Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

COVID-19 Treatment: Close to a Cure? – A Rapid Review of Pharmacotherapies for the Novel Coronavirus

Version 1 : Received: 25 March 2020 / Approved: 26 March 2020 / Online: 26 March 2020 (01:48:42 CET)

A peer-reviewed article of this Preprint also exists.

Song Y, Zhang M, Yin L, et al. COVID-19 Treatment: Close to a Cure? – A Rapid Review of Pharmacotherapies for the Novel Coronavirus. International Journal of Antimicrobial Agents. Published online July 4, 2020:106080. doi:10.1016/j.ijantimicag.2020.106080 Song Y, Zhang M, Yin L, et al. COVID-19 Treatment: Close to a Cure? – A Rapid Review of Pharmacotherapies for the Novel Coronavirus. International Journal of Antimicrobial Agents. Published online July 4, 2020:106080. doi:10.1016/j.ijantimicag.2020.106080

Abstract

Currently, there is no specific treatment for COVID-19 proven by clinical trials. WHO and CDC guidelines therefore endorse supportive care only. However, frontline clinicians have been applying several virus-based and host-based therapeutics in order to combat SARS-CoV-2. Medications from COVID-19 case reports, observational studies and the COVID-19 Treatment Guideline issued by the China's National Health Commission (7th edition published March 3rd, 2020. Edited translation attached) are evaluated in this review. Key evidence from relevant in vitro researches, animal models and clinical studies in SARS-CoV-2, SARS-CoV and MERS-CoV are examined. Antiviral therapies remdesivir, lopinavir/ritonavir and umifenovir, if considered, could be initiated before the peak of viral replication for optimal outcomes. Ribavirin may be beneficial as an add-on therapy and is ineffective as a monotherapy. Corticosteroids use should be limited without indicating comorbidities. IVIG is not recommended due to lack of data in COVID-19. Xuebijing may benefit patients with complications of bacterial pneumonia or sepsis. The efficacy of interferon is unclear due to conflicting outcomes in SARS and MERS studies. Chloroquine and hydroxychloroquine have shown in vitro inhibition of SARS-CoV-2 and may be beneficial as both prophylactic and treatment therapy. For patients who developed cytokine release syndrome, interleukin-6 inhibitors may be beneficial. Given the rapid disease spread and increasing mortality, active treatment with readily available medications may be considered timely prior to disease progression.

Keywords

China's COVID-19 Guide; Remdesivir; Xuebijing; Hydroxychloroquine; IL6 inhibitors; COVID-19

Subject

Medicine and Pharmacology, Epidemiology and Infectious Diseases

Comments (1)

Comment 1
Received: 4 April 2020
Commenter: Maria Rivero
The commenter has declared there is no conflict of interests.
Comment: What about intravenous Vitamin C?
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