COVID-19: Medication therapy: Difference between revisions

Line 9: Line 9:
***Previously used to treat Ebola<ref>Auwaerter. Johns Hopkins Antibiotic guide. Coronavirus COVID-19. April 8 2020</ref> this medication inhibits viral RNA polymerase and has shown some promisinng invitro activity against [[SARS-CoV-2]].  
***Previously used to treat Ebola<ref>Auwaerter. Johns Hopkins Antibiotic guide. Coronavirus COVID-19. April 8 2020</ref> this medication inhibits viral RNA polymerase and has shown some promisinng invitro activity against [[SARS-CoV-2]].  
***A recent small study among 53 patients with severe symptoms from COVID-19 were given [[Remdesivir]] for compassionate use. 68% percent of patients showed some clinical improvement.<ref>Grein, J., Ohmagari, N.,...Oda, R (2020). Compassionate Use of Remdesivir for Patients with Severe COVID-19. New England Journal of Medicine.</ref>
***A recent small study among 53 patients with severe symptoms from COVID-19 were given [[Remdesivir]] for compassionate use. 68% percent of patients showed some clinical improvement.<ref>Grein, J., Ohmagari, N.,...Oda, R (2020). Compassionate Use of Remdesivir for Patients with Severe COVID-19. New England Journal of Medicine.</ref>
*[[Chloroquine]]
***A large NIH funded trial is currently underway to assess the efficacy of this medication <ref>https://clinicaltrials.gov/ct2/show/NCT04280705</ref>
***Consider using in hospitalized patients with severe symptoms and significant Oxygen requirements
***Contact Gilead directly for use: compassionateaccess@gilead.com
**[[Oseltamivir]]
***Several small trials have not shown any benefit in patients with COVID-19. <ref>Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. E-pub Date: aheadofprint February 2020.
DOI # 10.1001/jama.2020.1585 . https://www.ncbi.nlm.nih.gov/pubmed/32031570 </ref>
*[[Chloroquine]]/[[Hydroxychloroquine]]
*[[Immunomodulators]]
*[[Immunomodulators]]
*[[Vaccine]]
*[[Vaccine]]

Revision as of 00:53, 11 April 2020

Investigational Treatment

Treatment for those infected with SARS-CoV-2 focuses on supportive care which includes symptomatic management, hand hygiene and social distancing. While many treatments are under investigation there is no proven efficacy of any drug for human as of April 8th 2020.[1].Medication management at this time is targeted towards those requiring inpatient admission.

  • Symptomatic management
  • Antivirals
    • Lopinavir/Ritonavir
      • Known in the U.S as Kaletra, this HIV medication has been widely used in China to treat COVID patients.[2].
      • An RCT with 199 confirmed COVID-19 positive patients concluded that there was no benefit to treating hospitalized patients with Lopinavir/Ritonavir versus supportive care.[3]
    • Remdesivir
      • Previously used to treat Ebola[4] this medication inhibits viral RNA polymerase and has shown some promisinng invitro activity against SARS-CoV-2.
      • A recent small study among 53 patients with severe symptoms from COVID-19 were given Remdesivir for compassionate use. 68% percent of patients showed some clinical improvement.[5]
      • A large NIH funded trial is currently underway to assess the efficacy of this medication [6]
      • Consider using in hospitalized patients with severe symptoms and significant Oxygen requirements
      • Contact Gilead directly for use: compassionateaccess@gilead.com
    • Oseltamivir
      • Several small trials have not shown any benefit in patients with COVID-19. [7]
  • Chloroquine/Hydroxychloroquine
  • Immunomodulators
  • Vaccine

Inpatient Treatment

See Also

COVID-19 Pages

References

  1. Auwaerter. Johns Hopkins Antibiotic guide. Coronavirus COVID-19. April 8 2020
  2. https://www.reuters.com/article/us-health-coronavirus-china-wuhan-hospit/key-china-coronavirus-hospital-says-hiv-drug-beneficial-to-patients-idUSKCN21R1LX
  3. Cao, B., Wang, Y., Wen, D., Liu, W., Wang, J., Fan, G., ... & Li, X. (2020). A trial of lopinavir–ritonavir in adults hospitalized with severe Covid-19. New England Journal of Medicine.
  4. Auwaerter. Johns Hopkins Antibiotic guide. Coronavirus COVID-19. April 8 2020
  5. Grein, J., Ohmagari, N.,...Oda, R (2020). Compassionate Use of Remdesivir for Patients with Severe COVID-19. New England Journal of Medicine.
  6. https://clinicaltrials.gov/ct2/show/NCT04280705
  7. Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. E-pub Date: aheadofprint February 2020. DOI # 10.1001/jama.2020.1585 . https://www.ncbi.nlm.nih.gov/pubmed/32031570