Abstract
The emergency situation of the COVID-19 pandemics requires immediate action. As happens with emerging pathogens, there are no specific treatments for this threat, so that the most logical answer in order to find safe and effective candidates seems to be drug repurposing. The main efforts in finding a specific treatment for this disease have been directed to finding antiviral agents, nonetheless, COVID-19 also involves lung and systemic inflammation, coupled with ineffective immunity; bacterial and fungal coinfections; respiratory dysfunction; and coagulopathy. These additional pathophysiologic axes also require a set of treatments, and in this review we will analyze such adjunctive therapies.
Highlights
Seven months after its appearance, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease (COVID-19), has caused more than 13 million infections and more than 500,000 deaths worldwide [1], producing a severe economic impact throughout the world [2]
In a recent study that included 449 patients with SARS-CoV-2 infections in serious condition who met the criteria for coagulopathy caused by sepsis and with elevated D-dimer levels, it was mentioned that the use of low molecular weight heparin was associated with lower mortality [121]; the use of anticoagulants improves the prognosis in patients with coagulopathy and high risk of venous thromboembolism
As a meta-analysis performed by Lansbury et al [56] found that only 7% of the hospitalized patients do course with coinfections, and there is no strong data showing that coinfections enhance mortality among COVID-19 patients [125], or that early antibiotic use impacts mortality [126], antibiotics are only recommended when coinfections by bacteria are confirmed
Summary
Seven months after its appearance, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease (COVID-19), has caused more than 13 million infections and more than 500,000 deaths worldwide [1], producing a severe economic impact throughout the world [2]. Current research has shown an incubation period of 1-14 days, usually ranging from 3-7 days [4] It is highly transmissible among humans by droplets and contact with contaminated surfaces, and it is especially severe in the elderly and people with underlying diseases. The median age of patients is 47-59 years, and 41.9-45.7% of patients are females [5] As such disease recently emerged, there is not known specific treatment to aid patients in their recovery, or even to increase survivability, but the rapid spread of SARS-CoV-2 has generated the urgent need to develop novel pharmacological therapies either by repurposing drugs that are usually prescribed to fight against other similar acute respiratory disease-inducing viruses, like SARS-CoV and Middle East respiratory syndrome coronavirus (MERS-CoV), or by developing novel specific therapeutic alternatives to fight this new pandemic. In the present article we will review the most interesting proposals for anti-COVID-19 chemotherapy, emphasizing in drug combinations to attack the disease
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