Emerging Treatment and Prevention Strategies against COVID-19: A Brief Update

• Published in: Journal of digestive endoscopy Vol. 11; no. 1; pp. 69 - 72
• Main Authors: Jha, Ashish K., Kumar, Ravikant, Goenka, Mahesh K., Dayal, Vishwa M.
• Format: Journal Article
• Language: English
• Published: A-12, Second Floor, Sector -2, NOIDA -201301, India Thieme Medical and Scientific Publishers Private Ltd 01-03-2020; Thieme Medical and Scientific Publishers Pvt. Ltd
• Subjects: chloroquine; convalescent plasma; hydroxychloroquine; novel coronavirus disease 2019; remdesivir; Review; Review Article; severe acute respiratory syndrome-coronavirus-2; vaccines; world health organization; chloroquine; severe acute respiratory syndrome-coronavirus-2; World Health Organization; hydroxychloroquine; vaccines; remdesivir; novel coronavirus disease 2019; convalescent plasma
• ISSN: 0976-5042; 0976-5050
• DOI: 10.1055/s-0040-1712547

Abstract
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.