The 15-Months Clinical Experience of SARS-CoV-2: A Literature Review of Therapies and Adjuvants

Abstract

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus responsible for the coronavirus disease of 2019 (COVID-19) that emerged in December 2019 in Wuhan, China, and rapidly spread worldwide, with a daily increase in confirmed cases and infection-related deaths. The World Health Organization declared a pandemic on the 11th of March 2020. COVID-19 presents flu-like symptoms that become severe in high-risk medically compromised subjects. The aim of this study was to perform an updated overview of the treatments and adjuvant protocols for COVID-19. Methods: A systematic literature search of databases was performed (MEDLINE PubMed, Google Scholar, UpToDate, Embase, and Web of Science) using the keywords: “COVID-19”, “2019-nCoV”, “coronavirus” and “SARS-CoV-2” (date range: 1 January 2019 to 31st October 2020), focused on clinical features and treatments. Results: The main treatments retrieved were antivirals, antimalarials, convalescent plasma, immunomodulators, corticosteroids, anticoagulants, and mesenchymal stem cells. Most of the described treatments may provide benefits to COVID-19 subjects, but no one protocol has definitively proven its efficacy. Conclusions: While many efforts are being spent worldwide in research aimed at identifying early diagnostic methods and evidence-based effective treatments, mass vaccination is thought to be the best option against this disease in the near future.

Early Corticosteroid Therapy May Increase Ventilator-Associated Lower Respiratory Tract Infection in Critically Ill Patients with COVID-19: A Multicenter Retrospective Cohort Study

“…Notably, ARDS severity per se was not shown to be an independent predictor of VA-LRTI risk [ 36 ]. Hydroxychloroquine and azithromycin have been shown to be ineffective in managing COVID-19 [ 37 , 38 , 39 ], and they are thus unlikely to have influenced our results. Based on recent results, prior exposure to antibiotic therapy was reported as unlikely to influence VA-LRTI occurrence among patients with COVID-19 [ 26 ], yet such treatment may well induce the occurrence of multi-drug resistant organisms.…”

Preliminary Findings on the Association of the Lipid Peroxidation Product 4-Hydroxynonenal with the Lethal Outcome of Aggressive COVID-19

“…Hence, we can hypothesize that the age of patients might play an important role in the survival of COVID-19 also due to the age-dependent accumulation of HNE in the wall of blood vessels, while the possible release of toxic HNE from the blood vessels into other tissues should be further studied, especially because the similar accumulation of the blood-originating HNE was also revealed in abdominal adipose tissue of obese people with metabolic syndrome [ 34 ]. This assumption deserves further research, which could increase our knowledge on the oxidative stress response not only to COVID-19 aggression but also about other stress- and age-associated diseases for which HNE is known to be an important factor of pathogenesis or hormesis [ 35 , 36 , 37 , 38 ].…”

COVID-19 Infection in Children and Infants: Current Status on Therapies and Vaccines

“…This disease has proven to predominantly clinically affect the adult and elderly populations, and has spared the majority of children, whom, from the beginning, have shown only mild symptoms [5]. The pediatric population percentage that was admitted into the ward for COVID-19 infection was lower compared to the adults' group although some critical cases have been reported in children as well as in adolescents [6][7][8][9][10][11][12]. Adults and children shared the same cohort of symptoms, which in the latter tend to be milder, leading to a clinical picture close to a common cold that is usually resolved within one or two weeks.…”