Causal Therapy of COVID-19: Critical Review and Prospects

Abstract

The COVID-19 outbreak that started in December 2019 in China has spread over all countries of the world within few months acquiring a pandemic nature, the incident population counting millions. The pathogenic mechanisms of the new coronaviral infection caused by never-before-seen virus SARS-CoV2 are yet to be studied. Drugs of different groups are used for COVID-19 treatment and guidelines are continuously revised as the new experience is accumulated. In the current pandemic situation, it is important to provide specialists with latest information concerning efficacy and safety drugs for COVID-19 patients and promising research in this field.The purpose of the review is to analyze critically the published outcomes of COVID-19 treatment using different groups of drugs for selection the most promising candidate drugs.The search has been carried out through such databases as PubMed, Scopus, Cyberleninka, Clinical Trials, Cochrane Library, etc. Randomized clinical trials and papers mostly published in 2020 and dedicated to candidate drugs have been considered. The review is structured on the base of the drug’s action mechanism and contains parts dedicated to antiviral, immunomodulatory, and antibacterial therapies. Looking for a new promising target in COVID-19 treatment, the authors focus their attention on matrix metalloproteinases (MMP), which abundance results in the destruction of extracellular matrix, epithelial and endothelial basal membranes and leads to secondary lung tissue injury. The paper gives a theoretic justification of MMP inhibitor use by an example of doxycycline and offers an efficacy study protocol for the new approach to COVID-19 therapy.Conclusion: as of now, there are no drugs, which efficacy for COVID-19 has been for sure proven. Drug with different mechanisms of action are commonly employed in combination due to various specified indications. Because of summation of drug effects, the adverse complications can hardly be avoided. Therapeutic efficacy of the drugs should become clear only when clinical trials are finished, analysis is performed and findings with recommendations for most COVID-19 patients are issued.