Treatment for COVID-19: An overview

Abstract

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by coronavirus-2 (SARS-CoV-2) that causes a severe acute respiratory syndrome, a characteristic hyperinflammatory response, vascular damage, microangiopathy, angiogenesis and widespread thrombosis. Four stages of COVID-19 have been identified: the first stage is characterised by upper respiratory tract infection; the second by the onset of dyspnoea and pneumonia; the third by a worsening clinical scenario dominated by a cytokine storm and the consequent hyperinflammatory state; and the fourth by death or recovery. Currently, no treatment can act specifically against the SARS-CoV-2 infection. Based on the pathological features and different clinical phases of COVID-19, particularly in patients with moderate to severe COVID-19, the classes of drugs used are antiviral agents, inflammation inhibitors/antirheumatic drugs, low molecular weight heparins, plasma, and hyperimmune immunoglobulins. During this emergency period of the COVID-19 outbreak, clinical researchers are using and testing a variety of possible treatments. Based on these premises, this review aims to discuss the most updated pharmacological treatments to effectively act against the SARS-CoV-2 infection and support researchers and clinicians in relation to any current and future developments in curing COVID-19 patients.

Development and Characterization of Inhaled Ethanol as a Novel Pharmacological Strategy Currently Evaluated in a Phase II Clinical Trial for Early-Stage SARS-CoV-2 Infection

“…Despite the recent development of vaccines to prevent the disease, new therapeutic alternatives to treat the established disease should be studied [ 38 , 39 ]. According to the pathological characteristics of COVID-19 and different clinical stages, especially for patients with moderate to severe disease, antiviral agents, inflammation inhibitors/antirheumatic drugs, low molecular weight heparins and convalescent plasma with high IgG titers against SARS-CoV-2 have been used and tested [ 9 , 10 , 11 ]. In the early stages of the disease, the treatment of COVID-19 remains elusive.…”

“…According to the pathological characteristics of COVID-19, especially for patients with moderate to severe COVID-19, several treatment strategies have been developed, including, among others, antiviral agents, inflammation inhibitors/antirheumatic drugs and low molecular weight heparins [ 9 , 10 ]. Concerning new therapies, it is necessary to highlight the administration of convalescent plasma with high IgG titers against SARS-CoV-2, which have revealed promising results, although further studies are required [ 11 ].…”

“…Despite all the above, it has been seen that, in the early stages, antiviral drugs can prevent the progression of the disease, while dexamethasone [ 15 ], immunomodulators and antiviral drugs seem to improve the clinical outcome of patients with severe COVID-19 [ 9 ]. However, treatment remains elusive in early stages, in which there are few strategies that can bring benefits; some strategies have failed, and others are under evaluation [ 11 ].…”

A novel glucocorticoid and androgen receptor modulator reduces viral entry and innate immune inflammatory responses in the Syrian Hamster model of SARS-CoV-2

“…IL-6 produced by activated macrophages is known to be a critical mediator of lung injury in COVID19 patients [54]. This cytokine is responsible for recruitment and activation of inflammatory cells and is closely associated with the hyperimmune response observed in patients characterized by severe infiltration of macrophages and lymphocytes into lung tissue.…”

A commentary on “A comparative overview of COVID-19, MERS and SARS: Review article”

“…Drugs utilized for COVID-19 involve broad-spectrum antiviral agents, for instance HIV-protease inhibitors and nucleoside analogues. According to recent articles, broad-spectrum antiviral drugs, containing neuraminidase inhibitors, lopinavir, RNA synthesis inhibitors and peptides, are regarded rational for the treatment method [ 3 ]. Ledford et al [ 4 ] has observed that dexamethasone is the first drug to be proven to decrease the deaths caused by COVID-19.…”