Treatment Considerations for COVID-19: A Critical Review of the Evidence (or Lack
Thereof)
#MMPMID32561148
Vijayvargiya P
; Esquer Garrigos Z
; Castillo Almeida NE
; Gurram PR
; Stevens RW
; Razonable RR
Mayo Clin Proc
2020[Jul]; 95
(7
): 1454-1466
PMID32561148
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The novel severe acute respiratory syndrome coronavirus 2 is causing a worldwide
pandemic that may lead to a highly morbid and potentially fatal coronavirus
disease 2019 (COVID-19). There is currently no drug that has been proven as an
effective therapy for COVID-19. Several candidate drugs are being considered and
evaluated for treatment. This includes clinically available drugs, such as
chloroquine, hydroxychloroquine, and lopinavir/ritonavir, which are being
repurposed for the treatment of COVID-19. Novel experimental therapies, such as
remdesivir and favipiravir, are also actively being investigated for antiviral
efficacy. Clinically available and investigational immunomodulators, such as the
interleukin 6 inhibitors tocilizumab and sarilumab and the
anti-granulocyte-macrophage colony-stimulating factor lenzilumab, are being
tested for their anticipated effect in counteracting the pro-inflammatory
cytokine environment that characterizes severe and critical COVID-19. This review
article examines the evidence behind the potential use of these leading drug
candidates for the treatment of COVID-19. The authors conclude, based on this
review, that there is still no high-quality evidence to support any of these
proposed drug therapies. The authors, therefore, encourage the enrollment of
eligible patients to multiple ongoing clinical trials that assess the efficacy
and safety of these candidate therapies. Until the results of controlled trials
are available, none of the suggested therapeutics is clinically proven as an
effective therapy for COVID-19.
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