COVID-19 Treatment

Authors

  • Suttichai Visuttichaikit Division of Infectious Diseases, Department of Internal Medicine, Faculty of Medicine, Thammasat University, Pathum Thani 12120, Thailand

Keywords:

COVID-19, SARS-CoV-2, Treatment

Abstract

        The ongoing outbreak of COVID-19 has posed a great threat to public health. The various degree and dynamic of illness severity, together with the fact that only few drugs have been proven as an effective therapy has created critical challenges in disease management. Patients in acute viral phase usually present with upper respiratory tract and/or gastrointestinal illness, fever, and myalgia. Antiviral therapy might provide the greatest benefit in reducing disease progression in such patients with older age or significant comorbidities while immunomodulators are less likely to provide advantages. Patients in immune dysregulation phase usually present with pneumonia of different severity. Main treatment that showed survival benefit in severe to critical COVID-19 patients in this phase seems to be immunomodulators, especially corticosteroids. Anticoagulation also has an important role in such patients. High-quality clinical trials are needed to identify effective treatments in reducing disease progression and mortality.

Downloads

Download data is not yet available.

References

Meyerowitz EA, Sen P, Schoenfeld SR, et al. Immunomodulation as treatment for severe coronavirus disease 2019: A systematic review of current modalities and future directions. Clin Infect Dis. 2021;72:1130-1143.

Coronavirus disease 2019 (COVID-19) treatment guidelines. The National Institutes of Health. https://files.covid19treatmentguidelines.nih.gov/guidelines/covid19 treatment guidelines.pdf. Updated 2021. Assessed June 16, 2021.

Guidelines for clinical practice, diagnosis, treatment and prevention of healthcare-associated infection in response to patients with COVID-19 infection. Department of medical services, Ministry of public health. https://ddc.moph.go.th/viralpneumonia/file/g_health_care/g_cpg_040864.pdf. Updated August 4, 2021. Assessed August 16, 2021.

Ramakrishnan S, Nicolau Jr DV, Langford B, et al. Inhaled budesonide in the treatment of early COVID-19 (STOIC): a phase 2, open-label, randomised controlled trial. Lancet Respir Med. 2021;9:763-772.

Yu LM, Bafadhel M, Dorward J, et al. Inhaled budesonide for COVID-19 in people at high risk of complications in the community in the UK (PRINCIPLE): a randomised, controlled, open-label, adaptive platform trial. Lancet. 2021.

Cai Q, Yang M, Liu D, et al. Experimental treatment with favipiravir for COVID-19: an open-label control study. Engineering (Beijing). 2020;6:1192-1198.

Chen C, Zhang Y, Huang J, et al. Favipiravir versus arbidol for COVID-19: a randomized clinical trial. medRxiv. 2020. doi: 10.1101/2020.03.17.20037432.

Rattanaumpawan P, Jirajariyavej S, Lerdlamyong K, Palavutitotai N, Saiyarin J. Real- world experience with favipiravir for treatment of COVID-19 in Thailand: results from a multicenter observational study. https://www.medrxiv.org/content/10.1101/2020.

24.20133249v2.full.pdf. Published 2020. Accessed June 15, 2021.

Manabe T, Kambayashi D, Akatsu H, Kudo K. Favipiravir for the treatment of patients with COVID-19: a systematic review and meta-analysis. BMC Infect Dis. 2021;21:489.

Hassanipour S, Zozani MA, Amani B, Heidarzad F, Fathalipour M, Hoyo RMD. The efficacy and safety of Favipiravir in treatment of COVID-19: a systematic review and meta-analysis of clinical trials. Sci Rep. 2021;11:11022.

Abdelnabi R, Foo CS, Jonghe SD, Maes P, Weynand B, Neyts J. Molnupiravir inhibits the replication of the emerging SARS-CoV-2 variants of concern (VoCs) in a hamster infection model. J Infect Dis. 2021;224(5):749-753.

Painter WP, Holman W, Bush JA, et al. Human safety, tolerability, and pharmacokinetics of molnupiravir, a novel broad-spectrum oral antiviral agent with activity against SARS-CoV-2. Antimicrob Agents Chemother. 2021;65. doi: 10.1128/AAC.02428-20.

Fischer W, Eron Jr JJ, Holman W, et al. Molnupiravir, an oral antiviral treatment for COVID-19. medRxiv. 2021. doi: 10.1101/2021.06.17.21258639.

Zaidi AK, Dehgani-Mobaraki P. The mechanisms of action of Ivermectin against SARS-CoV-2: An evidence-based clinical review article. J Antibiot (Tokyo). 2021;1-13.

Bryant A, Lawrie TA, Dowswell T, et al. Ivermectin for prevention and treatment of COVID-19 infection: A systematic review, meta-analysis, and trial sequential analysis to inform clinical guidelines. Am J Ther. 2021. doi: 10.31219/osf.io/dzs2v.

Kory P, Meduri GU, Varon J, Iglesias J, Marik PE. Review of the emerging evidence demonstrating the efficacy of ivermectin in the prophylaxis and treatment of COVID-19. Am J Ther. 2021;28:299-318.

Benjaponpithak A, Visithanon K, Sawaengtham T, Thaneerat T, Wanaratna K. Short communication on use of andrographis herb (FA THALAI CHON) for the treatment of COVID-19 patients. https://he01.tci-thaijo.org/index.php/JTTAM/article/view/249140. Published 2021. Accessed June 18, 2021.

Anderson B, Smith Z, Edupuganti S, Yan X, Masi CM, Wu HM. Effect of monoclonal antibody treatment on clinical outcomes in ambulatory patients with coronavirus disease 2019. Open Forum Infect Dis. 2021;8:315.

Webb BJ, Buckel W, Vento T, et al. Real-world effectiveness and tolerability of monoclonal antibody therapy for ambulatory patients with early COVID-19. Open Forum Infect Dis. 2021;8:331.

Sanders JM, Monogue ML, Jodlowski TZ, Cutrell JB. Pharmacologic treatments for coronavirus disease 2019 (COVID-19): a review. JAMA. 2020;323:1824-36.

Beigel JH, Tomashek KM, Dodd LE, et al. Remdesivir for the treatment of Covid-19 - Final report. N Engl J Med. 2020;383:1813-1826.

Horby P, Lim WS, Emberson JR, et al. Dexamethasone in hospitalized patients with Covid-19. N Engl J Med. 2021;384:693-704.

Almas T, Ehtesham M, Khan AW, et al. Safety and efficacy of low-dose corticosteroids in patients with non-severe coronavirus disease 2019: A retrospective cohort study. Cureus. 2021;13:12544.

Li Q, Li W, Jin Y, et al. Efficacy evaluation of early, low-dose, short-term corticosteroids in adults hospitalized with non-severe COVID-19 pneumonia: A retrospective cohort study. Infect Dis Ther. 2020;9:823-36.

Hu Z, Lv Y, Xu C, et al. Clinical use of short-course and low-dose corticosteroids in patients with non-severe COVID-19 during pneumonia progression. Front Public Health. 2020;8:355.

Dheir H, Sipahi S, Toptan H, et al. The effectiveness of favipiravir treatment in severe COVID-19 pneumonia: A single center experience. Konuralp Medical Journal. 2021;13:4-10.

Bosaeed M, Mahmoud E, Alharbi A, et al. Favipiravir and hydroxychloroquine combination therapy in patients with moderate to severe COVID-19 (FACCT Trial):an open-label, multicenter, randomized, controlled trial. Infect Dis Ther. 2021;1-17.

Dodaran MS, Ghanei M, Bagheri M, et al. Safety and efficacy of favipiravir in moderate to severe SARS-CoV-2 pneumonia. Int Immunopharmacol. 2021;95:107522.

Özlüşen B, Kozan S, Akcan RE, et al. Effectiveness of favipiravir in COVID-19: a live systematic review. Eur J Clin Microbiol Infect Dis. 2021;1-9.

Vichyanond P, Irvin CG, Larsen GL, Szefler SJ, Hill MR. Penetration of corticosteroids into the lung: evidence for a difference between methylprednisolone and prednisolone. J Allergy Clin Immunol. 1989;84:867-873.

Edalatifard M, Akhtari M, Salehi M, et al. Intravenous methylprednisolone pulse as a treatment for hospitalised severe COVID-19 patients: results from a randomised controlled clinical trial. Respir J. 2020;56:2002808.

Angriman F, Ferreyro BL, Burry L, et al. Interleukin-6 receptor blockade in patients with COVID-19: placing clinical trials into context. Lancet Respir Med. 2021;9:655-664.

RECOVERY collaborative group. Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. Lancet. 2021;397:1637-1645.

Seif F, Aazami H, Khoshmirsafa M, et al. JAK inhibition as a new treatment strategy for patients with COVID-19. Int Arch Allergy Immunol. 2020;181:467-475.

Gómez RI, Méndez R, Pastor TP, et al. Baricitinib against severe COVID-19: effectiveness and safety in hospitalised pretreated patients. Eur J Hosp Pharm. 2021;1-5. doi: 10.1136/ejhpharm-2021-002741.

Kalil AC, Patterson TF, Mehta AK, et al. Baricitinib plus remdesivir for hospitalized adults with covid-19. N Engl J Med. 2021;384:795-807.

Moonla C, Sosothikul D, Chiasakul T, Rojnuckarin P, Uaprasert N. Anticoagulation and in-hospital mortality from coronavirus disease 2019: A systematic review and meta-analysis. Clin Appl Thromb Hemost. 2021;27:10760296211008999.

Parisi R, Costanzo S, Castelnuovo AD, Gaetano GD, Donati MB, Iacoviello L. different anticoagulant regimens, mortality, and bleeding in hospitalized patients with COVID-19: a systematic review and an updated meta-analysis. Semin Thromb Hemost. 2021;47:372-391.

Jiang L, Li Y, Du H, Qin Z, Su B. Effect of anticoagulant administration on the mortality of hospitalized patients with COVID-19: an updated systematic review and meta-analysis. Front Med (Lausanne). 2021;8:698935.

Sadeghipour P, Talasaz AH, Rashidi F, et al. Effect of intermediate-dose vs standard-dose prophylactic anticoagulation on thrombotic events, extracorporeal membrane oxygenation treatment, or mortality among patients with COVID-19 admitted to the intensive care unit: The INSPIRATION randomized clinical trial. JAMA. 2021;325:1620-1630.

Lopes RD, Silva PGMDBE, Furtado RHM, et al. Therapeutic versus prophylactic anticoagulation for patients admitted to hospital with COVID-19 and elevated D-dimer concentration (ACTION): an open-label, multicentre, randomised, controlled trial. Lancet. 2021;397:2253-2263.

Lawler PR, Goligher EC, Berger JS, et al. Therapeutic anticoagulation with heparin in noncritically ill patients with covid-19. N Engl J Med. 2021;385:790-802.

Goligher EC, Bradbury CA, McVerry BJ, et al. Therapeutic anticoagulation with heparin in critically ill patients with covid-19. N Engl J Med. 2021;385:777-789.

Downloads

Published

2021-10-29

How to Cite

[1]
Visuttichaikit, S. 2021. COVID-19 Treatment. Asian Medical Journal and Alternative Medicine. 21, - (Oct. 2021), S108-S117.