Possible treatments of COVID-19 present and future
Keywords:COVID-19, SARS-Cov-2, Genetic shift
Since the outbreak of COVID-19 infection in December 2019, millions of people are infected, and thousands of people have died. Genetic shift and high infectivity rate made SARS-Cov-2 a pandemic. Doctors, researchers, and world leaders are scratching their heads, how to contained or treat the virus. Several treatment options are tried, but so far, there is no effective treatment available. Thousands of articles are published about COVID-19, and so much information is available that it is challenging for a practicing physician to review these articles in the limited time they have. This article summarized the treatment options for COVID-19 that have tried or are in clinical trials. The article also reviews other possibilities that are either briefly or not discussed in the literature but could play a role in the fight against COVID-19.
Li X, Geng M, Peng Y. Molecular Immune Pathogenesis and Diagnosis of COVID-19. Science Direct. 2020;10(2):102-8.
FDA. Fact sheet for health care providers. Emergency use authorization (EUA) for remdesivir (GS-5734). Available at: https://www.fda.gov/ media/137566/download. Accessed on 20 May 2020.
Gautret P, Lagier JC, Parola P. Hydroxychloroquine and azithromycin as a treatment on COVID-19; result of an open-label non-randomized clinical trial. Int J Anti-microb Agents. 2020;20:105959.
Mahevas M, Tran VT, Roumer T. No evidence of clinical efficacy of hydroxychloroquine in patients hospitalized for COVID-19 infection with oxygen requirement: results of a study using routinely collected data to emulate a target trial. Med Rxiv. 2020.
Magagnoli J, Narendran S, Pereira F. Outcomes of hydroxychloroquine usage in United States veterans hospitalized with COVID-19. Med Rxiv. Available at: https://doi.org/10.1101/2020.04.16.20065920. Accessed on 20 April 2020.
National Institute of Health. Coronavirus disease 2019 (COVID-19) treatment guidelines. Available at: http://www.covid19treatmentguidelines.nih.gov. Accessed on 22 April 2020.
Martin BJF, Kelvin DJ, Eiros JM, Castrodeza J, Lejarazu OR. Macrolides for the treatment of severe respiratory illness caused by novel H1N1 swine influenza viral strains. J Infect Dev Ctries. 2009;3(3):159‐61.
Wang D, Hu B, Hu C. Clinical Charachtersteristic of 138 Hospitalized Patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020;80:350-71.
Gautret P, Lagier JC, Parola P. Clinical and Microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 COVID-19patients with at least a six days follow up; an observational study. Preprint. Available at: http: www.mediterranee-infection.com/wp-content/ uploads/2020/03/COVID-IHU-2-1 pdf. Accessed on 23 April 2020.
Beeching NJ, Fletcher TE, Fowler R. Coronavirus disease 2019 (COVID-19). BMJ Best Practice. Available at: http: bestpractice.bmj.com/topics/ engb/3000168/management-approach. Accessed on 20 April 2020.
Xu X, Han M, Li T. Effective treatment of severe COVID-19 patients with tocilizumab. Proc Natl Acad Sci USA. 2020;117(20):10970‐5.
Luo P, Liu Y, Qiu L. Tocilizumab treatment in COVID-19: a single center experience. J Med Virol. 2020.
Tiberghien P, Lambalarie DX, Morel P. Collecting and evaluation convalescent plasma for COVID-19 treatment; why and how. VOX; 2020.
Shen C, Wang Z, Zhao F. Treatment of 5 critically ill patients with COVID-19 with convalescent plasma. JAMA. 2020.
Umapathi T, Kor AC, Venketasubramanian N. Large artery ischaemic stroke in severe acute respiratory syndrome (SARS). J Neurol. 2004;251:1227-31.
Ng KH, Wu AK, Cheng VC. Pulmonary artery thrombosis in a patient with severe acute respiratory syndrome. Postgrad Med J. 2005;81(956):3.
Arabi YM, Fowler R, Hayden FG. Critical care management of adults with community-acquired severe respiratory viral infection. Intensive Care Med. 2020;46:315-28.
Velthuis AJ, Worm SH, Sims AC, Baric RS, Snijder EJ. Zn (2+) inhibits coronavirus and arteri virus RNA polymerase activity in vitro and zinc ionophores block the replication of these viruses in cell culture. PLoS Pathog. 2010;6(11):e1001176.
Luisada A, Goldman MA, Weyl R. Treatment of pulmonary edema. JAMA. 1954;1(154):62.
Zheng P, Yang Z, Zhao Y. Inhalation of Alcohol Vapor Driven by Oxygen is a Useful Therapeutic Method for Postoperative Alcohol Withdrawal Syndrome in a Patient with Esophageal Cancer: A Case Report. Alcohol and Alcoholism. 2011;46(4):424-6.
Kong F, Zhang M, Wang H. Symptom-triggered alcohol vapor inhalation for postoperative alcohol withdrawal syndrome in patients with gastroesophageal carcinoma. JBUON. 2017;22(5):1266-71.
Kratzel A, Todt D, V’kovski P. Inactivation of severe acute respiratory syndrome coronavirus 2 by WHO-recommended hand rub formulations and alcohols. Emerg Infect Dis. 2020.
Watson R, Borgs P, Witte M, Roberts S. Alcohol, Immunomodulation, And Disease. Alcohol Alcoholism. 1994;29(2):131-9.
Vassalio R, Lipsky J. Theophylline: Recent Advances in the Understanding of Its Mode of Action and Uses in Clinical Practice. PlumX Metrics. 1998;73(4):346-54.
Kidney J, Dominguez M, Taylor PM. Immunomodulation by theophylline in asthma. Demonstration by withdrawal of therapy. Am J Respir Crit Care Med. 1995;151(6):1907‐14.
Blum L, Schiffmann S, Parham MJ. Immunomulation by Anti-biotics. Available at: http://iapc-obp.com/assets/files/429800_15_FAR_15.pdf. Accessed on 22 April 2020.
Borovikova LV, Ivanova S, Zhang M. Vagus nerve stimulation attenuates the systemic inflammatory response to endotoxin. Nature. 2000;405(6785):458-62.
Farsalinos K, Niaura R, Housezec J. Editorial: Nicotine and SARS-Cov-2: COVID-19 may be a disease of the nicotinic cholinergic system. Elsevier Toxicol Rep. 2020;7:658-63.