchandise, etc.

Cuban civil aeronautics authorities will convey the decision to airlines that continue to fly to the island, so protocols that are established in such cases are followed, the Prime Minister added.

(Source: Granma)

All have been placed under clinical and epidemiological observation to determine their condition if symptoms should appear. If any suspicious symptoms are noted over the next few days, testing of nasopharyngeal swab samples will be conducted and if confirmed as positive for the coronavirus, patients will be transferred to the Villa Clara Military Hospital, as established in the Plan for the Prevention and Control of Covid-19.

Established epidemiological procedures are being followed for individuals who were in contact with the three Italian tourists in Trinidad confirmed as the first cases of Covid-19 in Cuba.

According to Dr. Manuel Rivero Abella, provincial director of health in Sancti Spíritus, the seven persons in direct contact with the tourists – including their car driver, a tour operator and five in the hostel where they stayed – are currently asymptomatic, but are being transferred to the Doctor Faustino Pérez Provincial Rehabilitation Hospital, the center designated for the isolation of suspected Covid-19 cases in the province.

“They have all been placed under clinical and epidemiological surveillance to see if symptoms appear. In the event that, over the next few days, they exhibit any clinical symptoms, they will be swabbed and if confirmed positive, will be transferred to the Villa Clara Military Hospital, as established in the Plan for the Prevention and Control of Covid-19,” Dr. Rivero stated.

According to the doctor, if the contacts remain without clinical symptoms, they will return to their homes, where they will be closely monitored by epidemiologists and the community health care team.

Of the four Italian tourists who arrived in Cuba March 9, and in Trinidad the next day, three were confirmed positive for Covid-19 and to date, according to the Ministry of Public Health, their condition is not life-threatening.

A provincial strategy for treating suspicious cases of the virus was designed over the last few weeks, and has been implemented, including the establishment of specialized departments in all health institutions and the preparation of 42 beds in hospital isolation wards.

(Source: Granma)

President Díaz-Canel leads third regional meeting to evaluate implementation of Covid-19 prevention and control plan, noting that steps being taken are no cause for alarm, but rather intended to ensure timely preparation of authorities and the population

“This is not a plan of slogans, this is a realistic plan, to be executed with absolute precision,” said the President of the Republic of Cuba, Miguel Díaz-Canel Bermúdez, leading the third regional meeting to follow up on Covid-19 prevention and control plans, held in this eastern city, with public health, Party and government authorities in attendance, from the provinces of Holguín, Camagüey, Las Tunas, Granma, Santiago de Cuba and Guantánamo.

No cases of coronavirus have been identified in the country to date, and when they do appear, the news will be reported immediately, Díaz-Canel stated, noting that the situation has been objectively assessed based on the virus’s presence in the region, insisting that steps being taken are no cause for alarm, but rather intended to ensure timely preparation of authorities and the population.

“We must work with a great deal of intelligence. The plan contains fundamental concepts, to be followed by thousands of opportunities to enhance them based on everyday realities,” he stated.

He referred to the importance of community family doctors, basic working groups, district delegates and People’s Council leaders, who can ensure adequate vigilance and the dissemination of timely information at the grassroots level.

“Family doctors will need to work more intensely, covering more ground, visiting all families where there are symptoms of any abnormality associated with this type of virus,” he said.

Prime Minister Manuel Marrero insisted on the importance of outlining procedures for specific types of cases, including those for bed and breakfast inns and private restaurants, serving by a large number of international tourists. He insisted that support for personnel working in these establishments be added to surveillance and prevention plans.

(Source:Granma)