Presently Available and Emerging Treatments for COVID-19

Abstract

Supportive care is the standard treatment for COVID-19. Remdesivir taken for 5 days may shorten time to recovery in hospitalized patients with evidence of lower respiratory tract infection. Нe impact of remdesivir on survival is not established. In patients requiring respiratory support with at least supplemental oxygen, dexamethasone 6 mg daily for up to 10 days may improve survival. Нe optimal dosing and duration of glucocorticoids has not been fully established. Although many other therapies, including antiviral, antiinflammatory, and antibody-neutralizing medications, have been proposed to treat COVID-19, no evidence from randomized controlled trials (RCTs) currently exists to support use of these therapies. Clinical trials to evaluate potential therapies are ongoing. Favipiravir has shown promise as standalone therapy in in vitro models. Clinical data have shown no benefit for lopinavir-ritonavir as standalone therapy. Chloroquine and hydroxychloroquine with or without azithromycin have shown no clinical benefit in the treatment or prevention of COVID-19. Interleukin-6 (IL-6) and interleukin-1 (IL-1) inhibitors are being studied as a therapy in critically ill patients with severe respiratory failure and a pro-inflammatory state. Convalescent plasma has been used with success in other viral infections and appears safe in patients being supported by mechanical ventilation. Clinical trials are ongoing to explore its eٹcacy in the treatment of COVID-19.