Abstract
Since the report of the first cases of pneumonia caused by SARS-CoV-2 in December 2019, COVID-19 has become a pandemic and is globally overwhelming healthcare systems. The symptoms of COVID-19 vary from asymptomatic infection to severe complicated pneumonia with acute respiratory distress syndrome (ARDS) and multiple organ failure leading to death. The estimated case-fatality rate among infected patients in Wuhan, the city where the first case appeared, was 1.4%, with 5.1 times increase in the death rate among those aged above 59 years than those aged 30-59 years. In the absence of a proven effective and licensed treatment, many agents that showed activity against previous coronavirus outbreaks such as SARS and MERS have been used to treat SARS-CoV-2 infection. The SARS-CoV-2 is reported to be 80% homologous with SARS-CoV, and some enzymes are almost 90% homologous. Antiviral drugs are urgently required to reduce case fatality-rate and hospitalizations to relieve the burden on healthcare systems worldwide. Randomized controlled trials are ongoing to assess the efficacy and safety of several treatment regimens.
Highlights
Coronavirus disease 2019 (COVID-19) is caused by a novel coronavirus (2019-nCoV) that first manifested as atypical pneumonia and was distinct from usual pneumonia in terms of symptoms and lethality
Lopinavir and ritonavir are protease inhibitors that have shown some activity against SARS-CoV-2 in vitro, currently, there is no strong evidence of benefit to use it against COVID-19 [65]
Given the high levels of cytokines that are induced by COVID-19, corticosteroids have been used for their anti-inflammatory effect to treat critically ill patients
Summary
Coronavirus disease 2019 (COVID-19) is caused by a novel coronavirus (2019-nCoV) that first manifested as atypical pneumonia and was distinct from usual pneumonia in terms of symptoms and lethality. Repurposed drugs to treat SARS-CoV-2 Currently, there has been no potential therapy shown from randomized clinical trials to improve outcomes or to significantly reduce case-fatality rate among either suspected or confirmed cases of COVID-19.
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