Natural history of COVID-19 and current knowledge on treatment therapeutic options

[Display omitted] •Cytokine storm is a complication factor in COVID-19 infections.•Repurposed drugs are currently being tested under off-label emergencial approval in COVID-19 patients.•Interferon, lopinavir and ritonavir show promising results in clinical trials against SARS-CoV-2.•Anakinra seems p...

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Published in:Biomedicine & pharmacotherapy Vol. 129; p. 110493
Main Author: dos Santos, Wagner Gouvea
Format: Journal Article
Language:English
Published: France Elsevier Masson SAS 01-09-2020
The Author. Published by Elsevier Masson SAS
Elsevier
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Summary:[Display omitted] •Cytokine storm is a complication factor in COVID-19 infections.•Repurposed drugs are currently being tested under off-label emergencial approval in COVID-19 patients.•Interferon, lopinavir and ritonavir show promising results in clinical trials against SARS-CoV-2.•Anakinra seems promising for the treatment of severe forms of COVID-19.•COVID-19 vaccines are already under clinical trials and are expected to be available until the end of 2020. Despite intense research there is currently no effective vaccine available against the new severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) emerged in the later 2019 and responsible for the COVID-19 pandemic. This infectious and communicable disease has become one of the major public health challenges in the world. The clinical management of COVID-19 has been limited to infection prevention and control measures associated with supportive care such as supplemental oxygen and mechanical ventilation. Meanwhile efforts to find an effective treatment to inhibit virus replication, mitigate the symptoms, increase survival and decrease mortality rate are ongoing. Several classes of drugs, many of them already in use for other diseases, are being evaluated based on the body of clinical knowledge obtained from infected patients regarding to the natural history and evolution of the infection. Herein we will provide an updated overview of the natural history and current knowledge on drugs and therapeutic agents being tested for the prevention and treatment of COVID-19. These include different classes of drugs such as antiviral agents (chloroquine, ivermectin, nitazoxanide, hydroxychloroquine, lopinavir, remdesivir, tocilizumab), supporting agents (Vitamin C, Vitamin D, azithromycin, corticosteroids) and promising investigational vaccines. Considering the controversies and excessive number of compounds being tested and reported in the literature we hope that this review can provide useful and updated consolidated information on potential drugs used to prevent, control and treat COVID-19 patients worldwide.
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ISSN:0753-3322
1950-6007
1950-6007
DOI:10.1016/j.biopha.2020.110493