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The Rheumatology Drugs for COVID-19 Management: Which and When? #MMPMID33669218
Atzeni F; Masala IF; Rodriguez-Carrio J; Rios-Garces R; Gerratana E; La Corte L; Giallanza M; Nucera V; Riva A; Espinosa G; Cervera R
J Clin Med 2021[Feb]; 10 (4): ä PMID33669218show ga
While waiting for the development of specific antiviral therapies and vaccines to effectively neutralize the SARS-CoV2, a relevant therapeutic strategy is to counteract the hyperinflammatory status, characterized by an increase mainly of interleukin (IL)-1beta, IL-2, IL-6, IL-7, IL-8, and tumor necrosis factor (TNF)-alpha, which hallmarks the most severe clinical cases. 'Repurposing' immunomodulatory drugs and applying clinical management approved for rheumatic diseases represents a game-changer option. In this article, we will review the drugs that have indication in patients with COVID-19, including corticosteroids, antimalarials, anti-TNF, anti-IL-1, anti-IL-6, baricitinib, intravenous immunoglobulins, and colchicine. The PubMed, Medline, and Cochrane Library databases were searched for English-language papers concerning COVID-19 treatment published between January 2020 and October 2020. Results were summarized as a narrative review due to large heterogeneity among studies. In the absence of specific treatments, the use of immunomodulatory drugs could be advisable in severe COVID-19 patients, but clinical outcomes are still suboptimal. An early detection and treatment of the complications combined with a multidisciplinary approach could allow a better recovery of these patients.