Tags

Type your tag names separated by a space and hit enter

Treatment options for COVID-19: The reality and challenges.
J Microbiol Immunol Infect. 2020 Jun; 53(3):436-443.JM

Abstract

An outbreak related to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in Wuhan, China in December 2019. An extremely high potential for dissemination resulted in the global coronavirus disease 2019 (COVID-19) pandemic in 2020. Despite the worsening trends of COVID-19, no drugs are validated to have significant efficacy in clinical treatment of COVID-19 patients in large-scale studies. Remdesivir is considered the most promising antiviral agent; it works by inhibiting the activity of RNA-dependent RNA polymerase (RdRp). A large-scale study investigating the clinical efficacy of remdesivir (200 mg on day 1, followed by 100 mg once daily) is on-going. The other excellent anti-influenza RdRp inhibitor favipiravir is also being clinically evaluated for its efficacy in COVID-19 patients. The protease inhibitor lopinavir/ritonavir (LPV/RTV) alone is not shown to provide better antiviral efficacy than standard care. However, the regimen of LPV/RTV plus ribavirin was shown to be effective against SARS-CoV in vitro. Another promising alternative is hydroxychloroquine (200 mg thrice daily) plus azithromycin (500 mg on day 1, followed by 250 mg once daily on day 2-5), which showed excellent clinical efficacy on Chinese COVID-19 patients and anti-SARS-CoV-2 potency in vitro. The roles of teicoplanin (which inhibits the viral genome exposure in cytoplasm) and monoclonal and polyclonal antibodies in the treatment of SARS-CoV-2 are under investigation. Avoiding the prescription of non-steroidal anti-inflammatory drugs, angiotensin converting enzyme inhibitors, or angiotensin II type I receptor blockers is advised for COVID-19 patients.

Authors+Show Affiliations

Department of Emergency, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Emergency Medicine, Department of Emergency and Critical Care Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.Department of Pediatrics, National Taiwan University Children's Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address: hsporen@ntu.edu.tw.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32307245

Citation

Jean, Shio-Shin, et al. "Treatment Options for COVID-19: the Reality and Challenges." Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi, vol. 53, no. 3, 2020, pp. 436-443.
Jean SS, Lee PI, Hsueh PR. Treatment options for COVID-19: The reality and challenges. J Microbiol Immunol Infect. 2020;53(3):436-443.
Jean, S. S., Lee, P. I., & Hsueh, P. R. (2020). Treatment options for COVID-19: The reality and challenges. Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi, 53(3), 436-443. https://doi.org/10.1016/j.jmii.2020.03.034
Jean SS, Lee PI, Hsueh PR. Treatment Options for COVID-19: the Reality and Challenges. J Microbiol Immunol Infect. 2020;53(3):436-443. PubMed PMID: 32307245.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment options for COVID-19: The reality and challenges. AU - Jean,Shio-Shin, AU - Lee,Ping-Ing, AU - Hsueh,Po-Ren, Y1 - 2020/04/04/ PY - 2020/03/30/received PY - 2020/03/31/accepted PY - 2020/4/21/pubmed PY - 2020/6/17/medline PY - 2020/4/21/entrez KW - Angiotensin converting enzyme inhibitors KW - Coronavirus disease 2019 (COVID-19) KW - Hydroxychloroquine KW - Non-steroidal anti-inflammatory drugs KW - Remdesivir KW - Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) SP - 436 EP - 443 JF - Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi JO - J Microbiol Immunol Infect VL - 53 IS - 3 N2 - An outbreak related to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in Wuhan, China in December 2019. An extremely high potential for dissemination resulted in the global coronavirus disease 2019 (COVID-19) pandemic in 2020. Despite the worsening trends of COVID-19, no drugs are validated to have significant efficacy in clinical treatment of COVID-19 patients in large-scale studies. Remdesivir is considered the most promising antiviral agent; it works by inhibiting the activity of RNA-dependent RNA polymerase (RdRp). A large-scale study investigating the clinical efficacy of remdesivir (200 mg on day 1, followed by 100 mg once daily) is on-going. The other excellent anti-influenza RdRp inhibitor favipiravir is also being clinically evaluated for its efficacy in COVID-19 patients. The protease inhibitor lopinavir/ritonavir (LPV/RTV) alone is not shown to provide better antiviral efficacy than standard care. However, the regimen of LPV/RTV plus ribavirin was shown to be effective against SARS-CoV in vitro. Another promising alternative is hydroxychloroquine (200 mg thrice daily) plus azithromycin (500 mg on day 1, followed by 250 mg once daily on day 2-5), which showed excellent clinical efficacy on Chinese COVID-19 patients and anti-SARS-CoV-2 potency in vitro. The roles of teicoplanin (which inhibits the viral genome exposure in cytoplasm) and monoclonal and polyclonal antibodies in the treatment of SARS-CoV-2 are under investigation. Avoiding the prescription of non-steroidal anti-inflammatory drugs, angiotensin converting enzyme inhibitors, or angiotensin II type I receptor blockers is advised for COVID-19 patients. SN - 1995-9133 UR - https://www.unboundmedicine.com/medline/citation/32307245/Treatment_options_for_COVID_19:_The_reality_and_challenges_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1684-1182(20)30094-3 DB - PRIME DP - Unbound Medicine ER -