Pharmacological treatment of COVID-19: an update

Abstract

Background Background The ongoing coronavirus disease-19 (COVID-19) pandemic, caused by the novel coronavirus 2 (SARS-CoV-2) has triggered a worldwide search for medications addressing the morbidity and mortality associated with it. Various medications have been proposed and applied to control COVID-19 based on previous experiences with other viral infections. Some of these have been shown to be harmful or lack efficacy. This review discusses the medications that have been repurposed for SARS-CoV-2, experimental medications undergoing clinical trials, as well as the regional variations in COVID-19 treatments. Methods Methods A literature search was conducted to cover the period of January 2020 to September 2020 using the keywords "medications, treatment, therapeutics, pharmacological management for COVID-19" in various combinations as search strings. PubMed, LitCOVID, Google Scholar, Science Direct, and clinicaltrials.gov were the databases utilized. Results Results Evidence from ongoing clinical trials has shown promise with antiviral medications such as remdesivir, as well as corticosteroids, and convalescent plasma for severe cases of COVID-19. There is still, however, some conflicting evidence on the true benefits of these treatments. Other medications such as interferons, monoclonal antibodies, immune modulators, do not have enough clinical evidence of their safety and efficacy in COVID-19 patients for their recommended use. The role of anticoagulants and pulmonary vasodilators is still being explored. The efficacy of hydroxychloroquine is yet to be demonstrated in COVID-19 patients and is currently no longer recommended. Experimental medications targeting specific viral proteases are future promising therapies. Conclusions Conclusions The retinue of medications being used to treat COVID-19 is evolving and expanding as more clinical trials provide results. Several potential medication therapies are currently being investigated. While awaiting an approved safe and efficacious medication to treat this virus, a periodic review of ongoing research is highly encouraged.

COVID-19 Tanı Testleri, Tedavisindeki Aşılar ve İlaçlar; Güncel Durum

“…COVID-19 tedavisinde kullanılan antiviraller arasında remdesivir, favipiravir, umifenovir, lopinavir/ ritonavir ve ribavirin bulunur. Bu antivirallerin monoterapide ve başka ilaçlarla kombinasyon halinde kullanımı-nın değerlendirilmesine dair klinik araştırmalar sürmektedir 44 .…”

“…Ribavirin, viral RNA'ya bağımlı RNA polimerazı inhibe eden bir guanin analogudur 64 . Hepatit C, solunum sinsityal virüsü ve Lassa Ateşi gibi bazı viral hemorajik ateşleri tedavi etmek için kullanılan antiviral bir ilaçtır 44 . 2003'te SARS-CoV ve 2012'de MERS-CoV salgınları sırasında kesin bir terapötik fayda sağlamadığından, COVID-19 salgını sırasında COVID-19 Tanı Testleri, Tedavisindeki Aşılar ve İlaçlar daha az sayıda klinik test yapılmıştır 64 .…”

“…Yüksek IL-6 seviyesi kötü prognozla ilişkilendirildiğinden bu sitokinlerin inhibe edilmesin ağır COVID-19 hastalarında iyileşmeye sebep olacağı düşünülmüştür 74 . Ağır COVID-19 hastalarında kullanılan ve olumlu sonuçlar veren tek IL-6 inhibitörü tocilizumab'tır 44 . Tocilizumab, IL-6 reseptörüne yüksek afinite ile bağlanan bir rekombinant insan IL-6 reseptörü karşıtı monoklonal antikordur.…”

“…TNFα, esas olarak makrofajlar tarafından üretilir, ancak aynı zamanda monositler, B hücreleri ve diğer dokular tarafından da üretilebilir 86 . Ateş, apoptoz, kaşeksi ve inflamasyona neden olur ve aynı zamanda tümör oluşumunu ve viral replikasyonu inhibe eder 44 . Birincil işlevi bağışıklık düzenlemesidir ve sepsise IL-1 ve IL-6 üreten hücreler aracılığıyla yanıt verir 68 .…”

Machine Learning Approaches for COVID-19 Pandemic

“…In practice, the most observed symptoms of COVID-19 include dry cough, difficulty in breathing, fatigue, high fever, pneumonia, and infection [16]. Several experimental and clinical studies have proposed different therapeutic strategies to manage this disease; none of these pharmacological agents has been able to provide an overall treatment [17,18]. The available therapeutic regimen and preventive protocols against COVID-19 include monoclonal antibodies, convalescent plasma, repurposing of drugs used in the hospitals, and series of vaccines which are currently been explored [19].…”