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Emerging Treatment and Prevention Strategies against COVID-19: A Brief Update
#MMPMID40477045
Jha AK
; Kumar R
; Goenka MK
; Dayal VM
J Dig Endosc
2020[Mar]; 11
(1
): 69-72
PMID40477045
show ga
Patients with novel coronavirus disease 2019 (COVID-19) are at significantly
increased risk for mortality and morbidity. Current management remains supportive
care, ranging from symptomatic outpatient management to full-intensive care
support, including intravenous fluids, invasive, and non-invasive oxygen
supplementation. In patients with septic shock, treatment with antibiotics and
vasopressors are recommended to keep mean arterial pressure (MAP) ? 65 mm Hg and
lactate < 2 mmol/L. Because of the lack of effectiveness and possible adverse
effects, routine corticosteroids should be avoided unless they are indicated for
another reason (exacerbation of asthma or chronic obstructive pulmonary disease
[COPD], and septic shock in whom fluids and vasopressors do not restore
hemodynamic stability). There is currently no sufficient evidence of efficacy of
hydroxychloroquine/chloroquine, remdesivir, and other antivirals in the treatment
or prevention of COVID-19. Limited evidence shows that COVID-19 convalescent
plasma can be used as a treatment of COVID-19 without the occurrence of severe
adverse events. Drug regulatory agencies granted an emergency-use authorization
of chloroquine/hydroxychloroquine and remdesivir to treat patients when a
clinical trial is not available or participation is not feasible. Chloroquine and
hydroxychloroquine are associated with QT interval prolongation and
life-threatening cardiac arrhythmia in patients with pre-existing cardiovascular
disease. Guidelines are issued for use of convalescent plasma in patients with
serious or immediately life-threatening COVID-19. Data from several ongoing
randomized controlled trials will provide further evidence regarding the safety
and efficacy of these drugs for the treatment of COVID-19.
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