Treatment Options for COVID-19: A Review

Abstract

Background: The recent COVID-19 pandemic sweeping the globe has caused great concern worldwide. Due to the limited evidence available on the dynamics of the virus and effective treatment options available, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has had a huge impact in terms of morbidity and mortality. The economic impact is still to be assessed. Aims: The purpose of this article is to review the evidence for the multiple treatment options available, to consider the future of this global pandemic, and to identify some potential options that could revolutionize the treatment of COVID-19. Moreover, this article underscores the sheer importance of repurposing some of the available antiviral and antimicrobial agents that have long been in use so as to have an effective and expeditious response to this widespread pandemic and the need to conduct a multicenter global randomized controlled trial to find an effective single antiviral agent or a cocktail of available antimicrobial agents. Method: We thoroughly searched and reviewed various case reports, retrospective analyses, and in vitro studies published in PubMed, EMBASE, and Google Scholar regarding the treatment options used for SARS-CoV, MERS-CoV, and SARS-CoV-2 since its outbreak in an attempt to highlight treatments with the most promising results. Conclusion: We are currently facing one of the worst pandemics in history. Although SARS-CoV-2 is associated with a lower mortality rate than are SARS-CoV and MERS-CoV, its higher infectivity is making it a far more serious threat. Unfortunately, no vaccine against SARS-CoV-2 or effective drug regimen for COVID-19 currently exists. Drug repurposing of available antiviral agents may provide a respite; moreover, a cocktail of antiviral agents may be helpful in treating this disease. Here, we have highlighted a few available antimicrobial agents that could be very effective in treating COVID-19; indeed, a number of trials are underway to detect and confirm the efficacy of these agents.

Fluoxetine Can Inhibit SARS-CoV-2 In Vitro

“…Therefore, repurposing existing drugs and antiviral agents is pragmatic and an efficient short-term approach; however, it remains crucial to determine new potential antiviral targets. Several antivirals (remdesivir, favipiravir) and antimalarials (chloroquine, hydroxychloroquine) have emerged as potential therapies [ 11 , 12 , 13 ]. Despite the candidate drugs such as remdesivir and hydroxychloroquine target different viral infection response pathways or directly interfere with the SARS-CoV-2 replication cycle in vitro, none of them revealed any effect on mortality, mechanical ventilation, and length of hospital stay of patients with COVID-19 [ 14 , 15 ].…”

Long-term antibody-response monitoring following primary exposure to SARS-COV-2 and afterward mRNA COVID-19 vaccination: A case report

“…The most important pre-conditions for COVID-19 "expansion" are: 1) high potential of virus transmission from "human-to-human" and 2) existence of an "immunologically-naive" background, i.e. population [1][2][3][4] .…”

“…Potential treatments incorporate medicaments used for some earlier indications and innovative therapeutic approaches/strategiesthe use of antiviral drugs, anti-interleukin-6 receptor monoclonal antibodies (mAbs) and allogeneic convalescent plasma with neutralizing anti-SARS-CoV-2 [4][5][6][7][8][9] . Finally, numerous safe, well tolerated and immunogenic COVID-19 vaccines have been developed.…”

SARS-CoV-2: Immune Response Elicited by Infection and Development of Vaccines and Treatments

“…The design of therapeutic strategies for COVID-19 has been oriented in three fundamental directions: viral elimination using molecules that can interfere with viral replication, antiinflammatory therapies, or palliative treatments that help reduce symptoms and the regulation of the immune response (165). The COVID-19 emergency had challenged researchers to design treatments.…”