Antiviral treatment of COVID-19: a clinical pharmacology narrative review

Abstract

The outbreak of coronavirus disease 2019 (COVID-19) in December 2019 in China, has become a pandemic in March 2020. Repurposing old and relatively safe drugs becomes an advantageous option to obtain the urgently needed effective treatment. Repurposing chloroquine, hydroxychloroquine, oseltamivir, lopinavir/ritonavir, andfavipiravir, and the use of investigational drug remdesivir for treatment of COVID-19, are reviewed from the clinical pharmacology perspective, particularly its efficacy and safety. Limited clinical studies of chloroquine, hydroxychloroquine, favipiravir, and remdesivir showed some efficacy in COVID-19 treatment with tolerable adverse effects. Potential serious adverse effect of chloroquine and hydroxychloroquine is cardiac arrhythmia. Oseltamivir has no documented activity against SARS-CoV-2, while lopinavir/ritonavir showed limited efficacy in COVID-19. Currently, there is no sufficient evidence to recommend any specific anti-COVID-19 treatment. The decision to use these drugs during the COVID-19 pandemic must be based on careful consideration of the potential benefits and risks to the patient.

Therapy for patients with asymptomatic and mild cases of COVID-19 in Indonesia

“…Therefore, the administration of antivirals is not recommended for infections with no symptoms. To date, isolation and close observation are still considered as better options for asymptomatic patients 20 .…”

The effectively of favipiravir as antiviral therapy in the treatment of covid-19 in the several hospital in Blora, Indonesia

“…Initial dose of 1600 mg followed by 600 mg twice daily from day 2 to day 7 or 10. 6 The objective of the study is to analize the effectiveness of favipiravir as an antiviral therapy in the treatment of COVID-19 in several hospital in the district of Blora, Central Java, Indonesia. The hyphotesis of the research was that there was a significant difference in the proportion of improved patient given favipiravir over those who were not given favipirafir.…”

Untitled

“…As a prodrug, favipiravir is ribosylated and phosphorylated to form the active metabolite of ribufunanosyl-5'-triphosphate (favipiravir RTP). 6 Favipiravir is taken orally. If given with food, there will be a 1.5 hour delay in reaching peak levels.…”

“…Favipiravir is contraindicated for pregnant women. 6 Clinical research related to the use of favipiravir in Indonesia is still limited, but in a number of countries it has been or is in progress. In China there was a clinical study involving 320 COVID-19 patients and it was claimed that favipiravir was safe and efficacious in the treatment of COVID-19.…”