Current Pharmacological Therapy against COVID-19: A Latin American Perspective

Abstract

Introduction. SARS-CoV-2 infection is a public health emergency and several treatments against COVID-19 are in place while investigated simultaneously. Objective. To update on current pharmacological therapies against COVID-19, and its implications in Latin American countries. Material and Methods. Publications on PubMed and in open access journals regarding pharmacological interventions against SARS-CoV-2 infection were reviewed, followed by analysis of the protocols already in place in Latin American countries. Results. Recent clinical data showed that lopinavir/ritonavir therapy was not effective against severe SARS-CoV-2 infection; however, further trials are underway and will help define the role of this therapy. Remdesivir showed significant efficacy in vitro, and clinical improvement in a report of compassionate-use, but data from controlled trials is not available currently. Tocilizumab plays an important role during cytokine storm, and studies revealed promising results. Chloroquine and hydroxychloroquine showed efficacy in vitro but clinical data are controversial, then further trials are needed to assess their role. Convalescent plasma, tocilizumab, lopinavir/ritonavir, chloroquine, and hydroxychloroquine have been approved by the Infectious Diseases Society of America (IDSA) and the Food and Drug Administration (FDA) in the context of clinical research. Various Latin American countries have already implemented antimicrobial therapy within their local protocols. Conclusions. Promising agents, due to the emergency, are currently in some of the Latin American treatment protocols, although restricted to patients with non-favourable clinical course. Results from controlled clinical trials will be required to define the role of these drugs. Misuse and abuse of drugs can cause drug shortages if supply is not secured, and serious adverse effects might occur.

Adapting for the COVID-19 pandemic in Ecuador, a characterization of hospital strategies and patients

“…Due to the lack of control groups, our findings should be interpreted as preliminary and by no means as evidence to support any treatment scheme, which is still a topic largely debated with no consensus [21]. Lopinavir and Ritonavir treatment was exclusively used in ICU patients, a case control study published on March 18 th suggested a lack of effect in death reduction [63,64], however ICU attendant from this hospital decided to continue with the antiviral treatment scheme due to the lack of literature consensus and an apparent clinical improvement still on quantification.…”

Adapting for the COVID-19 pandemic in Ecuador, a characterization of hospital strategies and patients

“…Lopinavir/Ritonavir treatment was exclusively used in ICU patients. A case control study published on 18 March 2020, suggested a lack of effect in death reduction [ 61 , 62 ], however the ICU Department from this hospital decided to continue with the antiviral treatment scheme due to the lack of literature consensus and an apparent clinical improvement still on quantification.…”

COVID-19 Infection and Previous BCG Vaccination Coverage in the Ecuadorian Population

“…At the time of writing, SARS-CoV-2 has infected more than 70 million individuals worldwide and has caused nearly 1.2 million deaths [4]. From viral transmission mechanisms [5] to COVID-19 treatments [6], researchers are attempting to understand the disease dynamics better and reduce its burden on humankind. The global spread of COVID-19 cases drives research to attempt to understand how environmental factors may contribute to SARS-CoV-2 transmission and COVID-19 disease severity [7,8] Along with the spread of the pandemic, most countries imposed a policy of social distancing and other regulations to mitigate COVID-19 [9,10].…”