There is no specific drug or therapy against COVID-19. Since the beginning of the pandemic, scientists are running to discover a drug or therapy that can treat the disease. What we found until now are a combined drug and therapies that can mitigate the effects of the disease in the human body and how to manage the patient better. In this article, we tried to join the new discoveries and presented the drugs and therapies and their mechanisms to combat the SARS-CoV-2. We showed the immunomodulators, parasiticides, antiviral drugs (focused on Remdesivir), antimalarial drugs, anti-cytokine drugs focused on the role of IL-6, Reumathological drugs, inhibitors of cell-receptors, antiinflammatory drugs, especially the role of corticosteroids (dexamethasone), antibiotics (azithromycin), anti-thrombotic drugs, blood derivates therapies and alternative therapies currently used against COVID-19. Also, we listed the main results of clinical trials of new therapies presented by Recommended Panel Treatment Guidelines [NIAID-RML (USA)]. We searched the data in the main database (PubMed/Medline, Elsevier Science Direct, Scopus, Isi Web of Science, Embase, Excerpta Medica, UptoDate, Lilacs, Novel Coronavirus Resource Directory from Elsevier), in the high-impact international scientific Journals (Scimago Journal and Country Rank - SJR - and Journal Citation Reports - JCR), such as The Lancet, Science, Nature, The New England Journal of Medicine, Physiological Reviews, Journal of the American Medical Association, Plos One, Journal of Clinical Investigation, and in the data from Center for Disease Control (CDC), National Institutes of Health (NIH), National Institute of Allergy and Infectious Diseases (NIAID) and World Health Organization (WHO). We prior selected meta-analysis, systematic reviews, article reviews, and original articles in this order. We used 302 articles from March to June 2020, using the terms coronavirus, SARS-CoV-2, novel coronavirus, Wuhan coronavirus, severe acute respiratory syndrome, 2019-nCoV, 2019 novel coronavirus, n-CoV-2, covid, n-SARS-2, COVID-19, corona virus, coronaviruses, immunomodulators, parasiticides, antiviral, antimalarial, anti-thrombotic and anti-cytokine, antiinflammatory, Reumathological drugs, inhibitors of cell-receptors, antibiotics, blood derivates therapies and alternative therapies, with the tools MeSH (Medical Subject Headings), AND, OR, and the characters [,“,; /., to ensure the best review topics. We concluded that despite there is no treatment or drugs against the COVID-19, a combined therapy can help and mitigate the effects of the disease, helping the immune system to combat the virus.

Since the beginning of the pandemic of new coronavirus, scientists are trying to elucidate the mechanisms of SARS-CoV-2 replication in the human body, its genome, and the behavior of the virus into cells. Also, at the beginning of the outbreak, they found that the unique problem of the virus is the severe acute respiratory syndrome pneumonia, however, new discoveries revealed that the virus affects major organ systems in the human body, causing injuries and letal damages. In addtion, the tests for diagnosing the virus has became a priorty. So, based on the literature review, we showed in this articles the mechanisms of the virus into cells, the symptoms, the clinical course of the disease, and the main injuries caused in the human body’s systems by the SARS-Cov-2, and the laboratory findings. We based our research in the articles of the main database (PubMed/Medline, Elsevier Science Direct, Scopus, Isi Web of Science, Embase, Exerpta Medica, UptoDate, Lilacs, Novel Coronavirus Resource Directory from Elsevier), in the high-impact international scientific Journals (Scimago Journal and Country Rank - SJR - and Journal Citation Reports - JCR), such as The Lancet, Science, Nature, The New England Journal of Medicine, Physiological Reviews, Journal of the American Medical Association, Plos One, Journal of Clinical Investigation, and in the data from Center for Disease Control (CDC), National Institutes of Health (NIH), National Institute of Allergy and Infectious Diseases (NIAID) and World Health Organization (WHO). We prior selected meta-analysis, systematic reviews, article reviews and original articles in this order. We reviewed more than 317 articles and used 235 from March to June 2020, using the terms coronavirus, SARS-CoV-2, novel coronavirus, Wuhan coronavirus, severe acute respiratory syndrome, 2019-nCoV, 2019 novel coronavirus, n-CoV-2, covid, n-Sars-2, COVID-19, corona virus, coronaviruses, Pathogenesis, clinical manifestations, symtoms, damage, injuries, laboratory, diagnosis, with the tools MeSH (Medical Subject Headings), AND, OR, and characters [,“,; /., to ensure the best review topics. We concluded that the virus could affect and damage the respiratory system, cardiovascular system, digestive system, urogenital system, and central nervous system. It makes the treatment harder than the physicians found at the beginning of the pandemic. We are initiating our understanding of this new virus and the effect in patients during the symptoms and after them. A deeper understanding of this virus from biomedical research and epidemiological observation will provide important clues to etiologic research, diagnosis, differential diagnosis, treatment, and prognostic assessment against COVID-19.

In this review article, we presented a gold-standard method to detect the SARS-CoV-2, the novel virus that is causing the COVID-19 outbreak, and the use of a computer tomography (CT) method to detect the complications of the disease. We showed the controversial analysis about which method is the best to detect the disease earlier due to the COVID-19 complications. We searched the articles in the main database (PubMed/Medline, Elsevier Science Direct, Scopus, Isi Web of Science, Embase, Excerpta Medica, UptoDate, Lilacs, Novel Coronavirus Resource Directory from Elsevier), in the high-impact international scientific Journals (Scimago Journal and Country Rank - SJR - and Journal Citation Reports - JCR), such as The Lancet, Science, Nature, The New England Journal of Medicine, Physiological Reviews, Journal of the American Medical Association, Plos One, Journal of Clinical Investigation, and in the data from Center for Disease Control (CDC), National Institutes of Health (NIH), National Institute of Allergy and Infectious Diseases (NIAID) and World Health Organization (WHO). We prior selected meta-analysis, systematic reviews, article reviews, and original articles in this order. We reviewed 96 articles and used 45 from March to June 2020, using the terms coronavirus, SARS-CoV-2, novel coronavirus, Wuhan coronavirus, severe acute respiratory syndrome, 2019-nCoV, 2019 novel coronavirus, n-CoV-2, covid, n-SARS-2, COVID-19, corona virus, coronaviruses, RT-PCR, computer tomography (CT), diagnostic methods, with the tools MeSH (Medical Subject Headings), AND, OR, and the characters [,“,; /., to ensure the best review topics. We concluded that chest CT plays an important role in the timely detection of lung infection abnormalities in the early phase of COVID-19 infection. However, the RT-PCR is the gold standard method to detect SARS-CoV-2.

Scientists, health organizations, and pharmaceutical companies are making a large global effort to develop vaccines against SARS-CoV-2, the virus of COVID-19 since the outbreak began. Until now, we have more than 150 candidates. However, 19 vaccine candidates have entered clinical trials in phase 2 and 3 trials (31 July 2020). In this article we aimed to present the platforms for COVID-19 vaccine, the types of vaccines (live, attenuated, inactivated, DNA/RNA, proteins subunits, viral vector), the antigen selection, adjuvants, and we focused on the phase 2/3 trial vaccines at this point (Sinopharm, Coronavac, Moderna, Oxford, Biontech). We searched the data in the main database (PubMed/Medline, Elsevier Science Direct, Scopus, Isi Web of Science, Embase, Excerpta Medica, UptoDate, Lilacs, Novel Coronavirus Resource Directory from Elsevier), in the high-impact international scientific Journals (Scimago Journal and Country Rank - SJR - and Journal Citation Reports - JCR), such as The Lancet, Science, Nature, The New England Journal of Medicine, Physiological Reviews, Journal of the American Medical Association, Plos One, Journal of Clinical Investigation, and in the data from Center for Disease Control (CDC), National Institutes of Health (NIH), National Institute of Allergy and Infectious Diseases (NIAID) and World Health Organization (WHO). We prior selected meta-analysis, systematic reviews, article reviews, and original articles in this order. We reviewed 216 articles and used 106 from March to June 2020, using the terms coronavirus, SARS-CoV-2, novel coronavirus, Wuhan coronavirus, severe acute respiratory syndrome, 2019-nCoV, 2019 novel coronavirus, n-CoV-2, covid, n-SARS-2, COVID-19, corona virus, coronaviruses, vaccine, platform, antigen, subunit, live and attenuated vaccine, RNA vaccine, live vaccine, inactivated vaccine, types of vaccines, adjuvants, replication, viral vector, phase 1-3, trial, with the tools MeSH (Medical Subject Headings), AND, OR, and the characters [,“,; /., to ensure the best review topics. We concluded that although vaccines have shown safety in phase 1 and efficacy in phase 2 and the beginning of phase 3 is starting, the most renowned scientists believe that a vaccine will be available only in the middle of next year.

This Appendix 1 presents the clinical trials against COVID-19 registered in WHO and clinicaltrials.gov by United States of America database.