Antiviral Agent Therapy Optimization in Special Populations of COVID-19 Patients

Drug Des Devel Ther. 2020 Jul 28:14:3001-3013. doi: 10.2147/DDDT.S259058. eCollection 2020.

Abstract

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is now a global outbreak of disease. The antiviral treatment acts as one of the most important means of SARS-CoV-2 infection. Alteration of physiological characteristics in special populations may lead to the change in drug pharmacokinetics, which may result in treatment failure or increased adverse drug reactions. Some potential drugs have shown antiviral effects on SARS-CoV-2 infections, such as chloroquine, hydroxychloroquine, favipiravir, lopinavir/ritonavir, arbidol, interferon alpha, and remedsivir. Here, we reviewed the literature on clinical effects in COVID-19 patients of these antiviral agents and provided the potential antiviral agent options for pregnant women, elderly patients, liver or renal dysfunction patients, and severe or critically ill patients receiving renal replacement therapy or ECMO after SARS-CoV-2 infection.

Keywords: antiviral therapy; coronavirus disease 2019; severe acute respiratory syndrome coronavirus 2; special population.

Publication types

  • Review

MeSH terms

  • Aged
  • Antiviral Agents / adverse effects
  • Antiviral Agents / pharmacokinetics
  • Antiviral Agents / pharmacology*
  • Betacoronavirus / drug effects
  • Betacoronavirus / isolation & purification
  • COVID-19
  • COVID-19 Drug Treatment
  • Coronavirus Infections / drug therapy*
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / virology
  • Critical Illness
  • Female
  • Humans
  • Kidney Diseases / complications
  • Liver Diseases / complications
  • Pandemics
  • Pneumonia, Viral / drug therapy*
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / virology
  • Pregnancy
  • SARS-CoV-2

Substances

  • Antiviral Agents

Grants and funding

This work was supported by the National Natural Science Foundation of China under Grant No 81703578 and No 81703612.