Emerging treatment strategies for COVID-19 infection

Clin Exp Med. 2021 May;21(2):167-179. doi: 10.1007/s10238-020-00671-y. Epub 2020 Oct 30.

Abstract

The new type of coronavirus (COVID-19), SARS-CoV-2 originated from Wuhan, China and has led to a worldwide pandemic. COVID-19 is a novel emerging infectious disease caused by SARS-CoV-2 characterized as atypical pneumonia. As of July 1, 2020, more than 10 million people worldwide had been infected with SARS-CoV-2. The typical manifestations of COVID-19 include fever, sore throat, fatigue, cough, and dyspnoea combined with recent exposure. Most of the patients with COVID-19 have mild or moderate disease, however up to 5-10% present with severe and even life-threatening disease course. The mortality rates are approximately 2%. Therefore, there is an urgent need for effective and specific antiviral treatment. Currently, supportive care measures such as ventilation oxygenation and fluid management remain the standard of care. Several clinical trials are currently trying to identify the most potent drug or combination against the disease, and it is strongly recommended to enroll patients into ongoing trials. Antivirals can be proven as safe and effective only in the context of randomized clinical trials. Currently several agents such as chloroquine, hydroxychloroquine, favipiravir, monoclonal antibodies, antisense RNA, corticosteroids, convalescent plasma and vaccines are being evaluated. The large numbers of therapeutic interventions aim to define the most efficacious regimen. The aim of this article is to describe the treatment strategies that have been used for COVID-19 patients and review all the available literature.

Keywords: Antivirals; COVID-19; Convalescent plasma; Remdesivir; SARS-CoV-2; Vaccines.

Publication types

  • Review

MeSH terms

  • Adenosine Monophosphate / analogs & derivatives
  • Adenosine Monophosphate / therapeutic use
  • Alanine / analogs & derivatives
  • Alanine / therapeutic use
  • Amides / therapeutic use
  • Antiviral Agents / therapeutic use*
  • COVID-19 / therapy*
  • COVID-19 Drug Treatment*
  • COVID-19 Serotherapy
  • COVID-19 Vaccines / therapeutic use
  • Chloroquine / therapeutic use
  • Humans
  • Hydroxychloroquine / therapeutic use
  • Immunization, Passive / methods
  • Palliative Care
  • Pyrazines / therapeutic use
  • SARS-CoV-2 / drug effects*
  • SARS-CoV-2 / immunology
  • Treatment Outcome

Substances

  • Amides
  • Antiviral Agents
  • COVID-19 Vaccines
  • Pyrazines
  • remdesivir
  • Adenosine Monophosphate
  • Hydroxychloroquine
  • Chloroquine
  • favipiravir
  • Alanine