Contemporary narrative review of treatment options for COVID‐19

Abstract

The coronavirus disease 2019 (COVID-19) pandemic is ongoing and many drugs have been studied in clinical trials. From a pathophysiological perspective, anti-viral drugs may be more effective in the early stage while immunomodulators may be more effective in severe patients in later stages of infection. While drugs such as lopinavirritonavir, hydroxychloroquine and azithromycin have proved to be ineffective in randomized controlled trials, corticosteroids, neutralizing monoclonal antibodies, remdesivir, tocilizumab and baricitinib have been reported to benefit certain groups of patients with COVID-19. In this review, we will present the key clinical evidence and progress in promising COVID-19 therapeutics, as well as summarize the experience and lessons learned from the development of the current therapeutics.

Alamandine: Potential Protective Effects in SARS-CoV-2 Patients

“…Although only one medication to treat COVID-19 has been approved by the U.S. Food and Drug Administration (FDA), many medications are being tested [ 9 ]. Below, we describe various available treatments for COVID-19 [ 9 ].…”

“…Remdesivir is the only drug approved by the FDA to treat COVID-19 [ 9 ]. Remdesivir binds to the viral RNA-dependent RNA polymerase and inhibits viral replication by preventing RNA transcription from being completed.…”

“…Remdesivir binds to the viral RNA-dependent RNA polymerase and inhibits viral replication by preventing RNA transcription from being completed. In in vitro , it exhibits anti-SARS-CoV-2 activity [ 9 ]. However, the results of remdesivir randomized controlled trials (RCTs) have been inconsistent.…”

“…Current RCTs of remdesivir focused on hospitalized patients have revealed that remdesivir had no significant therapeutic effects for COVID-19 patients. However, several individual studies have shown promising outcomes among individuals at the early stages of the disease [ 9 , 10 ].…”

“…Chloroquine and hydroxychloroquine prevent viral infection by increasing the pH (from approximately 4.0 to 6.0) of cellular endosomes (which is required for virus-cell fusion) and interfering with SARS-CoV cellular receptor glycosylation [ 11 ]. RCTs and meta-analyses indicate that chloroquine and hydroxychloroquine do not protect against SARS-CoV-2 infection, decrease mortality, reduce the duration of hospital stay, or improve clinical outcomes [ 9 ].…”